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IMG1036 (OB-GYN 2) > week 1- uterine pathology > Flashcards

week 1- uterine pathology Flashcards

1
Q

another name for fibroids

A

leiomymoa

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2
Q

cause of leiomymoa

A

unknown

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3
Q

leiomyoma typically arise after menarche and regress after ___ implicating ___ as a promoter of growth

A
  • menopause

- estrogen

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4
Q

leiomyoma (fibroids) are __ tumours

A

bengign

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5
Q

benign tumors of smooth muscle cells and fibrous CT, single or multiple and vary in size`

A

leiomyoma

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6
Q

Rate of occurrence for leiomyoma is markedly greater in ___ than ___

A

African American

whites

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7
Q

3 areas where leiomyoma affcets in the uterus

A
  1. intramural (within myometrium)
  2. submucosal (beneath endometrium)
  3. subserosal (serosal)
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8
Q

serosal surface of uterus projecting into the peritoneal cavity, including pedunculated myomas

A

subserosal (serosal)

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9
Q

types of leiomyoma (4)

A
  1. pedunculated
  2. submucosal
  3. subserosal
  4. calcified
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10
Q

symptoms of ___ include:

  • menorrhagia (long bleed)
  • spotting
  • abdominal girth
  • pain
  • urinary frequency/ urgency
  • low back pain
  • leg discomfort/ swelling
A

leiomyoma

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11
Q

sonographic findings of leiomyoma

A
  • heterogeneous myometrium
  • irreg endometrial stripe
  • hypoechoic areas in myo
  • whorled internal architecture of mass
  • calcifications
  • posterior bladder contour change
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12
Q

what to do when requisition says: asymptomatic for leiomyoma

A

routine & FU

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13
Q

what to do when requisition says: large myomas and desire to become preg

A

myomectomy

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14
Q

what can the use of a prostaglandin or oral contraceptive do for leiomyoma

A

reduce eliminate symptoms bc control estrogen/progesterone levels

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15
Q

Pedunculated uterine leiomyomas occur when the fibroid is in continuity with the uterus. They may grow either ____ or ___

A
  • within uterine cavity (submucosal)

- outside the uterus (subsersosal)

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16
Q

appearance of calcified myoma

A

echogenic

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17
Q

___ calcifications of the uterus image as echogenic foci in the periphery.

A

arcuate artery

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18
Q

if the location of the myoma is difficult to determine it is likely ____. However disruption of endometrium could result in categorization as a ____

A
  • intramural (within myometrium)

- submucosal

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19
Q

within myometrium

A

intramural

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20
Q

beneath endometrium

A

submucosal

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21
Q

beneath the outer layer

A

subserosal

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22
Q

excessive growth of endometrium

A

endometrial hyperplasia

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23
Q

endometrial hyperplasia caused by

A
  • high estrogen
  • HRT (hormone replacement therapy)
  • tamoxifen therapy
  • diabetes
  • obesity
  • PCOD/ anovulatory cycles
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24
Q

t/f: endometrial hyperplasia increases womens risk for endometrial cancer and must be closely monitored

