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DMST 315 OBGYN 3 > Uterine Pathology > Flashcards

Uterine Pathology Flashcards

1
Q

The caudal ends of the Müllerian ducts fuse to form what? 3

A
  1. Uterus
  2. Cervix
  3. Upper vagina
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2
Q

The unfused ends of the Müllerian ducts form what?

A

Fallopian tubes

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3
Q

What are the three types of Müllerian duct abnormalities?

A
  1. Arrested development
  2. Failure of fusion
  3. Failure of resporption
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4
Q

What are examples of arrested development 6

A
  1. Double uterus
  2. Uterus duplex bicornis
  3. Uterus bicornuate
  4. Uterus unicornuate
  5. Complete septate uterus
  6. Subseptate uterus
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5
Q

Label the images

A
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6
Q

What is a prolapsed uterus?

A

The descent of the uterus down the vagina

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7
Q

What is a prolapsed uterus usually due to?

A

Weak pelvic floor muscles

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8
Q

What happens to the endometrium with asherman’s syndrome?

A

Endometrial lining is replaced by fibrous adhesions

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9
Q

Asherman’s syndrome is considered a ____ in the endometrium? (what does it look like?)

A

Scar

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10
Q

What might cause Asherman’s syndromes ? 3

A
  1. A second D and C
  2. Multiple abortions
  3. Infections
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11
Q

Endometrium in Ahserman’s syndrome varies in appearance how?

A

Thick to thin endometrium

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12
Q

Asherman’s syndrome may cause what symptoms?3

A
  1. Loss of menstruation
  2. Infertility
  3. Recurrent pregnancy loss
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13
Q

What is synechie a form of?

A

Ahserman’s

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14
Q

What causes synechie? 3

A
  1. A scar on the uterine lining from prior D and C,
  2. C sections
  3. Abortions
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15
Q

When would we commonly see synechiae? (What type of scan?)

A

Obstetrical scanning

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16
Q

What is the DDX for Synechiae?

A

Amniotic band

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17
Q

What is this a image of ?

A

Synechiae

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18
Q

What are Arteriovenous malformations?

A

Abnormal connection between veins and arteries

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19
Q

What are some causes of Arteriovenous malformation? 2

A
  1. Congenital - rare
  2. Trauma or surgery - common
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20
Q

What is a symptom of Arteriovenous malformations?

A

Menorrhagia

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21
Q

What is the sonographic appearance of Arteriovenous malformation?

A

Difficult to see until you use colour doppler

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22
Q

What does this image demonstrate?

A

Arteriovenous malformation

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23
Q

Label the image

A
  1. Menstrual
  2. Proliferative
  3. Secretory
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24
Q

How thick is the endometrial during the Proliferative phase?

