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Ob / Gyn 2 > Uterine pathology > Flashcards

Uterine pathology Flashcards

1
Q

The Müllerian ducts fuse to form the

A

Uterus, cervix and upper vagina

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2
Q

Which ends of the Müllerian ducts fuse

A

Caudal

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3
Q

The infused ends of the Müllerian ducts form the

A

Fallopian tubes

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4
Q

What is a unicornate

A

Form of arrested development
Deviation of the fundal endometrium to the Lt or Rt
Banana shaped uterus

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5
Q

What Müllerian duct abnormality has the highest association of renal anormialites arising on the contralateral side

A

Unicornuate

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6
Q

Bicornuate uterus and uterine didelphys is a form of what mullarian duct abnormality

A

Failure of fusion

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7
Q

What are the forms of Müllerian duct abnormalities that are from failure of resorption

A

Septations >1cm indictation

Subseptate

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8
Q

What is a prolapsed uterus

A

The decent the uterus down the vagina

Caused by weak pelvic floor muscles

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9
Q

Is a prolapsed uterus diagnosed sonographically

A

No

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10
Q

What is asherman’s syndrome

A

When the endometrial lining is replaced by fibrous adhesions
It is considered a scar in the endometrium
Occurs after a D&C, multiple abortions or infections

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11
Q

Can asherman’s syndrome vary in appearance of a thick to thin endometrium

A

Yes

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12
Q

What does asherman’s syndrome cause

A

Loss of menstruation and infertility

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13
Q

are AV malformations of the uterus common or rare

A

Rare

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14
Q

What is the cause of AV malformations of the uterus and what are the symptoms

A

Congenital
From trauma or surgery

  • menorrhagia
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15
Q

What is the sonographic apperance of AV malformations of the uterus

A

Difficult to assess until the use of colour Doppler

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16
Q

What is neoplasia

A

Multiplication of abnormal cells, can be malignant or benign

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17
Q

What are non neoplasticism conditions

A 
Endometrial hyperplasia 
Endometrial polyps
Adenomyosis
Uterine varices
Endometritis
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18
Q

What is endometrial hyperplasia

A

Unopposed estrogen stimulation from ovarian dysfunction

Occurs immediately after menarche and also before menopause (premenopausal)

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19
Q

What can endometrial hyperplasia cause

A

Irregular uterine bleeding

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20
Q

What is the sonographic appearance of endometrial hyperplasia

A

Thick hyperechoic endometrium

Can Involve most, focal or modular parts of the endometrium

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21
Q

What is a DDX of endometrial hyperplasia

A

Endometrial CA or polyps

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22
Q

What are endometrial polyps

A

Endometrial growth extending into the canal from a stalk

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23
Q

What can endometrial polyps protrude into and what can it cause

A

Into the cervix if it has a long stalk

Bleeding or be asymptomatic

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24
Q

What type of test is done to see endometrial polyps

A

Sonohysterogram

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25
Q

What is adenomyosis

A

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

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26
Q

What is adenomyosis a form of

A

Endometriosis because it is an ectopically placed endometrium into the myometrium and causes the endo/myometrium junction to be less pronounced (fuzzy) or jagged.

27
Q

Where does adenomyosis typically occur in the uterus

A

Posterior wall

28
Q

What can adenomyosis cause

A

Pain

Abnormal bleeding

29
Q

What is the sonographic appearance of adenomyosis

A

Slight diffuse uterine enlargement
Hypoechoic or cystic lesions within the myometrium
May have focal lesions
May look like a fibroid or polyp
Myometrium of unequal thickness
~endometrium is not in the centre of the uterus

30
Q

What is adenomyosis appearance often described as

A

Venetian blind

~which is multiple lines shadowing in the posterior aspect of the uterus in the myometrium

31
Q

Where are uterine varices typically found on

A

The lateral aspect of the uterus, colour Doppler will help differentiate from an ovary

