W10_07 Ultrasound in Gynecology Flashcards
which two types of transducers are typically used in gynecology?
transabdominal or transvaginal
pros of trans-vaginal probe?
higher resolution (lower penetrance); unaffected by BMI
recall piezoelectrical phenomenon
ok
what’s A mode imaging?
amplitude - one slice, height proportional to intensity of signal
what’s B mode imaging?
brightness - 2D image. Typically used in clinic
what’s M mode imaging?
motion - records amplitudes in a slice wrt time
what does ALARA stand for?
As Low As Reasonably Achievable
what’s the purpose of a hysterosalpingogram?
use contrast to check patency of fallopian tubes
what does cervical motion tenderness indicate?
peritoneal irritation or PID?
when do you see a gestational sac?
5.5 weeks (TA), 5 weeks (TVS)
when do you see a double decidual sign?
5.5-6 weeks
when do you see the fetal heart beat?
6.5 weeks (TAS), 5-6 weeks (TVS)
when do you see the fetal pole?
6-7 weeks
read the slides for images
read the slides for images
how to tell the gestational sac from the pseudogestational sac?
gestational sac has the double-decidual sign
how do hemoperitoneums look on ultrasound?
hypoechoic area, posterior to uterus
note: hemorrhagic cyst is hypoechoic, not anechoic
note that they retract and clot after a while
what’s the point of the hysterosonogram?
distend endometrial cavity to see the lining better. With saline
define primary amenorrhea
absence of: secondary sex characteristics by 14;
menses by 16
menses after 4 years post thelarche
menses after 1 year post pubarche
define secondary amenorrhea
6 months of amenorrhea after 1st menstruation or 3 cycles with no menstruation
disorders of which organs can cause amenorrhea?
hypothalamus, pituitary, thyroid, adrenals, ovary, outflow tract
what’s sheehan syndrome?
at birth, some event results in hypovolemia. They recover okay, but then can’t breastfeed because of an infarct in the pituitary and can’t secrete prolactin
how does hyperthyroidism affect the luteal phase?
shortens it
what’s kallman’s syndrome?
failure to get to puberty. Also anosia. Caused by failure of neurons that make GnRH to migrate into the hypothalamus
what’s the ferriman-gallwey score?
scores various body parts for the presence of hair. Total = 36
what’s the tanner scale?
looks at breast and pubic/armpit hair development
when to order labs for LH/FSH/estradiol?
when the person is not having their period, these are helpful
which labs to order when there’s amenorrhea?
LH/FSH/estradiol;
TSH;
prolactin;
bone age;
pregnancy test;
ultrasound;
bone densitometry if long hx
note: prolactin is the only inhibited hormone. It’s inhibited by dopamine
ok
how to treat hyperprolactinemia?
dopamine agonist
what’s the minimum treatment for PCOS?
cyclic provera to prevent endometrial growth
define oligomenorrhea
reduction in frequency of menses
define hypomenorrhea
reduction in number of days and volume of flow
define menometrorrhagia
prolonged, heavy uterine bleeding occuring at irregular intervals
define menorrhagia
prolonged, heavy uterine bleeding occuring at regular intervals
what causes menorrhagia?
uterus is unable to contract down on open venous sinuses in the zona basalis
define anovulatory bleed
the endometrium gets huge and can’t maintain itself - causing huge downpour and shedding of the tissues
what’s the medical management for menorrhagia?
NSAIDs, danazol (less commonly used now), antifibrinolytics, OCP, IUD w/progesterone, GnRH agonist, conjugated estrogens for acute bleeding