A

4-8 mm

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25
How thick is the endometrial during the Secretory phase?
7-14 mm
26
How thick is the endometrial during the Post menopausal phase?
Typically 1-3 mm
27
What is neoplasia?
Multiplication of abnormal cells, can be malignant or benign
28
What are some non neoplasticism conditions? 5
1. Endometrial hyperplasia 2. Endometrial polyps 3. Adenomyosis 4. Uterine varicella s 5. Endometritis
29
Endometrial hyperplasia happens as a result of what?
Unopposed estrogen stimulation from ovarian dysfunction
30
When does endometrial hyperplasia occur?
Immediately after menarche or before menopause
31
What does Endometrial hyperplasia cause?
Irregular uterine bleeding
32
What is the sonographic appearance of Endometrial hyperplasia? 2
1. Thick hyperechoic endometrium 2. Most of the endometrium can be focal or nodular
33
What is the DDX for endometrial hyperplasia?
Endometrial calcification or polyps
34
What does this image demonstrate?
Hyperplasia
35
What is endometrial polyps?
Endometrial growths extending into the canal from a stalk
36
Endometrial polyps May protrude into what?
Cervix if the stalk is long enough
37
Endometrial polyps may cause what?
Bleeding
38
Patients with endometrial polyps may be asymptomatic or symptomatic?
Asymptomatic
39
What is the sonographic appearance of the endometrium with endometrial polyps?
Thick endometrium
40
What do we look for when doing colour ultrasound of endometrial polyps?
Vessels with colour doppler
41
What is the DDX for Endometrial polyps? 2
1. Endometrial cancer 2. Endometrial hyperplasia
42
What is a hysterosonogram?
When saline is administered into the endometrial canal by a gynaecologist for better visualization of the canal
43
What does this image demonstrate?
Endometrial polyps
44
What does this image demonstrate?
Hysterosonogram
45
What is Adenomyosis?
Extension of endometrial tissue (glands and stroma) beyond the endometrium into the myometrium
46
Adenomyosis is a form of what?
Endometiosis
47
Adenomyosis is ectopically placed endometrium where?
Into the myometrium
48
Adenomyosis can cause what? (s/s) 2
Pain and abnormal bleeding
49
What is the sonographic appearance of Adenomyosis? 5
1. slight diffuse uterine enlargement 2. Anterior/ posterior wall myometirum asymmetry 3. Endometrium/ myometrium junction is less pronounced (fuzzy) or jagged 4. Hypoechoic or cystic lesions within the myometrium 5. May have focal lesions (look like a fibroid or polyp)
50
What does this image demonstrate?
Adenomyosis
51
What does this image demonstrate?
Adenomyosis
52
What is this image of? And what can it be described as?
1. Adenomyosis 2. Venetian blind
53
What does this image demonstrate?
Prominent arcuate vessels
54
What does this image demonstrate?
Prominent arcuate vessels
55
What does this image demonstrate?
Uterine varices
56
What is endometritis?
Bacterial infection/ inflammation of the endometrium
57
With endometritis, what does the endometrium have the potential to do?
Extending into surrounding tissues
58
When does endometritis usually occur? 2
Postpartum or with pelvic inflammatory disease
59
What is the sonographic appearance of endometritis? 3
1. Normal endometrium 2. Irregular endometrium 3. Fluid filled cavity or demonstrate gas bubbles from micro- organisms
60
What does this image demonstrate?
Endometritis
61
What does this image demonstrate?
Endometritis
62
What are two types of benign uterine neoplasia?
1. Leiomyoma 2. Lipoleiomyoma
63
What is leiomyoma?
Benign neoplasticism mass of fibromuscular tissue
64
What are other ways to refer to leiomyoma? 4
1. Myoma 2. Leiomyomata 3. Fibromyoma 4. Fibroids
65
What is the most common tumor in the female pelvis?
Leiomyoma
66
Which demographic of individuals are most likely to have leiomyoma?
1. 40% of females over 35 years of age
67
Leiomyoma is most common in which race of women?
African American
68
What is leiomyoma influenced by?
Increase of estrogen which occurs in pregnancy and menopause
69
IF leiomyoma is malignant it is called what?
Leiomyosarcoma
70
How common is leiomyosarcoma?
Rare
71
What are some symptoms of leiomyoma? 6
1. Size and location determine symptoms 2. May be asymptomatic 3. Menorrhagia 4. Pain or pressure 5. Urinary frequency/ urgency 6. Infertility
72
What are some sonographic features of fibroids? 3
1. Hypoechoic with high attenuation 2. Overall enlarged uterus with an irregular contour 3. May be complex looking with cystic degeneration and necrosis
73
In terms of fibroids, what might occur in older women?
Calcifications
74
Label the image
75
What is a parasitic myoma?
Term used when the blood supply of a leiomyoma comes from other organs
76
Parasitic myomas typically only happens with what? (location) 3
1. Large posterior 2. Fundal tumours 3. Pedunculated ones
77
What is the etiology of parasitic myoma? (what is thought to cause it)
Thought to be pressure necrosis and revascularization during healing of bowel wall
78
Fibroids with pregnancy do what with increased estrogen?
Enlarge
79
Fibroids with pregnancy rapidly growing may result in what?
Lack of adequate blood supply resulting in necrosis
80
If there was a large fibroid near cervix what would happen during pregnancy?
It would inhibit delivery of the fetus
81
Mucosal fibroid can inhibit what?
Implantation
82
Large serosal fibroids may block what?
Fallopian tubes
83
What is a myomectomy in terms of fertility?
Surgery to remove to fibroid can assist in fertility but has risk associated with it
84
In terms of fibroids and fertility, Uterine artery embolization is what?
Where embolic agents are injected into the uterine arteries, cutting off blood flow to the fibroid, causing them to shrink
85
What is the sonographic appearance of Adenomyosis? 6
1. Irregular endometrial margins 2. Varied shape 3. Diffuse 4. No calcifications 5. Multiple attenuating focal areas 6. Vascularization across hypertrophied myometrium
86
What is the sonographic appearance of leiomyoma? 6
1. May intrude into endometrium 2. Rounded to Lobulated 3. Mass like 4. Calcifications 5. Edge shadowing with attenuation 6. Vascularity around the periphery
87
Lipoleiomyoma is what?
Lipcytes and fibromuscular tissues
88
How common are Lipoleiomyoma?
Uncommon
89
What is the sonographic appearance of Lipoleiomyoma?
Very hyperechoic and attenuating
90
What are two types of malignant uterine neoplasia?
1. Leiomyosarcoma 2. Endometrial carcinoma
91
How common is leiomyosarcoma?
Rare
92
Leiomysarcoma may arise from what?
Pre-existing fibroid
93
What are the symptoms of leiomyosarcoma? 3.
1. Abnormal vaginal bleeding 2. Palpable pelvic mass 3. Pelvic or abdominal pain
94
What suggests a leiomyosarcoma?
A rapid increase in size of uterine tumor after menopause
95
What is the sonographic appearance of a leiomyosarcoma? 3
1. Degenerating fibroid appearance 2. Vascularity at the border and typically within 3. May see local invasion of surrounding organs or hepatic metastases
96
What does this image demonstrate?
Leiomyosarcoma
97
_____ of all uterine malignancies are endometrial carcinomas
90%
98
What is the most commonly occurring cancer in post menopausal women?
Endometrial carcinoma
99
What is the symptoms of endometrial carcinomas?
Postmenopausal bleeding
100
What are the 4 stages of endometrial carcinoma?
1. Confined to endometrium 2. Confined to uterus 3. Spread beyond uterus, yet confined to pelvis 4. Distal metastasis
101
What increases the risk for endometrial carcinoma? 6
1. **Strong association with estrogen therapy** 2. Obesity 3. Hypertension 4. Diabetes 5. Polycystic ovarian syndrome 6. Granulosa cell tumours of the ovary
102
What is the sonographic appearance of endometrial carcinoma? 2
1. Thick echogenic endometrium 2. Difficult to distinguish from hyperplasia or polyps
103
What is this ?
Endometrial carcinoma
104
What is tamoxifen?
Non steroidal anti-estrogen Hormonal drug
105
What is tamoxifen used for?
In treatment of breast cancer
106
Tamoxifen is a estrogen antagonist to what?
The uterus resulting in stimulation of the endometrium
107
Tamoxifen increases the risk of endometrial cancer by how much? But what is the benefit?
1. 1% 2. But benefit for breast cancer treatment outweighs the risk for a uterine cancer
108
What is the sonographic appearance of tamoxifen?
Heterogenous bizarre endometrium
109
What doe this image demonstrate?
Tamoxifen therapy

DMST 315 OBGYN 3 (21 decks)

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