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72 Cards in this Set
- Front
- Back
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what do leiomyosarcomas look like sonographically?
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-same as a fibroid
-possible cystic degeneration clinical enlargement of mass |
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when are cysts seen in the endometrium?
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-cystic atrophy
-cystic hyperplasia -endometrail polyps -endometrial CA -GTD -Tomaxifen therapy |
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when do the uterovaginal ducts obtan lumens?
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7-12 weeks
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name the 6 sonographic features of leiomyomas
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-globular
-localized-hypo, heterogenous -distortion of uterine wall -attenuation of sound -old fibroids have calcified walls -degeneration/necrosis |
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what does an endometrial hyperplasia look like sonographicallY?
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-abnormal thickening of the echogenic encometrium
-post menopausal vaginal bleeding |
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if someone is having acute localized pain, what are some diff dx?
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-ovarian torsion
-torsion of a pedunculated fibroid -ectopic pregnancy -appendicitis or other GI pathology |
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if a postmenopausal female is having pelvic pain, what are some diff. dx?
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-infection
-uterine/ovarian neoplasm |
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the most common finding seen frequently in middle aged women is what?
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nabothian cysts
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nabothian cyst
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benign tiny cysts within the cervix
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why, with congenital uterine anomolies, is there an increased rate of miscarriage and preterm dellivery?
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-increased weakness of cervcal muscles
-decreased intrauterine space -decreased vascularity of placental implantation site -septate uterus associated with 1, 2nd trimester loss. -congenital anomolies associated with uterine rupture |
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cervical cancer
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-affects menstral age women
-associated with: -early sex encounters -multiple sex partners -exposure to herpes2 -usually affects squamus cells |
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intrauterine synechiae
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found in women with posttraumatic history(curretage, and/or infertility)
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what is the cause and presentation of adenomyosis?
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cause:
multiple pregnancies, or rough curettage presentation: utering enlargement, menorrhagia, and/or dysmenorrhea |
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perforation of IUCD
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IUCD becoes embeddded in thebsuperficial layers of the mycometrium; may lead to fibrosis
-partial perforation occurs when a portion of the device remains in the myometrium |
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name and explain some different types of IUCD's
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Lippes loop and Saf T- Coil:
-poyethylene; appears as 5 echogenic dots longitudinally Copper 7 and Copper T: -Releases copper from a wire; effective for 10 yrs Progestasert: core of preogesterone that is released over time -must be replaced every year |
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what is the only reason for myometrial cysts?
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adenomyosis(usually in 35-50 yr olds) not affected by patients' cycle
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what are the pelvic findings that may be influenced by tomoxafin therapy?
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-thickened endometrium
-endometrial polyps -endometrial CA -endometrial cystic hyperplasia |
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ectocervix
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a portion of the canal of the uterine cervix that is lined with squamous epithelium
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what is the clinical presentation of endometriosis?
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-dysmenorrhea
-dysmarunia -infertility -pain 24-48 hrs before menstration -normal uterus |
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if a prepubertal female is having pelvic pain, what are some diff. diagnosis?
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-pelvic mass
-urinary tract infection -imperforate hypmen/cryptomenorrhea |
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what are the risks of IUCD usage?
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-with pregnancy increases spontaneous abortion
-removal may initiate abortion -ncreases risk of ectopic pregnancy -increased risk of preterm labor |
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what are the risk factors for adenomyosis?
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trauma:
-childbirth -uterine instrumentation -chronic endometritis -hyperestrogenism |
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diff. dx for dysmenorrhea?
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-endometriosis
-salpingoophoritis -acute uterine retroersion |
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diff. dx for dyspareunia
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-endometriosis
-PID |
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what are the congenital and acquired causes of hydrometrocolpos and hydrometra?
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CONGENITAL:
-imperforate hymen -vaginal septum -vaginal atresia -rudimentery uterine horn ACQUIRED: -endo/cervical tumors post radiation fibrosis |
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IUCD
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-placed in the uterine cavity providing a hostile environment which discourages implantation by producing an inflammatory response
-WBC's are produced which are toxic to sperm -ovulation not impared |
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causes of secondary cervical stenosis?
