Uterine Pathology Flashcards
This is the most common type of female reproductive tract anomaly.
mullerian duct defects
These are the embryonic tubes that develop to form the upper vagina, cervix, uterus, and fallopian tubes.
mullerian ducts
T/F? Mullerian ducts are present in the embryo of both genders.
true
What duct develops into the male reproductive organs?
wolffian ducts
The development of the mullerian ducts is controlled by the presence of absence of…
anti-mullerian hormone (AMH/MIF/MIH)
What should the sonographer evaluate in all cases of uterine anomalies?
the urinary tract
Urinary tract abnormalities are found in approx __% of patients with uterine anomalies.
20-50%
The ___ do NOT develop from the mullerian duct and are generally normal in the presence of mullerian anomalies.
ovaries
What are the four categories of anomalous internal genitalia development?
Failure of…
- formation
- fusion
- dissolution
- structures to disappear
This formation anomaly results in complete absence of the vagina, cervix, uterus and fallopian tubes.
complete agenesis
This formation anomaly can result in the absence of the upper vagina and cervix with persistence of the uterus and fallopian tubes or the more common unicornuate uterus and single fallopian tube.
partial agenesis
What’s the most common partial agenesis mullerian anomaly?
unicornate uterus
This mullerian anomaly may be suspected when the uterus appears small and laterally positioned.
unicornate uterus
The poorest fetal survival among all MAs has been reported with a ___ anomaly.
unicornate uterus
A missing __ or other __ problems may accompany a unicornate uterus.
kidney
Where might the ovary on the rudimentary side of a UU be found?
further up by the ribs
A rudimentary horn that does not communicate with the normal side leads to…
retrograde menstruation, endometriosis, and probably a resection.
With this fusion anomaly there may be complete duplication of the vagina, cervix and uterus.
uterus didelyphs
This MA has the best pregnancy outcomes.
uterus didelyphs
T/F? In a UD each separate uterus is narrower than a normal uterus.
true
In 67% of cases, a didelphus uterus is associated with…
two vaginas separated by a thin wall.
In this fusion anomaly there’s a single vagina and cervix but variable lack of fusion of the upper uterine cavity.
bicornuate uterus
A serosal indentation of more than __ is indicative of a bicornuate uterus.
1 cm
This MA has relatively few pregnancy complications, but breech presentation is the most common.
bicornute uterus
These two MAs need to be distinguished from each other, so a single cervix should be confirmed.
uterus didelphys and bicornuate uterus
This may be confused with a uterine or adnexal mass if the central endometrial echo complex is not seen in one of the horns.
bicornuate uterus
The subset of MA features a single vagina and cervix and two uterine horns which are partially fused.
bicornis unicollis
This subset of MA features a double or single vagina, a double cervix, and two uterine horns which are partially fused.
bicornis bicollis
This is the mildest fusion anomaly, resulting in a slight indentation of the uterine fundus and mostly normal endometrial cavity.
uterus arcuatus
This failure of dissolution results in a single vagina and cervix but a uterine cavity that is split into 2 hemi-uteri.
septate uterus
T/F? A septate uterus can be complete or partial.
true
SUs have very poor pregnancy outcomes because…
the fibrous septation has inadequate blood supply and progesterone receptors.
T/F? 25% of uterine anomalies are septated.
FALSE, 55%
The septate uterus and bicornuate uterus can be distinguished by…
looking at the external contour.
SUs have a fundal contour that is flat or indented by less than..
1 cm.
The most typical example of a failure of disappearance is…
gartner’s cyst.
This is a remnant of a mesonephric or wolffian duct in the lateral wall of the vagina.
gartner’s cyst
This is a synthetic preparation used in the treatment of menopause and other disorders due to estrogen deficiencies.
diethystilbestrol (DES)
What caused small and T-shaped uterine cavities in women a generation later?
DES
T/F? In a DES uterus, the external contour is extremely indented.
FALSE, is normal
This is the most common neoplasm of the uterus.
leiomyomas (fibroids)
T/F? Leiomyomas occur in approximately 30-40% of women over 30.
FALSE, 20-30%
T/F? Leiomyomas are more common in African-American women.
true
These are the most common cause of enlargement of the non-pregnant uterus.
leiomyomas (fibroids)
Fibroids are also known as…
myomas, fibromyomas, leiomyomas
These are benign muscular tumors of the uterus.
Fibroids
These are most commonly present as palpable pelvic masses and cause pelvic pain and dysfunctional uterine bleeding.
fibroids
This kind of fibroid is confined to the myometrium.
intramural
This is the most common kind of fibroid.
intramural
This kind of fibroid projects into the uterine cavity.
submucosal
This kind of fibroid produces the most symptoms.
submucosal
This kind of fibroid projects from the peritoneal surface of the uterus.
subserosal
This kind of fibroid arises from a stalk.
pedunculated
This kind of fibroid grows OUT of the uterus.
exophytic
This kind of fibroid occurs within the broad ligament.
interligamentous
T/F? Cervical fibroids are rarer and usually small.
true
Name the seven kinds of fibroids.
- intramural
- submucosal
- subserosal
- pendunculated
- exophytic
- interligmentous
- cervical
Fibroids are __ dependent and may increase in size during __ cycles and during __.
estrogen, anovulatory, pregnancy
Fibroids identified in the __ trimester are associated with an elevated pregnancy risk.
first
T/F? The risk of pregnancy loss is higher in patients with multiple fibroids.
true
When do large fibroids interfere with pregnancy or normal delivery?
When they are located inthe LUS or cervix
Do fibroids develop in postmenopausal women?
rarely
Fibroids may increase in a postmenopausal woman who is on __.
HRT
Fibroids are composed of __ cells separated by fibrous connective tissue.
spindle-shaped smooth muscle
This results when fibroids outgrow their blood supply.
ischemia and cystic degeneration
Clinical symptoms of fibroids…
- heavy periods
- lengthy periods
- period pain
- spotting between periods
- painful intercourse
- heaviness, pressure
- frequent urination
- lump in lower abdomen
Treatments for fibroids…
- drugs
- hysteroscopy
- laparoscopy
- open surgery
- hysterectomy
This is when fibroids are removed via the cervix.
hysteroscopy
This is when a thin tube is inserted through the abdomen to remove the fibroids.
laparoscopy
What is a malignant leiomyoma called?
leiomyosarcoma
T/F? Leiomyosarcomas tend to be asymptomatic and are rarely diangosed preoperatively.
true
This benign condition is characterized by diffuse infiltration of the endometrium into the posterior myometrium.
adenomyosis
In this condition, the arteries and veins connect without an intervening capillary network.
AV malformation
Patients with an AV malformation present with metrorrhagia and…
hemoglobin-dropping blood loss.
Sonographically, uterine AV malformation appears as…
serpiginous anechoic structures within the pelvis (turn on your doppler).
This is the result of obstructed and dilated endocervical glands.
nabothian cysts