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Year Three - Reproductive System > Uterine Fibroids > Flashcards

Uterine Fibroids Flashcards

1
Q

What is another term for uterine fibroids?

A

Leiomyomas

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2
Q

What are uterine fibroids?

A

They are benign tumours of the smooth muscle of the uterus

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3
Q

What hormone are the uterine fibroids sensitive to? What does this mean?

A

Oestrogen

They grow in response to oestrogen

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4
Q

What are the three classifications of uterine fibroids?

A

Intramural Uterine Fibroids

Subserosal Uterine Fibroids

Submucosal Uterine Fibroids

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5
Q

What is the most common uterine fibroid classification?

A

Intramural Uterine Fibroids

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6
Q

What are intramural uterine fibroids?

A

They are defined as those which are confined to the myometrium of the uterus

These fibroids protrude into and distort the uterine cavity

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7
Q

What are subserosal uterine fibroids?

A

They are defined as those which occur within the subserosal layer of the uterus – which is the outermost layer

These fibroids can protrude into the abdominal cavity

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8
Q

What are submucosal uterine fibroids?

A

They are defined as those which occur within the submucosal layer of the uterus – which is the layer underneath the endometrium

These fibroids protrude into and distort the uterine cavity

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9
Q

What fibroid classification is usually associated with subfertility? Explain?

A

Submucosal

They occur in the uterine cavity and disrupt the process of embryo implantation

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10
Q

What four risk factors are associated with uterine fibroids?

A

Older Age

Afro-Caribbean Ethnicity

Family History

Early Menarche

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11
Q

What are the seven clinical features of uterine fibroids?

A

Menorrhagia

Lower Abdominal Pain

Abdominal Distention

Subfertility

Urinary Frequency

Palpable Suprapubic Mass

Enlarged, Bulky & Firm Uterus

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12
Q

Describe the lower abdominal pain associated with uterine fibroids

A

It is described as cramping abdominal pain

It usually occurs during menstruation

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13
Q

What are the three investigations used to diagnose uterine fibroids?

A

Blood Tests

Ultrasound Scan

MRI Scan

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14
Q

What blood test result indicates uterine fibroids? Explain

A

Increased Hb Levels

They can lead to polycythaemia due to autonomous production of erythropoietin

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15
Q

What is the gold standard investigation used to diagnose uterine fibroids?

A

Transvaginal Ultrasound Scans

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16
Q

What is the feature of uterine fibroids on transvaginal ultrasound scans?

A

Concentric, solid hypoechogenic mass

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17
Q

When is conservative management used to manage uterine fibroids?

A

It is used to manage asymptomatic uterine fibroids

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18
Q

What is the conservative management of uterine fibroids?

A

It involves regular monitoring of uterine fibroid size and growth

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19
Q

What are the six pharmacological management options of uterine fibroids?

A

Tranexamic Acid

Levonorgestrel Intrauterine System

Combined Oral Contraceptive Pill

Progesterone Only Pill

Injectable Progesterone

GnRH Agonists

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20
Q

When is tranexamic acid used to manage uterine fibroids?

A

It is used to manage symptomatic, small (<3cm) uterine fibroids

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21
Q

How is tranexamic acid used to manage uterine fibroids?

A

It is administered to provide symptomatic relief of menorrhagia clinical features

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22
Q

When are levonorgesteral uterine systems used to manage uterine fibroids?

A

They are used to manage symptomatic, small (<3cm) uterine fibroids – without uterine cavity distortion

23
Q

How are levonorgestrel intrauterine systems used to manage uterine fibrodis?

A

They are administered to provide symptomatic relief of menorrhagia clinical features

24
Q

When is the combined oral contraceptive pill used to manage uterine fibroids?

A

It is used to manage symptomatic, small (<3cm) uterine fibroids

25
Q

How is the combined oral contraceptive pill used to manage uterine fibroids?

A

It is administered to provide symptomatic relief of menorrhagia clinical features

26
Q

When is the progesterone only pill used to manage uterine fibroids?

