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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 symptoms 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
Q

How thick is the endometrial during the Secretory phase?

A

7-14 mm

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26
Q

How thick is the endometrial during the Post menopausal phase?

A

Typically 1-3 mm

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27
Q

What is neoplasia?

A

Multiplication of abnormal cells, can be malignant or benign

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28
Q

What are some non neoplasticism conditions? 5

A
  1. Endometrial hyperplasia
  2. Endometrial polyps
  3. Adenoma oasis
  4. Uterine varicella s
  5. Endometritis
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29
Q

Endometrial hyperplasia happens as a result of what?

A

Unopposed estrogen stimulation from ovarian dysfunction

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30
Q

When does endometrial hyperplasia occur?

A

Immediately after menarche or before menopause

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31
Q

What does Endometrial hyperplasia cause?

A

Irregular uterine bleeding

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32
Q

What is the sonographic appearance of Endometrial hyperplasia? 2

A
  1. Thick hyperechoic endometrium
  2. Most of the endometrium can be focal or nodular
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33
Q

What is the DDX for endometrial hyperplasia?

A

Endometrial calcification or polyps

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34
Q

What does this image demonstrate?

A

Hyperplasia

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35
Q

What is endometrial polyps?

A

Endometrial growths extending into the canal from a stalk

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36
Q

Endometrial polyps May protrude into what?

A

Cervix if the stalk is long enough

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37
Q

Endometrial polyps may cause what?

A

Bleeding

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38
Q

Patients with endometrial polyps may be asymptomatic or symptomatic?

A

Asymptomatic

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39
Q

What is the sonographic appearance of the endometrium with endometrial polyps?

A

Thick endometrium

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40
Q

What do we look for when doing colour ultrasound of endometrial polyps?

A

Vessels with colour doppler

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41
Q

What is the DDX for Endometrial polyps? 2

A
  1. Endometrial cancer
  2. Endometrial hyperplasia
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42
Q

What is a hysterosonogram?

A

When saline is administered into the endometrial canal by a gynaecologist for better visualization of the canal

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43
Q

What does this image demonstrate?

A

Endometrial polyps

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44
Q

What does this image demonstrate?

A

Hysterosonogram

45
Q

What is Adenomyosis?

A

Extension of endometrial tissue (glands and stroma) beyond the endometrium into the myometrium

46
Q

Adenomyosis is a form of what?

A

Endoetiosis

47
Q

Adenomyosis is ectopically placed endometrium where?

A

Into the myometrium

48
Q

Adenomyosis can cause what?

A

Pain and abnormal bleeding

49
Q

What is the sonographic appearance of Adenomyosis? 5

A
  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
Q

What does this image demonstrate?

A

Adenomyosis

51
Q

What does this image demonstrate?

A

Adenomyosis

52
Q

What is this image of? And what can it be described as?

A
  1. Adenomyosis
  2. Venetian blind
53
Q

What does this image demonstrate?

A

Prominent arcuate vessels

54
Q

What does this image demonstrate?

A

Prominent arcuate vessels

55
Q

What does this image demonstrate?

A

Uterine varices

56
Q

What is endometritis?

A

Bacterial infection/ inflammation of the endometrium

57
Q

What does endometritis have the potential to do?

A

Extending into surrounding tissues

58
Q

When does endometritis usually occur? 2

A

Postpartum or with pelvic inflammatory disease

59
Q

What is the sonographic appearance of endometritis? 3

A
  1. Normal endometrium
  2. Irregular endometrium
  3. Fluid filled cavity or demonstrate gas bubbles from micro- organisms
60
Q

What does this image demonstrate?

A

Endometritis

61
Q

What does this image demonstrate?

A

Endometritis

62
Q

What are two types of benign uterine neoplasia?

A
  1. Leiomyoma
  2. Lipoleiomyoma
63
Q

What is leiomyoma?

A

Benign neoplasticism mass of fibromuscular tissue

64
Q

What are other ways to refer to leiomyoma? 4

A
  1. Myoma
  2. Leiomyomata
  3. Fibromyoma
  4. Fibroids
65
Q

What is the most common tumor in the female pelvis?

A

Leiomyoma

66
Q

Which demographic of individuals are most likely to have leiomyoma?

A
  1. 40% of females over 35 years of age
67
Q

Leiomyoma is most common in which race of women?

A

African American

68
Q

What is leiomyoma influenced by?

A

Increase of estrogen which occurs in pregnancy and menopause

69
Q

IF leiomyoma is malignant it is called what?

A

Leiomyosarcoma

70
Q

How common is leiomyosarcoma?

