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gyn-benign uterine

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