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gyn-benign uterine
| Question | Answer |
|---|---|
| 5 benign uterine conditions | endometriosis, adenomyosis, uterine fibroids, endometrial polyps, uterine anomalies |
| the presence and growth of the glands and stroma of the lining of the uterus in an aberrant location | endometriosis |
| the growth of endometrial glands and stroma in the uterine myometrium (at least 2.5mm from the basalis layer of the endometrium) | adenomyosis |
| also known as leiomyomas, or myomas, benign tumor of muscle cell origin found in any tissue that contains smooth muscle | uterine fibroids |
| localized overgrowths of endometrial glands and stroma that project BEYOND the surface of the endometrium | endometrial polyps |
| endometriosis is an ______-dependent dz and is mainly in ________ women | estrogen; pre-menopausal |
| in endometriosis, ovaries are involved in how many pts? | 2/3 of pts |
| sxs of endometriosis? | CYCLIC pelvic pain, 2ndary dysmenorrhea, pelvic heaviness, welling, bloating, abnormal bleeding, dyspareunia, cyclic abd pain, intermittent constipation/diarrhea, urinary frequency/dysuria, hematuria |
| classic sign of endometriosis? | fixed retroverted uterus w/ tenderness and scarring posteriorly |
| dx of endometriosis? | direct visualization of lesions w/ histologic confirmation (laparoscopically) |
| tx of endometriosis? | induction of amenorrhea is goal (danazol, GnRH agonists, OCPs, progestins). surgical therapies (for failed med therapy): conservative (cautery, excision), definitive (hysterectomy w/ bilateral salpingo-oophorectomy and removal of all visible implants) |
| 3 types of GnRH agonists | Lupron (inj), Synarel (intranasal), Zoladex (subQ implant) |
| when does anenomyosis occur? | when basal is layer of endometrium invades myometrium |
| adenomyosis is most often seen in ______ women | parous |
| most common type of adenomyosis? | diffuse involvement of ant and post walls of uterus. spongy appearance |
| sxs of adenomyosis? | usually asxs or have minor sxs (dysmenorrhea and menorrhagia, occasionally dyspareunia) |
| clinical dx of adenomyosis? | diffuse enlargement of uterus (2-3x normal size), uterus globular and tender right before and during menses, diff in tenderness and consistency of uterus from one pelvic exam to another |
| most helpful imaging study of adenomyosis? | MRI |
| tx of adenomyosis? | tx anemia (if cause), HYSTERECTOMY is the only definitive tx |
| leiomyomas are _____ tumors of ______ cell origin | benign, muscle |
| what is the most common benign pelvic tumor and when do they commonly occur? | leiomyomas, 5th decade of life (40s) |
| 5 types of fibroids? | intramural, submucosal, subserosal, broad ligament, parasitic |
| sxs of fibroids? most common sx? | abnormal bleeding and pain. PRESSURE IS MC SX. most women are asxs, rapid growth is VERY worrisome |
| dx of fibroids? | on PE (bimanual--uterus is enlarged, firm, and irregular) |
| preferred imaging of fibroids? | US--always use! |
| tx of fibroids? | observation--pelvic exam every year and yearly sono is small. Meds (GnRH agonists-Lupron), myomectomy, hysterectomy |
| localized overgrowths of endometrial glands and stroma that project beyond the endometrium | endometrial polyps |
| bases of endometrial polyps? (2) | sessile (wide), pedunculated (narrow) |
| sxs of endometrial polyps? | most are asxs, abnormal bleeding, polyp may protrude through external os |
| dx of endometrial polyps? which is most useful? | labs (CBC, TSH, prolactin, FSH), US, SALINE SONOHYSTEROGRAM (most useful), hysteroscopy |
| tx of endometrial polyps? | surgical removal by curettage, always send for pathology |
| uterine malformation is the result of an abnormal development of the _______ ducts during embryogenesis | Mullerian |
| sxs of uterine anomalies? | amenorrhea, manual obstruction, ectopic pregnancy, recurrent miscarriage or infertility |
| uterus not present (class I) | Mullerian agenesis |
| single vagina, single cervix, single horn of uterus w/ fallopian tube | unicornuate uterus (class II) |
| both mullein ducts develop but fail to fuse | uterine didelphys (class III) |
| only the upper part of that part of the Mullerian system that forms the uterus fails to fuse ("heart-shaped" uterus) | bicornuate uterus (class IV) |
| mullerian ducts have fused by partition is still present (septum) | septate uterus (class V) |
| uterine funds displays a concave contour towards the uterine cavity | arcuate uterus (class VI)...often considered a normal variant |
| T-shaped uterus, result of exposure to DES | DES uterus (class VII) |
Created by:
rjerome09
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