A

Rare

71
Q

What are some symptoms of leiomyoma? 6

A
  1. Size and location determine symptoms
  2. May be asymptomatic
  3. Menorrhagia
  4. Pain or pressure
  5. Urinary frequency/ urgency
  6. Infertility
72
Q

What are some sonographic features of fibroids? 3

A
  1. Hypoechoic with high attenuation
  2. Overall enlarged uterus with an irregular contour
  3. May be complex looking with cystic degeneration and necrosis
73
Q

In terms of fibroids, what might occur in older women?

A

Calcifications

74
Q

Label the image

A
75
Q

What is a parasitic myoma?

A

Term used when the blood supply of a leiomyoma comes from other organs

76
Q

Parasitic myomas typically only happens with what?

A

Large posterior or Fundal tumours, especially pedunculated ones

77
Q

What is the etiology of parasitic myoma?

A

Thought to be pressure necrosis and revascularization during healing of bowel wall

78
Q

Fibroids with pregnancy do what with increased estrogen?

A

Enlarge

79
Q

Fibroids with pregnancy rapidly growing may result in what?

A

Lack of adequate blood supply resulting in necrosis

80
Q

If there was a large fibroid near cervix what would happen during pregnancy?

A

It would inhibit delivery of the fetus

81
Q

Mucosal fibroid can inhibit what?

A

Implantation

82
Q

Large serosal fibroids may block what?

A

Fallopian tubes

83
Q

What is a myomectomy in terms of fertility?

A

Surgery to remove to fibroid can assist in fertility but has risk associated with it

84
Q

In terms of fibroids and fertility, Uterine artery embolization is what?

A

Where embolic agents are injected into the uterine arteries, cutting off blood flow to the fibroid, causing them to shrink

85
Q

What is the sonographic appearance of Adenomyosis? 6

A
  1. Irregular endometrial margins
  2. Varied shape
  3. Diffuse
  4. No calcifications
  5. Multiple attenuating focal areas
  6. Vascularization across hypertrophied myometrium
86
Q

What is the sonographic appearance of leiomyoma? 6

A
  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
Q

Lipoleiomyoma is what?

A

Lipcytes and fibromuscular tissues

88
Q

How common are Lipoleiomyoma?

A

Uncommon

89
Q

What is the sonographic appearance of Lipoleiomyoma?

A

Very hyperechoic and attenuating

90
Q

What are two types of malignant uterine neoplasia?

A
  1. Leiomyosarcoma
  2. Endometrial carcinoma
91
Q

How common is leiomyosarcoma?

A

Rare

92
Q

Eiomysarcoma may arise from what?

A

Pre-existing fibroid

93
Q

What are the symptoms of leiomyosarcoma? 3.

A
  1. Abnormal vaginal bleeding
  2. Palpable pelvic mass
  3. Pelvic or abdominal pain
94
Q

What suggests a leiomyosarcoma?

A

A rapid increase in size of uterine tumor after menopause

95
Q

What is the sonographic appearance of a leiomyosarcoma? 3

A
  1. Degenerating fibroid appearance
  2. Vascularity at the border and typically within
  3. May see local invasion of surrounding organs or hepatic metastases
96
Q

What does this image demonstrate?

A

Leiomyosarcoma

97
Q

_____ of all uterine malignancies are endometrial carcinomas

A

90%

98
Q

What is the most commonly occurring cancer in post menopausal women?

A

Endometrial carcinoma

99
Q

What is the symptoms of endometrial carcinomas?

A

Postmenopausal bleeding

100
Q

What are the 4 stages of endometrial carcinoma?

A
  1. Confined to endometrium
  2. Confined to uterus
  3. Spread beyond uterus, yet confined to pelvis
  4. Distal metastasis
101
Q

What increases the risk for endometrial carcinoma? 6

A
  1. Strong association with estrogen therapy
  2. Obesity
  3. Hypertension
  4. Diabetes
  5. Polycystic ovarian syndrome
  6. Granulosa cell tumours of the ovary
102
Q

What is the sonographic appearance of endometrial carcinoma? 2

A
  1. Thick echogenic endometrium
  2. Difficult to distinguish from hyperplasia or polyps
103
Q

What is this ?

A

Endometrial carcinoma

104
Q

What is tamoxifen?

A

Non steroidal anti-estrogen Hormonal drug

105
Q

What is tamoxifen used for?

A

In treatment of breast cancer

106
Q

Tamoxifen is a estrogen antagonist to what?

A

The uterus resulting in stimulation of the endometrium

107
Q

Tamoxifen increases the risk of endometrial cancer by how much? But what is the benefit?

A
  1. 1%
  2. But benefit for breast cancer treatment outweighs the risk for a uterine cancer
108
Q

What is the sonographic appearance of tamoxifen?

A

Heterogenous bizarre endometrium

109
Q

What doe this image demonstrate?

A

Tamoxifen therapy

DMST 315 OBGYN 3 (21 decks)

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