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Clin Med Final Material 5 > Uterine Disorders- Dobbs > Flashcards

Uterine Disorders- Dobbs Flashcards

1
Q

Discrete, round, firm, often multiple uterine tumor with well-defined border composed of smooth muscle and connective tissue found within the uterus on bi-manual exam

A

Leiomyoma (uterine fibroid)

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2
Q

_______ is the mc presenting symptom of a uterine fibroid

A

bleeding

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3
Q

A patient comes in complaining of pressure or fullness in her pelvis with increased bleeding when she is not on her period. What is the most likely dx?

A

Uterine fibroid

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4
Q

What is the best way to dx a uterine fibroid?

A

Pelvic u/s

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5
Q

What is the treatment for a uterine fibroid?

A

Depends on how severe it is. Observation, myomectomy, D&C or Depo-provera can be used to stop the bleeding

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6
Q

Condition where endomitreal tissue is found outside of the endometrial cavity

A

Endometriosis

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7
Q

On ovaries, you may see “chocolate cysts”

A

Endometriosis

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8
Q

3 D’s:

A

Dysmenorrhea, dyspareunia, Dyschezia (painful bleeding, painful intercourse, painful stools)

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9
Q

How to dx endometriosis?

A

Tissue bx with labrascopy

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10
Q

Treatment for endometriosis?

A

Depends on the severity of symptoms, location and desire for childbearing

  • Expectant (watch and wait)
  • NSAIDs for pain
  • Can try oral contraceptives to control menses to know when the pain will occur
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11
Q

T/F: Pregnancy cures endometriosis?

A

False preg does not cure endometriosis. It may temporarily improve or worsen symptoms

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12
Q

A middle aged woman comes into the clinic with severe dysmenorrhea, hx of childbearing, symmetric enlarged uterus and menorrhagia. What is the most likely dx?

A

Adenomyosis (this is where the endometrial cells end up in the uterine musculature)

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13
Q

How to diagnose Adenomyosis?

A

Pelvic U/S or MRI

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14
Q

Treatment for Adenomyosis?

A
  • NSAID

- Hormones (trying to control hormonal fluctuation to suppress/irregulate menstrual cycle

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15
Q

This is a bladder prolapse of the anterior (front) vaginal wall where the bladder dalls towards the vagina and creates a bulge

A

Cystocele

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16
Q

This is a prolapse of the rectum or large bowel

A

Rectocele (feels full during intercourse- difficulty passing stool)

17
Q

A patient states that she feels vaginal fullness and lower abdominal pain that is worse with prolonged standing and she feels a “falling out sensation.” What could the possible cause be?

A

Uterine prolapse

18
Q

What grade uterine prolapse is this?

normal- no prolapse

A

Grade 0 uterine prolapse

19
Q

What grade uterine prolapse is this?

Descent is >1cm above the hymen

A

Grade 1

20
Q

What grade uterine prolapse is this?

Descent to hymen

A

Grade 2

21
Q

What grade uterine prolapse is this?

Protrudes, but no less than 2cm total vaginal length

A

Grade 3

22
Q

What grade uterine prolapse is this?

Total eversion of lower genital tract

A

Grade 4

23
Q

Uterine prolapse management?

A

Refer to gyn!

24
Q

Bleeding between periods, bleeding after intercourse, spotting anytime in the menstrual cycle, bleeding heavier for more days than normal and bleeding after menopause. NOrmal?

A

NO! Abnormal uterine bleeding (AUB)

25
Q

What are structural causes of AUB?

A 
PALM 
Polyp 
Adenomyosis (when the muscle of the uterus breaks through the uterus)
Leiomyoma 
Malignancy & hyperplasia
26
Q

Nonstructural Causes of AUB?

A 
COEIN 
Coagulopathy 
Ovarian dysfunction 
Endometrial process 
Iatrogenic 
Not yet classified
27
Q

What is the gold standard way of figuiring out AUB cause?

A

hysterocopy (where they look into the uterus)

28
Q

Treatment of AUB?

A

Primary goal is to determine the underlying cause and resume regular shedding of the endometrium
-Could give progesterone or oral contraceptives

29
Q

What FSH and estradiol level is suggestive of menopause?

A

FSH >30 and estradiol below 20

30
Q

Is postmenopausal bleeding in a woman normal?

A

No- endometrial cancer until proven otherwise

31
Q

What is the most common cause of postmenopausal bleeding?

A

The use of exogenous hormones

32
Q

What is the most common type of endometrial cancer?

A

adenocarcinoma

33
Q

Abnormal uterine bleeding is the cardinal symptom of what disease?

A

endometrial cancer

34
Q

How to dx endometrial cancer?

A

U/S and bx

**Refer to GYN

35
Q

Treatment for endometrial cancer?

A

Total hysterectomy with salpingo-oophrectomy because we dont want any chance that we missed anything)

Clin Med Final Material 5 (18 decks)

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