Uterine Disorders Flashcards
Uterine anomalies associated with
First trimester pregnancy loss
Second
V Septate
II Unicornuate IV Bicornuate
MC anatomic anomalies
V Septate Uterus
Uterine leiomyoma
Degeneration
Hyaline MC
Carneous/Red (during pregnancy)
MC leiomyoma
Intramural
Leiomyoma associated with bleeding
Submucosal
MC symptom myomas
AUB
Menorrhagia
MC diagnostic test
Pelvic utz
Surgical therapies for myomas
Myomectomy
Embolization
Hysterectomy definitive
Benign overgrowth of endometrial grands and stroma over vascular. Ore usually at
Endrometrial polyp
Fundus
MC symptom of endometrial polyp
AUB
Metrorrhagia
Presence and growth of uterine lining glands and stroma in an aberrant location
Endometriosis
Most widely accepted theory regarding endometriosis
Metastatic theory
Retrograde menstruation
Growth of endometrial glands and stroma into myometrium to a depth of at least 2.5 mm (one LPF) from basalis layer of endometrium
Adenomyosis
MC site of endometriosis
Ovaries
Mid 30s nulliparous infertile
Secondary dysmenorrhea
Cyclic pelvic pain
Fixed tender uterus with post scarring and tenderness on IE
Nodularities in uterosacral and cul de sac
Endometriosis
Definitive
TAHBSO
Medical tx endometriosis
Pseudomenopause
Medical oophorectomy
Pseudopregnancy
Danazol
Leuprolide
High dose OCP or progestin
MC type of adenomyosis
Symmetrical
Vs. Asymmetrical
Multiparous woman with menorrhagia
Cyclic pain
Adenomyosis
No definitive treatment
Hysterectomy
Confirmation
Endometriosis
Adenomyosis
Laparoscopy
MRI then histology
Inc in endometrial mass due to unopposed estrogen
MC symptom
Endometrial hyperplasia
Vaginal bleeding
Diagnostic of choice
Endometrial sampling
Cytologic atypia
TV utz of EM hyperplasia
Thickened myometrial stripe
Most important determinant for premalignant potential of EM hyperplasia
Cytologic atypia
Repeat endometrial biopsy after
6 months
MCC post menopausal bleeding
EM atrophy
R/O EM ca
MC symptom of EM ca
Postmenopausal bleeding
Precursor of EM ca
Atypical complex hyperplasia
MC type of EM ca
Adenocarcinoma
MC route of spread of EM ca
Direct extension
MC site of distant mets of EM ca
Lungs
Retroperitoneal nodes
Abdomen
MC subtype of EM ca
Subtype with poorest prognosis
Endometrioid
Clear cell and serous
Diagnostic of choice for EM ca
EM biopsy
Uterine ca staging 1 2 3 4
Uterus
Cervical stroma
Regional spread serosa vagina pelvic and para aortic LN
Bladder bowel distant mets
Basic tx for all stages of EM ca
TAHBSO with node sampling and peritoneal washing
Radiation for stages
2-4
Hormone tx for
Progesterone receptor positive 4
High dose progestin or chemotherapy for
Advanced or recurrent EM ca
