WK 1- Gynaecological Conditions (incomplete) Flashcards
What is Pelvic Inflammatory Disease?
Pelvic Inflammatory Disease [PID] is an infection & inflammation of organs affecting the female reproductive system (eg. uterus, vagina & fallopian tubes)
What are some key signs & symptoms of Pelvic Inflammatory Disease?
Signs & Symptoms of PID-
- Fever
- Sepsis Signs
- Lower abdo pain
- Pain on mobilising
Pelvic Inflammatory Disease can cause a lot of scar tissue to develop. What are some IMPLICATIONS/complications of this?
- Pelvic adhesions- Scar tissue binds adjacent organs
- Infertility- Scarring of fallopian tubes can block pathway of egg
- Ectopic Pregnancy- Scar tissue can prevent a fertilised egg from moving into the uterus. Instead, it can begin to grow in the fallopian tube
Which gynaecological condition can cause Tubo-ovarian Abscesses?
Pelvic Inflammatory Disease can cause Tubo-ovarian Abscesses (an infectious mass filled with pus)
Describe the Pathophysiology of Pelvic Inflammatory Disease
Pelvic Inflammatory Disease:
1- Infection in genital tract [eg. secondary to STDs like Chlamydia & Gonorrhoea]
2- Causes cervical inflammation
What is Endometritis?
Endometritis= the inflammation of the endometrium (inner lining of the uterus)
Endometritis can be classified as either ‘Acute’ or ‘Chronic’. How are differentiated?
- Acute Endometritis= Characterised by infiltration of micro-abscesses & neutrophils in the endometrial tissue
- Chronic Endometritis= Characterised by the presence of plasma cells in the endometrial stroma (soft tissue)
What are the most common organisms which cause Chronic Endometritis?
Chronic Endometritis is often caused by:
1. Chlamydia
2. Gonorrhoea
3. Streptococcus
4. Various viruses
What are the key Signs & Symptoms of Acute Endometritis?
Acute Endometritis=
1. Fever [secondary to infection]
2. Purulent vaginal discharge [thick, puss filled discharge secondary to infection]
3. Excessive menstruation following
How is Acute Endometritis treated?
Acute Endometritis is treated with Antibiotics
What are 3 risk factors which can increase likelihood of developing Endometritis?
Risk Factors for Endometritis=
1. Post Caesarean section
2. Prolonged rupture of membranes/ long labour
3. Multiple vaginal examinations
What is the pathophysiology of Endometritis?
Endometritis=
1. Risk factors (caesarean, prolonged rupture of membranes/long labour, multiple vaginal examinations)
2. Causes an infection within the endometrium
3. Infection leads to inflammation of the endometrium
What is Endometriosis?
Endometriosis= condition when ectopic endometrial tissue exists outside the uterine cavity
What is the difference between Endometriosis and Endometritis?
- Endometriosis= a diseased condition where endometrial tissues grows outside the uterus
- Endometritis= inflammation of the endometrium following an infection
[Hint- ‘itis’= inflammation secondary to infection, ‘osis’= diseased condition]
Using the theory of menstrual regurgitation/retrograde menstruation, explain the Pathophysiology of Endometriosis
Endometriosis Pathophysiology=
1. Menstrual blood containing endometrial cells is regurgitated/flows backwards through fallopian tubes
2. Cells enter peritoneal cavity rather than out of the body
3. Endometrial tissue implants & grows outside uterus [growths called ‘ectopic endometrial implants’. ectopic= defined as occurring in abnormal positions]
4. Endometrial implants grow as small cystic lesions/structures
5. During menstruation, ectopic endometrial tissue/cysts undergo same process of clinical breakdown & bleeding as endometrial tissue within uterus
6. Breakdown causes release of cytokines & prostaglandins, signalling inflammatory response
7. Adhesions (scar tissue) form and connect reproductive organs to other organs (eg. ovaries to pelvic wall or bladder)
What is the Clinical Presentation of Endometriosis?
Endometriosis=
1. Chronic pelvic pain [secondary to adhesion’s/scar tissue]
2. Dyspareunia (painful sex) [secondary to adhesions/scar tissue]
3. Dysmenorrhoea (menstrual pain which impacts functioning) [secondary to adhesions/scar tissue]
4. Spotting before period [secondary to the ectopic tissue undergoing same process of clinical breakdown as uterine tissue]
Where is the most common area for Endometrial implants to develop in? [as a result of having Endometriosis]
Endometrial implants can commonly develop in:
a) Ovaries
b) Utero-sacral and round ligaments
c) Fallopian tubes
d) Peritoneal surfaces (& other surfaces)
What are the implications/complications of Endometriosis?
Implications/complications of Endometriosis=
1. Compression & infiltration of pelvic nerves [secondary to scar tissue/adhesions applying pressure on nerves]
2. Pelvic adhesions [secondary to scar tissue binding adjacent organs]
3. Infertility [secondary to adhesions, altered immune functioning, inflammation, distorted pelvic anatomy, scarred fallopian tubes, hormonal changes]
What are the Pharmacological treatment options for Endometriosis?
Pharmacological Treatment of Endometriosis=
1. NSAIDs
2. Hormonal therapy containing Progesterone (oral contraceptive)
3. Gonadotropin-releasing hormone (GnRH)
What are the Surgical treatment options for Endometriosis?
Surgical Treatment of Endometriosis=
1. Laparoscopic Ablation/Excision
2. Hysterectomy
What is an Ovarian Cyst?
Ovarian Cyst= fluid filled sac on the surface of an ovary. They are asymptomatic when intact
What is the Pathophysiology of a Ruptured Ovarian Cyst?
Ruptured Ovarian Cyst=
1. Ovarian cyst develops within the ovaries & fills with fluid
2. Tissue bursts an ovarian cyst ruptures
3. Ovarian cyst wall opens up, exposing fluid & sometimes blood within to the abdominal cavity
4. Leakage of cystic content into peritoneum can cause Peritonitis & sepsis
What is the Clinical Presentation of a Ruptured Ovarian Cyst?
Ruptured Ovarian Cyst=
- Localised unilateral lower abdo pain
- Fever & other signs of infection
What are the Implications/complications of a Ruptured Ovarian Cyst?
Ruptured Ovarian Cyst can result in-
1. Peritonitis (inflammation of peritoneum) secondary to cystic contents leaking into the peritoneal cavity
2. Sepsis- secondary to peritonitis
3. Intraperitoneal Haemorrhage- if a haemorrhagic cyst ruptures
