Uterus Flashcards
represents a uterine malformation where the uterus is present as a paired organ when the embryogenetic fusion of the Müllerian ducts fails to occur. As a result, there is a double uterus with two separate cervices, and rarely a double vagina as well
Uterus didelphyls
commonly referred to as a “heart-shaped” uterus, is a uterus composed of two “horns” separated by a septum
Bicornuate uterus
Premenopausal Hyperplasia Without Atypia, Simple
OCP x 6 cycles
Premenopausal Hyperplasia Without Atypia, Complex
MPA 10-20 mg OD x 14d
Premenopausal Hyperplasia With Atypia, Desires Pregnancy
MPA x 3 mos
Megestrol acetate
DMPA every 3 mos
Premenopausal Hyperplasia With Atypia, No desire Pregnancy
EH +/- BSO
Postmenopausal Hyperplasia Without Atypia, Simple
OCP x 6 cycles
Postmenopausal Hyperplasia Without Atypia, Complex
MPA 10-20 mg OD x 14d
Postmenopausal Hyperplasia With Atypia
EH +/- BSO
3rd most common genital tract cancer in the PH
Endometrial Ca
Primary Prevention Endometrial CA
OCP
Raloxifene
Secondary Prevention Endometrial CA
Annual screening biopsy >35 years old with HNPCC risk
Most common type of Endometrial CA
Adenocarcinoma
types of Endometrial CA with poor prognosis
Serous
Clear Cell
Stage of endometrial cancer: confined to the corpus
1
Stage of endometrial cancer: extension to cervix but not beyond uterus
2
Stage of endometrial cancer: outside uterus, within pelvis
3
Stage of endometrial cancer: invades bladder and/or bowel mucosa +/- distant metastasis
4
Most common sarcoma of the uterus
Leiomyosarcoma
Pure Sarcoma in the Uterus
Leiomyosarcoma - m/c
Endometrial stromal sarcoma/ adenosarcoma
type of cancer that contains two types of cancer cells - carcinoma and sarcoma cells
Carcinosarcoma
Uterine sarcoma with an aggressive behavior and poor prognosis
Uterine sarcoma that is confused with lymphoma, leukemia, high-grade endometrial CA
Undifferentiated type of Sarcoma
Surgical tx for Leiomyosarcoma
EH
Adjuvant for Leiomyosarcoma
Doxorubicin
Theory of Endometriosis etiology: most widely accepted
Retrograde Menstruation
Theory of Endometriosis etiology: explains the rare and remote sites of endometriosis
Lymphatic and Vascular Mets
Theory of Endometriosis etiology: endometrial glands ad stroma are implanted during surgical procedures
Iatrogenic dissemination
Theory of Endometriosis etiology: Hyperactive monocytic type macrophages -> growth factor
NK cells decreased toxicity on endometrial cells
Immunologic Changes
3 Cardinal histologic features of Endometriosis
Ectopic endometrial glands
Ectopic endometrial stroma
Hemorrhage on adjacent tissues
Classic signs and symptoms of Endometriosis
Cyclic pelvic pain
Infertility
Fixed retroverted uterus with scarring and tenderness posteriorly is a classic PE finding in
Endometriosis
Medical treatment for endometriosis that induces atrophic changes to implants
Danazol
Drug class used in medical oophorectomy for endometriosis
GnRH Agonist (Leuprolide, Goserelin)
definitive treatment for Endometriosis
Hysterectomy
