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99 Cards in this Set
- Front
- Back
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The most common gynecological tumor is the
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fibroid
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Different names for fibroids include:
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myomas, leiongyomas, leiomyomata
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Fibroids are more prevelant in _____ women.
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African american
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Usually fibroids occur in _____ women.
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Premenopausal
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What % of women have fibroids?
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40%
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20& of women with fibroids are under the age of ____.
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35
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Fibroids consists of ____ ____ lobulations of _____ tissue.
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Whorled spherical, myometrial
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True or False. Fibroids distorts the uterine contour.
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True
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Fibroids arise from ____ muscle of the ____ wall.
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Smooth, uterine
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What is a fibroid encapsulated with?
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Pseudo capsule
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True or False. Fibroids are usually asymptomatic.
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True
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What are some signs of fibroids?
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Low blood pressure, constipation, pelvic pressure, and pain
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Fibroids may contribute to _____.
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Infertility
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How do fibroids cause infertility?
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They distort the fallopian tubes or endo cavity
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During pregnancy, an increase in ____ can cause tumors to grow and ____.
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Estrogen, bleed
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When pregnancy causes tumors to bleed, what is it called?
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degenerating fibroids
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What are the 4 classifications of fibroids?
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Subserosal, intramural, submucosal, and pedunculated
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Where do subserosal fibroids project from?
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The peritoneal surface of the uterus
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Subserosal fibroids may become _____ and appear as a ______.
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pedunculated, extrauterine mass
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What does pedunculated mean?
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When something develops a "stalk"
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Subserosal fibroids may ____ and cause ____.
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enlarge, pressure
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What is the most common type of fibroid?
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Intramural fibroid
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The intramural fibroid is confined to the _____.
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Myometrium
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Intramural fibroids cause _____ & _____.
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Pressure & infertility
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The least common type of fibroid is a ____ fibroid.
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Submucosal
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Submucosal fibroids are typically _____.
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Hypoechoic
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The ____ fibroids are most likely to produce symptoms.
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Submucosal
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What does the submucosal fibroid displace?
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The basalis layer of the endometrium
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The submucosal fibroid may be removed______
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Hysteroscopically
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The endometrial cavity is eroded by _____ fibroids.
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Submuscosal
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What 3 things can submucosal fibroids cause?
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Irregular bleeding, anemia, and infertility.
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____ are more echogenic than fibroids.
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Polyps
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With polyps, you may see a ____ rising from the endo.
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Pedicle
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When something is pedunculated, a ____ ____ may be seen arising from the superior _____.
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Fibrous stalk, fundus
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True or False. Sometimes the fibrous stalk cannot be visualized on US.
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True
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When looking for a pedunculated fibroid you should always look in the ____ ____, superior to the ____.
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False pelvis, fundus
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Fibroids that are very rare are ____ fibroids.
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Cervical
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Only a small % of fibroids are found in the ____.
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Cervix
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What 2 things can cervical fibroids cause?
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Obstruction of cervical OS, and interrupted fetal delivery
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Broad ligament fibroids are extremely ____.
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Rare
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What can broad ligament fibroids mimic?
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Adnexal masses
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Another name for broad ligament fibroids is...
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Extrauterine mass
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Fibroids have ____ echogenicity.
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Variable
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True or False. Fibroids can be homogeneous or heterogeneous.
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True
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Most fibroids are ____.
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Hypoechoic
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The appearance of fibroids is usually...
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Solid, well borders, and complex (degenerating)
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What is the appearance of a bulky fibroid uterus?
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Uterine enlargement w/ heterogenous myometrial echo pattern
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What does the internal echo appearance of a fibroid depend on?
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The amount of fibrous calcium in the mass
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The internal appearance of a fibroid may contain _____ & _____.
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Necrosis & cystic degeneration
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Two things that may be present in fibroids that are more common in older women include:
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Calcification & hemorrhage
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_____ makes fibroids appear more lucent and ____ than the myometrium.
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Hyalinization, hypoechoic
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The most common cause of uterine calcifications are ____.
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Fibroids
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What is the least common cause of uterine calcifications?
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Arcuate artery calcifications
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Arcuate artery calicification in the uterine periphery may indicate 3 underlying diseases. What are they?
