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11 Cards in this Set
- Front
- Back
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Define: Endometriosis
-definition -sx -theories (3) about how it travels |
The presence of endometrial tissue outside the endometrial cavity,.
endometriosis disrupts normal tissue, forms adhesions and fibrosis, and causes inflammation and pain. 1) lymphatic spread 2) retrograde menstruation 3) multipotent peritoneal cells that undergo metaplastic transformation |
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Describe the clinical sx of endometriosis in detailed chronology
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pain starts getting bad 1-2 weeks before menses, peaks 1-2 days before onset, then subsides after onset of flow.
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Besides cyclic pain (dysmenorrhea), what are some other clincal sx to look for w/ endometriosis?
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-dyspareunia
-infertility |
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How do you make a dx of endometriosis?
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Surgical exploration. the physical exam findings are essentially nonexistent. You have to directly visualize the tissue w/ laparoscopy
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Discuss the different treatment options for endometriosis
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1) Medical: give progesterone/OCPs to induce a state of pregnancy and stop ovulation. Note that this is temporary and not actually a cure. Also can give leuprolide to reduce GnRH pulsatile secretions and inhibit FSH and LH, which inhibits estrogen, which is what stimulates the implants.
2) Surgical treatment. You can either have the implants themselves removed while keeping uterus and ovaries. if you don't want to have any more kids, you can have a hysterectomy. |
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Define: adenomyosis
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invasion of the endometrial tissue into the myometrium that leads to menorrhagia or metromenorrhagia
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Define: endometrioma
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a cystic collection of endometrial cells on the ovary known as a "chocolate cyst"
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Why does the uterus feel "boggy" with adenomyosis?
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Because adenomyosis can also present as adenomyomas, collections of smcs and endometrial glands and stroma that grow in the myometrium or into the endometrial cavity. However, since there is no capsue, they can infiltrate throughout the myometrium, disrupting the muscular tone and giving it a boggy feeling!
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Describe how the uterus feels in fibroids vs. adenomyosis
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fibroids: rubbery, firm uterus
adenomyosis: diffusely enlarged, globular, boggy, soft |
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What is the tx for adenomyosis? What is the dx for adenomyosis?
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Hysterectomy is the only definitive means of diagnosis and treatmnet!
Do and EMB to rule out endometrial hyperplasia/carcinoma |
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A patient who is suspected of having endometriosis talks to you about treatment options. she wants kids. what do you say?
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There is no role for medical management in pts trying to conceive because medical tx's involve inducing an infertility state.
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