Uterine and Ovarian Pathophysiology Flashcards
Menstruation starts because of what hormone?
No hormones
What is endometriosis?
Endometrial tissue outside of the uterine cavity
Where does endometriosis commonly grow?
Within the pelvic structures but can grow anywhere
What causes anatomical changes in endometriosis?
Scaring that can result in infertility and chronic pain
What is adenomyosis?
Enlargement of the myometrium d/t presence of endometrial glands, essentially a form of endometriosis
Normal PT with prolonged PTT will be seen in labs in women with abnormal uterine bleeding that have what coagulopathy?
Von Willebrand
Per ACOG, 20% of women with heavy bleeding have what underlying coagulopathy?
Von Willebrand
In anovulatory cycles, there is no spike in LH or no ovulation which results in the lack of production of what?
Corpus Luteum due to the lack of progesterone
What is the role of progesterone and why does an increase result in anovulatory cycle?
Proliferation of the endometrium while also keeping the endometrium stable, without this, bleeding can be irregular, proliferation/stability of endometrial lining can vary
At the time of puberty, there is likely low levels of LH stimulation which will lead to what kind of cycle?
Anovulatory cycle
What is endometrial hyperplasia?
Overgrowth of the endometrial glands
When is endometrial hyperplasia more common?
Older patients and obesity
How does endometrial carcinoma present?
Abnormal uterine bleeding
What are endometrial polyps?
Overgrowth of endometrial glands and stroma, this forms around a vascular bed and will hang in a peduculated fashion
What can lead to long-term consequences in pelvic inflammatory disease?
Scaring and inflammation, requires early diagnosis
What is the primary microorganism in the vagina?
Lactobacilli
What infections are pelvic inflammatory disease most commonly associated with?
Gonorrhea and Chlamydia
E. Coli can be associated in post-menopausal women
Often polymicrobial
Do you need to be sexually active for a diagnosis of PID?
Yes
*sure it could be possible to not be but extremely unlikely
Chylamydia has an affinity for columnar epithelial cells of mucus membranes, therefore chylamydia infection is common in what locations?
Conjunctiva
Cervix
Lungs (pneumonia)
Endometritis is the inflammation of ________, and is most commonly associated with ________.
Intrauterine lining, PID
Idiopathic endometritis can lead to chronic disease, which will result in what long term complication?
Decrease in fertility (increased risk of spontaneous abortion, problems with implantation)
Salpingitis is inflammation of the _________ and is due to ____________.
Fallopian tube, PID
If a patient of child-bearing age presents with syncope what needs to be included in the work-up?
Evaluation of ectopic pregnancy
What are ovarian torsions m/c associated with?
Enlarged ovary (from cysts), typically >4cm
What ovary is most likely to be torsed?
Right, due to increased ligament length
What is the presentation of ovarian torsion?
Severe, sudden onset of adnexal pain, vomiting