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Diabetes, hypertension, and chronic renal failure
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A translucent product of some forms of tissue degeneration is ____.
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Hyalin
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The transformation of a substance to a glasslike/transparent state is considered to be _____.
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Hyalinized
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True or False. Fibroids range in size from microscopic to massive.
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True
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Large fibroids can displace _____ and alter the ____ contour.
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Adnexal structures, bladder
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Fibroids commonly increase the size of the ____, especially with ____ secretion.
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Uterus, estrogen
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What is the most accurate form of ultrasound for imaging fibroids?
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Transabdominal
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When measuring the uterus with fibroids, what measurements do you take?
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Longest Cx-fundus, largest AP diameter, and widest TRV diameter
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What does it mean when a fibroid is characterized as being discrete?
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It is characterized by distinct unconnected lesions
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True or False. Fibroid uterus size is typically compared with pregnancy size.
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True
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Imaging the uterus in transvagianl is sonographically useful in...
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detecting small fibroids
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When measuring discrete fibroids, always scan the _____ to see the effect it has.
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endometrium
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What would you do to find a definitive diagnosis for a submucosal mass with abnormal bleeding?
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Complete an endometrial biopsy and/or sonohysterography
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If there is rapid fibroid growth, especially in PM women, it should raise the question of ______.
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Malignancy
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Fibroids are responsible for ____% of all infertility problems.
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10%
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Fibroids near the uterine cornua may obstruct the _____ and impair _____.
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Fallopian tubes, fertilization
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What 3 things do submucosal and intramural fibroids cause?
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Recurrent miscarriages, impeded sperm flow, and inadequate implantation
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_____ fibroids may block the _____ and impede sperm flow.
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Submucosal, fallopian tubes
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Placenta implantation over a fibroid may cause ____ ____ ____.
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Poor placental perfusion
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What can poor placenta perfusion lead to?
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IUGR (intrauterine growth restriction)
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How do submucosal fibroids prevent adequate implantation?
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The impair blood supply of the endo, and disturb the structure of it
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Most submucosal fibroids lead to _____ complications.
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pregnancy
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Estrogen stimulated tumors are ____.
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fibroids
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Fibroids are _____ responsive.
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Hormonally
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What are fibroids affected by?
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BCP, pregnancy, tamoxifentherapy, menopause, HRT
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What breast cancer drug can cause growth of fibroids?
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Tamoxifen
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True or False. Fibroids rarely develop in PM women.
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True
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Fibroids _____ in size with decreasing estrogen levels but do not ____.
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Decrease, disappear
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Fibroids ____ in size with pregnancy.
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Increase
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Rapid enlargement of fibroids under the influence of ____, occur during pregnancy.
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Estrogen
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1st trimester fibroids are associated with...
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a greater chance of pregnancy loss (especially multiple fibroids)
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Large fibroids may not receive adequate ____ & may ____.
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Blood supply, degenerate
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Degenerating fibroids are very ____.
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Painful
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Some degenerating fibroids can cause ____ ____.
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Premature labor
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The sonographic appearance of a degenerating fibroid includes _____, and anechoic areas of ____ & _____.
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internal echoes, necrosis & cystic degeneration
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Doppler evaluation of a fibroid contain ____ vessels with ___ velocity flow.
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Thin, low
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True or False. Vessels are NOT seen in a degenerating fibroid.
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True
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Large pelvic masses may cause ____, so the ____ should be evaluated.
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urinary obstruction, kidneys
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To check for hydronephrosis you should scan the ____, after _____.
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Kidneys, voiding
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What are the different grades of hydronephrosis?
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Grade I (mild), Grade II (moderate), and Grade III (severe)
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____ is more sensitive than ultrasound for evaluation of fibroids.
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MRI
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What is the surgical removal of fibroids called?
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Myomectomy
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Three ways for completing a myomectomy are...
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abdominally, laparoscopic, and hysteroscopic
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Two treatments for fibroids include...
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Uterine artery embolization & hysterectomy
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Cutting off the blood supply to the fibroid is called:
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Uterine artery embolization
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What does a uterine artery embolization involve?
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Catheter inserted into uterine artery with injecting agent into arterial branches to block blood flow to fibroids
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