A

It is used to manage symptomatic, small (<3cm) uterine fibroids

27
Q

How is the progesterone only pill used to manage uterine fibroids?

A

It is administered to provide symptomatic relief of menorrhagia clinical features

28
Q

When is injectable progesterone used to manage uterine fibroids?

A

It is used to manage symptomatic, small (<3cm) uterine fibroids

29
Q

How is injectable progesterone used to manage uterine fibroids?

A

It is administered to provide symptomatic relief of menorrhagia clinical features

30
Q

When are GnRH agonists used to manage uterine fibroids?

A

They are used to manage symptomatic, large (>3cm) uterine fibroids

31
Q

How are GnRH agonists used to manage uterine fibroids?

A

They are used temporarily in order to reduce the size of uterine fibroids – typically in order to prepare for surgical management options

32
Q

Why do we administer GnRH agonists temporarily when managing uterine fibroids?

A

They are associated with side effects, such as hot flushes, vaginal dryness and reduced bone mineral density

33
Q

Name a GnRH agonist used to manage uterine fibroids

A

Triptorelin

34
Q

What are the four surgical management options of uterine fibroids?

A

Myomectomy

Hysteroscopic Endometrial Ablation

Uterine Artery Embolisation

Hysterectomy

35
Q

When is myomectomy used to manage uterine fibroids?

A

It is used to manage symptomatic, large (>3cm) uterine fibroids – which is particularly recommended in those with subfertility features who wish to preserve their fertility

36
Q

What is myomectomy?

A

It involves surgical removal of uterine fibroids from the myometrium layer of the uterus

37
Q

What are the three complications of myomectomy?

A

Uterine Adhesions

Bladder Injury

Uterine Perforation

38
Q

What is the main complication associated with myomectomy?

A

Uterine Adhesions

39
Q

When is hysteroscopic endometrial ablation used to manage uterine fibroids?

A

It is used to manage symptomatic, large (>3cm) uterine fibroids

40
Q

What is hysteroscopic endometrial ablation?

A

It involves the use of various techniques in order to destroy the endometrial lining of the uterus

41
Q

When is uterine artery embolisation used to manage uterine fibroids?

A

It is used to manage symptomatic, large (>3cm) uterine fibroids

42
Q

What is uterine artery embolisation?

A

It involves insertion of a catheter into the femoral artery, which is then guided towards the uterine artery under x-ray guidance

There is the injection of particles into the uterine artery, which cause an occlusion of arterial supply to the uterine fibroid – leading to shrinkage of the uterine fibroid

43
Q

When is hysterecomy used to manage uterine fibroids?

A

It is used to manage symptomatic, large (>3cm) uterine fibroids

44
Q

What is hysterectomy?

A

It involves surgical removal of the uterus

45
Q

What are the three complications of uterine fibroids?

A

Subfertility

Iron Deficiency Anaemia

Red Degeneration

46
Q

What is red degeneration?

A

It is defined as a condition in which there is haemorrhagic infarction of the uterine fibroid.

47
Q

What is the most common risk factor of red degeneration? Explain

A

2nd/3rd Trimester of Pregnancy

This is due to the expanding uterus resulting in kinking of uterine blood vessels

48
Q

What are the four clincial features of red degeneration?

A

Low Grade Fever

Nausea & Vomiting

Severe Abdominal Pain

Tachycardia

49
Q

What is the management option of red degeneration?

A

Supportive treatment with rest, fluids and analgesia

50
Q

During pregnancy, what complication of uterine fibroids can occur?

A

Uterine Fibroid Degeneration

51
Q

What is the pathophysiology of uterine fibroids degeneration during pregnancy?

A

The uterine fibroids are sensitive to oestrogen and can therefore grow during pregnancy

When growth outstrips their blood supply, they can undergo degneration

52
Q

What are the three clincial features of uterine fibroid degeneration?

A

Low Grade Fever

Vomiting

Abdominal Pain

53
Q

What is the management option of uterine fibroid degeneration?

A

Rest

Analgesia

Year Three - Reproductive System (52 decks)

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