Uterine Pathology

Question 1

what two abnormalities may be indistinguishable from hyperplasia?

Answer 1

endo cancer and polyp

Question 2

most common cause of abnormal uterine bleeding?

Answer 2

hyperplasia

in peri- and postmenopausal women

may be caused by unopposed estrogen hormone replacement therapy

Question 3

during saline infusion sonohysterography what approach is used?

Answer 3

transvaginal

Question 4

failure of fusion consists of?

Answer 4

uterus didelphys: complete dublication of uterus, cervix, and vagina

bicornuate uterus: most common Mullerian anomaly, single vagina, one or two cervices, and variable lake of fusion of upper uterine cavity

Question 5

sonographic findings of endometritis

Answer 5

endo appears prominent, irregular, with small amount of fluid

pus in cul-de-sac

enlarge cystic ovaries

dilation of tube (5mm or more)

tubo-ovarian complex

Question 6

Example of a persistant structure that arises from the caudal remnants of the mesonephric (Wollfian) duct?

Answer 6

gartners duct cyst

Question 7

Rare malignancy arising from the myometrium?

Answer 7

leiomyosarcoma

may be indistinguishable from fibroid

clue is relatively rapid growth of mass in post-menopause

Question 8

Clinical signs of leiomyomas

Answer 8

menometrorrhagia

frequent urination

enlarged uterus

increasing pain with degenerative changes

infertiliy or spontaneous abortions

alteration in normal menstrual flow

Question 9

sonographic findings of cervical cancer

Answer 9

normal in early disease

enlarged uterus

similar to cervical myoma

hydronephrosis

involvement of other pelvic organs

Question 10

What is failure of dissolution?

Answer 10

median septum fails to dissolve after fusion of the two separate Mullerian ducts, septate uterus

least severe Mullerian anomaly is a slightly protruding into the uterine cavity, arcuate uterus

Question 11

The uterus, fallopian tubes and upper vagina develop from what?

Answer 11

Mullerian ducts

(paramesonephric ducts)

Question 12

what is endometrial hyperplasia?

Answer 12

proliferation of endometrial glandular tissue

Question 13

typical patient of adenomyosis

Answer 13

30-50 yrs old

dysmenorrhea and irregular bleeding

parous women

Question 14

Exposure associated with poor pregnancy outcome, cervical cancinoma and breast carcinoma, and a T-shaped uterus?

Answer 14

DES (diethylstilbestrol) syndrome

Question 15

Are the ovaries affected in the presence of mullerian anomalies?

Answer 15

No, do not develop from Mullerian ducts

Question 16

most common gyn malignancy, usually occurs in postmenopausal women?

Answer 16

endometrial carcinoma

present with early postmenopausal bleeding

increased risk between estrogen and malignancy

Question 17

third most common GYN malignancy?

Answer 17

cervical cancer

20-30 yrs old

most common symptom is post-coital bleeding

Question 18

Failure of formation demonstrates?

Answer 18

complete agenesis:

absence of vagina, cervix, uterus, and fallopian tubes

partial agenesis:

range of anomalies, most common is unicornate uterus and single fallopian tube

Question 19

hyperplasia clinical signs are similar to endo cancer, sonographic findings differ?

Answer 19

smooth boarders

more homogeneous

premenopause > 14mm

tamoxifen > 10mm

postmeno estrogen only > 5mm

postmeno w/ estrogen and progesterone > 8mm

Question 20

Commonly acquired after surgical procedure or uterine trauma and associated with heavy vaginal bleeding?

Answer 20

uterine arteriovenous malformation

Question 21

causes of endometritis

Answer 21

PID

retained products

postprocedural complication

vaginitis

Question 22

In the case of uterine anomalies, what other system should be evaluated for anomalies?

Answer 22

urinary system

Question 23

abnormality found in posttraumatic or postsurgical historiesincluding uterine curettage?

Answer 23

synechiae or ashermans syndrome

Question 24

sonographic findings associated with synechiae

Answer 24

bright echoes within endo

better identified during secretory phase or under SIS

bridging bands of tissue that distort cavity

Question 25

What are the four categories of anomalous internal genitalia development?

Answer 25

failure of formation

failure of fusion

failure of dissolution

failure of structures to disappear

Question 26

risks associated with endometrial cancer

Answer 26

obesity and anovulatory cycles

estrogen replacement

history of hyperplasia

tamoxifen therapy

family history