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67 Cards in this Set
- Front
- Back
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What are the 4 benign pelvic inflammatory conditions?
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PID, Endometritis, Endometriosis, Adenomyosis
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What is PID?
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Inflammation of Pelvic & Adnexal Structures
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What are causes of P.I.D?
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STD's (85%), Post-surgical abscess formation, IUD's, & Instrument invasion into the Endometrium.
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What are risk factors for PID?
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Early sexual Contact
Multiple Sexual partners History of STD's Menstruating women/sex during. Douching |
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What is the frequency of STD's?
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10% women; 1 million each yr.
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What are symptoms of PID?
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Intense Pelvic Pain
Vaginal Discharge (75%) Abnormal Bleeding (35%) Palpable Adnexal Mass caused by enlarged ovaries Elevated WBC's Febrile (30%) |
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P.I.D. can present as?
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Salpingitis
Hydrosalpinx Pyosalpinx |
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How is P.I.D. Spread?
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Thru' fluids surrounding pelvic organs.
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Route of transmittal for PID.
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Cervicitis, Endometritis, salpingitis
oophoritis, peritonitis |
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What has a "Chandeller sign"?
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Patient reaction to PID
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What is the most common site of PID infection?
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Fallopian Tubes
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What is sonographic appearance of PID?
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Collection of fluid or pus in the pelvic cavity.
Possible inflammatory mass or abscess. Endometritis, Salpingitis, Oophritis TOA Varies in appearance depending on infection. |
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What can chronic PID lead to?
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Loss of bowel mobility
Infertility Ectopic Pregnancy Tubo-Ovarian abscess Peritonitis, Salpingitis |
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What are the characteristics of PID?
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Salpingitis
Tubo-Ovarian Abscess (TOA) Peritonitis |
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What is Salpingitis?
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Inflammation of the fallopian tubes.
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What are causes of Salpingitis?
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PID
Endometriosis Adhesions or Scar tissue (Asherman's Syndrome) |
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What is Asherman's syndrome?
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formation of adhesions scar tissue inside the uterus;
when trauma to the endometrial lining triggers the normal wound-healing process, which causes the damaged areas to fuse together. |
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What are symptoms of Salpingitis?
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Acute/chronic pain
Possibly asymptomatic Pelvic fullness Febrile (low-grade) |
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When can the fallopian tube be seen on ultrasound?
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When f.tube is surrounded by ascites, blood, or pus.
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What is the sonographic appearance with Salpingitis?
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Tube is thick walled
Fluid in cul-de-sac Fluid in Endometrium |
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What is a Tubo-Ovarian Absess (TOA)?
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Infection of the fallopain tube and ovary.
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What occurs with a Tubo-Ovarian abscess?
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Escape of pus beyond the tube
Ovarian enlargement & adherance Loculation of pus in Ovary. Unilateral or bilateral and appears as complex mass. Creates a dirty shadow complex |
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Benign conditon that responds well to Antibiotics. No surgery is needed.
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TOA - Tubo-Ovarian Abscess
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What is a complex mass in the left Adnexa?
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Tubo-Ovarian Abscess
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Ovary appears as a complex cyst and enhancement is noted.
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TOA - Tubo-Ovarian Abscess
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Infection of the inner lining of the abdomen.
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Peritonitis
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Infection that involves the bladder, ureters, bowel, & adnexa.
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Peritonitis
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Loculated fluid seen with this infection.
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Peritonitis
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Creates poorly defined borders of all pelvic structures.
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Peritonitis
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Infection that causes fluid throughout the Pelvis.
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Peritonitis
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Infection involving the Endometrial cavity & endometrium
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Endometritis
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What are the causes of endometritis
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PID, Post-partum infection from labor, PROM, Retained POC, Invasion of instruments into endometrium, IUD's.
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Symptoms of endometritis
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Fever & intense pelvic pain
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What is found on u/s in a patient with Endometritis?
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Prominent or irregular endometrium.
Fluid within endo-, pus in cul-de-sac., enlarged ovaries, dilated fallopian tubes, gas bubbles, increased vascularity. |
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What are 2 types of endometriosis?
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Diffuse & Localized
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What is diffuse endometriosis?
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Condition women develop when functioning endometrial tissue is present outside the uterus (ectopic tissue).
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Diffuse endometritis is most commonly found on what organs?
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Ovaries, bladder, rectum, fallopian tubes, & Bowel.
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What tissue sheds & bleeds due to hormonal influences.
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Endometrial Tissue
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Menopause brings releif to this pelvic condition.
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Diffuse Endometriosis
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7-10% of women get this condition during reproductive years.
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Diffuse Endometriosis
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What are the 4 D's of Endometriosis?
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Dysmenorrhea
Dyspareunia Dysuria Dyschezia |
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What are the secondary characteristics of endometriosis?
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Infertility, Hematuria, & Bloody stools.
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What does endometriosis look like on ultrasound?
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Poorly defined pelvic cavity.
Looks like PID in appearance Only diagnosed laparoscopically. Has adhesions on ovaries, bowel, & uterus. |
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What are the 2 main things you can't see on ultrasound in pelvic cavity?
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Endometriosis & scar tissue
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What is another name for localized endometriosis?
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Chocolate cyst or endometrioma
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What are the "focal implants of endometriosis?"
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Localized Endometriosis
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What is endometrial tissue that is contained to the ovary?
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Localized endometriosis
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What contains internal hemorrhage within the ovary and is asymptomatic?
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Localized endometriosis
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Type of cyst formed when endometrial tissue grows in the ovaries.
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Endometrioma
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What is the sonographic appearance of localized endometriosis?
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Low-level echoes, enhanced, appears complex due to hemorrhage, ovary has ground glass appearance.
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Localized areas of endometrial tissue within the myometrium.
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Adenomyosis
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Myometrial "nests" or "islands" of endometrial tissue.
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Adenomyosis
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Most extensive along the posterior wall of the uterus.
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Adenomyosis
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A condition that is confined to the uterus.
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Adenomyosis
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Caused by multiple pregnancies/deliveries & abnormally high estrogen levels.
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Adenomyosis
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Pain throughout the cycle makes the uterus enlarged from this benign pelvic disorder.
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Adenomyosis
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Symptoms of Adenomyosis
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Dysmenorrhea
Uterine enlargement Abnormal bleeding Pain throughout cycle |
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ultrasound appearance of Anenomyosis
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Symetrically enlarged uterus
Myometrial cyst Inhomogeneous areas within the myometrium. |
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Benign pelvic condition that looks similar to an atropied fibroid in the uterus.
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Adenomyosis
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Not confined to the uterus
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Endometriosis
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Normal sized uterus
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Endometriosis
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Pain occurs during menstruation with this condition.
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Endometriosis
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Condition that's confined to the Uterus
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Adenomyosis
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"Enlarged Uterus"
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Adenomyosis
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Creates pain throughout a cycle with no releif.
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Adenomyosis
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Put blood flow on the uterus to make sure it's a cyst and not arcuate vessels.
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Adenomyosis
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Differential diagnosis for Adenomyosis?
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Fibroids
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