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Womens Health Cards > Uterine Disorders > Flashcards

Uterine Disorders Flashcards

1
Q

What is another name for leiomyoma

A

Uterine fibroids

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2
Q

What is a benign tumor of localized proliferation of smooth muscle cells surrounded by a pseudo capsule of compressed muscle fibers

A

Leiomyoma

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3
Q

Are Leiomyoma hormoally resonsive

A

Yes they come with a rapid growth if high estrogen and will often go away with menapause

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4
Q

Name the dx.
32 y/o Patient comes to you with bleeding from the vagina. Recently she has noticed her menses are getting heavier and longer and she has been trying to get pregnant over the past 2 years with no success.
On exam there is an irregular mobile hard mass. That has a cobblestone feel to it.

A

Leiomyoma

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5
Q

What is used to confirm the dx of Leiomyoma

A

Ultrasound

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6
Q

What is the treatment of Leiomyoma

A

NSAIDS and iron supplements if anemic

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7
Q

What can be used to minimize the bleeding of a Leiomyoma

A

Progesterone, GnRH agonist, and Danazol

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8
Q

What are the surgical options for Leiomyoma

A

Myomectomy: preserves pregnancy
Hysterectomy: No longer desire pregnancy

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9
Q

What is the definitive treatment of a Leiomyoma

A

Hysterectomy

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10
Q

What is the most common indication for a hysterectomy

A

Leiomyoma

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11
Q

What is known as an abnormal proliferation of endometrial tissue

A

Endometrial hyperplasia

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12
Q

Can endometrial hyperplasia go to cancer? And if so what kind?

A

Yes, Endometrial cancer

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13
Q

What hormone can cause endometrial hyperplasia

A

It is due to unopposed estrogen, there is no progesterone to balance out the estrogen

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14
Q

What is simple endometrial hyperplasia

A

Abnormal proliferation of both stromal and glandular tissue, basic structure not changed

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15
Q

What is complex endometrial hyperplasia

A

Abnormal proliferation of glandular tissue, abnormal structure with crowding of glands

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16
Q

What is atypical simple endometrial hyperplasia

A

Abnormal proliferation of both stromal and glandular tissue, basic structure not changed + atypia-large nuclei hyperchromatic

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17
Q

What is atypical complex endometrial hyperplasia

A

Abnormal proliferation of glandular tissue, abnormal structure with crowding of glands + atypia-large nuclei hyperchromatic

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18
Q

60 y/o women presents to you with abnormal bleeding. On exam the uterus feels enlarged and on US you find 6mm of thickness of endometrium. What is the next best step

A

Possibly cancer or endometrial hyperplasia need an endometrial biopsy to diagnose

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19
Q

What is the treatment of endometrial hyperplasia

A

Progestin for simple

Hysterectomy if atypia present due to high rate of possible cancer

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20
Q

When do you want to repeat an EMB after starting Progestin for endometrial hyperplasia

A

3 months

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21
Q

What is the most common type of endometrial cancer

A

Adenocarcinoma

22
Q

What is the most common GYN cancer

A

Endometrial cancer

23
Q

What can reduce the risk of developing endometrial cancer

A

OCP

24
Q

What is the most common symptom of endometrial cancer

A

Abnormal bleeding typically post-menopausal

25
Q

How do you diagnose endometrial cancer

A

EMB

26
Q

Where is endometrial cancer most likely to spread to

A

Direct extension downward to cervix and outward through myometrium

27
Q

What is the treatment of endometrial cancer

A

Total hysterectomy and bilateral salpingo-oophorectomy with peritoneal cytology and LN sampling

28
Q

What is the presence of endometrial tissue in any extrauterine site

A

Endometriosis

29
Q

Where is endometriosis most commonly found

A

Ovaries

30
Q

What can endometriosis lead to

A

Scarring and adhesions

31
Q

When is endometriosis seen most likely age wise

A

Reproductive years

32
Q

Name the dx.
38 y/o G0P0 female comes to you with pelvic pain. Patient stated that she has a lot of pain with intercourse and her pelvic pain is getting worse. On exam you find uterosacral nodularity and otherwise the pelvic exam is normal.

A

Endometriosis

33
Q

How do you confirm the diagnosis of endometriosis

A

Endometrial tissue biopsy

34
Q

What is the treatment for endometriosis

A

NSAIDS and OCP’s for pain

35
Q

What is the most definitive treatment of endometriosis

A

TAH-BSO

36
Q

What is irregular bleeding unrelated to anatomic lesions of the uterus

A

Anovulatory uterine bleeding

37
Q

What is due to the high levels of estrogen without progesterone, so the endometrium will continually grow leading to irregular bleeding

A

Anovilatory uterine bleeding

38
Q

What will you find if you check a patient with anovilatory uterine bleeding, progesterone during the literal phase

A

Will be low because she is not ovulating

39
Q

What is the treatment for anovulatory uterine bleeding

A

Progesterone for 10-14 days

OCP

40
Q

What is it called if you have pain with menstruation

A

Dysmenorrhea

41
Q

What kind of dysmenorrhea has no underlying pathology

A

Primary Dysmenorrhea

42
Q

What kind of dysmenorrhea is associated with an underlying pathology

A

Secondary dysmenorrhea

43
Q

What disorder is due to increased prostaglandins during menses and causing uterine contractions

A

Dysmenorrhea

44
Q

During what time of the menses does dysmenorrhea normally occur

A

1st and 2nd day of menses

45
Q

Do you want to suspect primary or secondary dysmenorrhea if onset is well after menarche

A

Secondary, primary will normally be within 1-2 years of menarche

46
Q

What is the treatment for dysmenorrhea

A

NSAIDS-start them 1-2 days before period OR

OCP’s

47
Q

What is the constellation of sx that recur 4 days prior to onset of menses and stop within 4 days after the start of menses

A

Premenstrual syndrome

48
Q

Name the dx.
A 28 y/o female presents to you because she is tired of feeling bloated, breast pain, irritatbilty, fatigue and food cravings around the time of her period. THis is beginning to severely affect her life and she wants something to be done.

A

Premenstrual Syndrome

49
Q

How do you treat a patient with premenstral syndrome

A

No single treatment
Patient education: good diet and exercise
OCP’s or NSAIDS for pain
SSRI if mood symptoms

50
Q

What is a severe form of PMS

A

Premenstrual dysphoric disorder

51
Q

Name the dx.
A patient comes to you with mood swings, and sudden sadness around the time of her period. She has food cravings, difficulty concentrating, feeling overwhelmed, tired, and has breast tenderness. This normally all goes away a few days after her period starts. What is the diagnosis and treatment of this patient

A

Premenstral dysphoric disorder
Treat with SSRI (Fluoxetine, Paroxetine, Sertiline) OR
OCP’s which inhibit ovulation and reduce sx.

52
Q

Your patient comes to you who has premenstral dysphoric disorder. SHe is currently taking an SSRI daily for this disorder. She wants to know if there is anyway she can just take the SSRI a couple times a month rather than everyday because the side effects are starting to bother her some. Is this possible to do and if so when can she take it?

A

The patient can just take in during the luteal phase of her cycle (so day 14-start of next cycle)

Womens Health Cards (17 decks)

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