32
Q

What is endometritis

A

Inflammation of the endometrium

33
Q

When does endometritis often occur

A

Postpartum

Or

PID

34
Q

What is the sonographic appearance of endometritis

A

Normal endometrium
Irregular endometrium
Fluid filled cavity to it can demonstrate gas bubbles from micro-organisms

35
Q

Leiomyoma and lipoleiomyoma are

A

Benign uterine neoplasia

36
Q

What is leiomyoma

A

Aka fibroids
A benign neoplasticism mass of fibromuscular tissue
Most common tumor in the female pelvis
And most commonly found in African American women

37
Q

Leiomyoma are influenced by

A

Increase in estrogen

~like pregnancy or menopause

38
Q

If leiomyoma is malignant what is called and is it common or rare

A

Leiomyosarcoma and it is rare

39
Q

What are symptoms from leiomyoma

A 
Menorrhagia
Pain
Pressure
Palpable mass on pelvic exam 
Infertility
40
Q

What are classifications of leiomyoma

A

Intramural
Submucosal
Sub serosal

41
Q

Where are intramural fibroids

A

Confined in the myometrium

Most common

42
Q

Where are submucosal fibroids

A

Project into the uterine cavity
Can be pedunculated
Can cause bleeding

43
Q

Where are subserosal fibroids

A

Project from perimetrium
Can be pedunculated
Can be found in the broad ligament

44
Q

What are the sonographic appearances of fibroids

A

Hypoechoic with high attenuation
Enlarged uterus with irregular contour
Calcifications may be present in older women
May be complex looking with degeneration and necrosis

45
Q

Why can fibroids look necrotic

A

Because they have outgrown their blood supply

46
Q

What happens to fibroids with pregnancy

A

Enlarge from the increase in estrogen
Because of rapid growth it may result in necrosis from lack of adequate blood supply
Large fibroids near cervix can inhibit delivery of the fetus
~c-section would become necessary

47
Q

Where are fibroids typically located in the uterus

A

Lateral aspect

48
Q

What are lipoleiomyoma and are they common

A

Lipocystes (fat) and fibromuscular tissue

They are uncommon

49
Q

What is the sonographic appearance of lipoleiomyoma

A

Very hyperechoic and attenuating

Appear similar to dermoid

50
Q

Leiomyosarcoma and endometrial carcinoma are

A

Malignant uterine neoplasias

51
Q

What is leiomyosarcoma

A

Rare
May arise from pre-exisiting fibroid
Has the same symptoms as fibroids

52
Q

What is the sonographic appearance of leiomyosarcoma

A

Degenerating fibroid appearance

May see local invasion of surrounding organs or hepatic metastasis

53
Q

What is endometrial ca

A

Makes up 90% of all uterine malignancies

Most common in postmenopausal women

54
Q

What is the symptom of endometrial ca

A

Postmenopausal bleeding

55
Q

How many stages are there of endometrial ca

A

4

56
Q

What is stage 1 endometrial ca

A

Confined to the endometrium

57
Q

What is stage 2 endometrial ca

A

Confined to the uterus

58
Q

What is stage 3 endometrial ca

A

Spread beyond the uterus but still within the pelvis

59
Q

What is stage 4 endometrial ca

A

Distal metastasis (i.e liver)

60
Q

What are the risk factors associated with developing endometrial ca

A 
Strong association with estrogen therapy (HRT)
obesity 
Hypertension
Diabetes
PCOS
Granulosa cell tumour of the ovary
61
Q

What is the sonographic appearance of endometrial ca

A

Thick echogenic endometrium

Ifficulty distinguishing from hyperplasia or polyps

62
Q

What is tamoxifen

A

A non-steroidal anti-estrogen hormonal drug
Used in the treatment of breast ca

An estrogen antagonist to the uterus resulting in simulation of the endometrium

63
Q

What does tamoxifen increase the risk for

A

Developing endometrial ca by 1% but the benefit for breast cancer outweighs the risk for uterine ca

64
Q

What is the sonographic appearance of the endometrium when a patient is on tamoxifen

A

Heterogenous and bizarre

Ob / Gyn 2 (8 decks)

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