A

true

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25
main cause of abnormal uterine bleeding
endometrial hyperplasia
26
upper limit endometrial thickness in premenopausal women
14mm
27
upper limit endometrial thickness in women on tamoxifen
10mm
28
upper limit endometrial thickness in postmenopausal women
8mm
29
Rx endometrial hyperplasia
- Hysteroscopy - progesterone orally - IUD (progesterone containing) - hysterectomy - D&C (dilation & curettage)
30
removal of uterus
Hysterectomy
31
sonographic finding of hyperplasia
- thickened endo | - homogeneous , hererogenic endo w/ small cystic areas
32
The findings of endo hyperplasia on US are nonspecific – a __ or ___ is necessary to confirm diagnosis
- biopsy | - D&C (scrape your uterus)
33
adhesion of the endometrium
Asherman’s Syndrome/ Synechia
34
synechia / asherman's syndrome is due to
- trauma - surgery - c-section - d&c
35
fertility problems, normal-absent menses, recurrent pregnancy loss are common with ___
asherman's syndrome / synechia
36
Rx of ashermans syndrome/ synechia is
removal or rupture of the intrauterine adhesion
37
HSG
Hysterosalpingography
38
endometrium appears normal or hypoechoic with bridge like bands
US appearance for ashermans syndrome/ synechia
39
SIS stands for
Saline infusion sonohysterography
40
when is SIS used
for ashermans syndrome/ synechia
41
what do we look at when we scan the uterus (6)
- size - echogenicity - contour - shape - fluid in the PCDS - endometrium --> size
42
pedunculated can be found ___ around the uterus because it is ____
anywhere | on a "string"
43
t/f: Leiomyoma are commonly incidental findings
true
44
from the muscles & CT, in different spaces, defined based on where they are situated, pt may have no symptoms until they grow (can cause swelling in legs)
Leiomyoma
45
Tamoxifen
hormonal med given to women with certain type of breast cancer
46
differential diagnosis
when something look likes it could be one condition so you need to look at signs and symptoms to differentiate between what the condition really is
47
what helps to distinguish a benign from malignant process
3D (colour doppler)
48
what plane allows further evaluation of the uterine lining
coronal
49
bridging / adhesions of ___ is asherman’s syndrome
endometrium
50
characterized by a large base located in the uterine wall (thicker)
amniotic sheet
51
Color Doppler ___ (shows/ does not show) blood flow in the majority of synechial bands, while this is not typical of amniotic bands
shows
52
synechial bands ____ show blood flow
do
53
amniotic bands ___ show blood flow
do not
54
during pregnancy asherman's syndrome is called
amniotic sheets or folds
55
endometrial polyp is Common benign lesion, involving the ___ of the endometrium
thickening
56
how are polyps identified
saline infusion (SIS)
57
Uterine Arterial Venous Malformation can occur in what parts of the uterus
endometrium or myometrium
58
Uterine Arterial Venous Malformation is most commonly found in
myometrium
59
result from formation of multiple arteriovenous fistulous communications within the uterus without an intervening capillary network.
UVAM
60
AVM ((arterial venous malformation)) as seen with colour doppler
Abundant turbulent flow | High velocity, low resistance flow
61
Polypoid appearance in endometrium indicate
AVM (arterial venous malformation)
62
colpos refers to the ___
vagina
63
Metra means the ___
uterus
64
Hydrometrocolpos is fluid in
both vagina and uterus
65
Hematocolpos is
blood in the vagina
66
Hydrametra is
fluid in the uterus
67
Hematometra is
blood in the uterus
68
Hydrocolpos is
fluid in the vagina
69
Hematometracolpos is
blood in both uterus and vagina
70
does pain accomodate hydrosalpinx ?
NO, usually no pain
71
the older the hematoma gets the ___ complex it becomes. Why?
more | starts to coagulate
72
can you always see pedunculated on transvaginal?
No, can go far from uterus you need to do transabdonminal
73
Most common gynecologic cancer in USA
endometrial carcinoma
74
high/ longer exposure to this hormone means higher chance for endometrial carcinoma
estrogen
75
endometrial carcinoma found in ___ (older/ younger) women .. what age?
older | 60-70 yrs
76
clinically presents as: Bleeding Pain Uterine distention
endometrial carcinoma
77
stage 1 indicates
localized / confined carcinoma
78
stage 4 indicates
carcinoma spread through blood to lymph nodes etc
79
stage 2/3 indicates
carcinoma spread adjacently to surrounding organs
80
if you see changes in cervix it likely means the carcinoma is in what stage
late stage
81
best modality for METS
CT / MRI
82
best modality for cervix carcinoma
pap smear
83
Sonography is important role in evaluating what with IUD
it is in proper location
84
how does IUD look on US
echogenic line in endometrial canal
85
if IUD is NOT seen on US then what imaging technique is used
x-ray

IMG1036 (OB-GYN 2) (3 decks)

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