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-cervical carcinoma
-radiation therapy -cone biopsy -post menopausal cervical atrophy |
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how big are endometriomas usually? when do they most often occur?
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2-6cm in size, occur with multiple sex partners, and in reproductive age women
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what does adenomyoisis look like sonographically?
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-thickening and asymmetry of the myoetrial walls
-diffuse or focal -heterogenous areas -myometrial cysts may be present-bulky uterus -swiss cheese or honey comb appeaence. -most extensive on posterior mortion of the uterus |
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most common presenting symptoms of adenomyosis?
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-uterine enlargement
-pelvic pain -dysmenorrhea -menorrhea |
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endometrial polyps
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-occur in 10% of women
-perimenopausal women -adenomatous endometrial tissue -usually asymptomatic but may present with bleeding |
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what is the sonographic appearence of mucinous cystadenoma and cystadenocarcinoma?
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-shaggy appearence
-cystic mass w/multiple septa -septa thicker than serous -may contain papillary bodies -possible ascites - |
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cystadenocarcinoma
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type of ovarian cancer to do with surface epithelial stroma tumor
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endometriosis facts
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-most common among young reproductive women
-symptoms decrease w/ pregnancy and in postmenopausal years -can cause fixed retroversion of the uterus -usually a bilateral disease -diffuse or focal |
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arrenoblastoma: what is it, when does it occur, what is the clinical appearence?
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-sertoli-leydig tumor/androblastoma
-"sir" or"andro"=masculinizing -25-45 yrs. -ammenorrhea dn infertility |
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mucinous cystadenoma
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multilocular, usually benign, tumor produced by ovarian epithelial cells and having mucin-filled cavities
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serous cystadenocarcinoma
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-malignant
-multilocular -90% of ovarian cancers -may contain debris -up to 20 cm - |
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what is the most common malignant neoplasm of childhood?
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DYSGERMINOMA:
-ages 10-30 -rapidly growing -metastatic spread via the lymph system -highly radiosensitive |
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fitz hugh curtis syndrome
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extrapelvic manifestation of RUQ pain from perihepatitis
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what is the clinical and sonographic appearence of pyosalpinx?
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CLINICALLY:
-febrile -pelvic pain SONOGRAPHIC: --internal echos in tubes(may require EV) -thick irregular walls -area sensitive to ev exam. |
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what is the clinical and songoraphic appearance of hydrosalpnx?
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CLINICAL:
-colicky pain -asymptomatic-incidental finding -B-hCG useful to differentiate from ectopic SONOGRAPHICALLY: -anechoic fluid filled tube that is enlarged and fusiform(sausage shaped) -uni/biateral -tube normally tapers where it enters uterus and enlarges distally. |
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what is teh clinical and sonographic appearance of thecomas?
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clinical: pelvic pain, and presssure symptoms
sonographic: same and fibroma |
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what is a theca lutein cyst, and what are the symptoms of it?
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-cuased by increase b-hCG
-multiple cysts which means enlarged ovaries(up to 20cm) Symptoms: Nausea and vommitting |
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when ovarian masses occur in the monopausal age group?
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-theocma
-fibroma -ovarian CA |
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acute PID
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-fuzzy outline of the uterus
-bilateral adnexal masses -clinical symptoms of uterus and ovaries feel fixed due to adhesions and fivrosis formation in pelvis |
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what is ovarian carcinoma? what are the clinical symptoms of it?
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-disease that whispers
-postmenopausal -high mortality rate due to late detection -95% epithelial origin CLINICALLY: -vague abdominal pain or discomfort -bloating -urinary frequency -constipation -weight change-ascites -asymptomatic |
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chronic salpingitis
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-sereial incidents of falllopian tube inflammation
-tubal ostium may bo obliterated -peritoneal adheasion that devolop may cause tubal occlusion -associated w/ infertility and ectopic pregnancy -diagnosed w/ hysterosalpingofraphy or sonogysterography |
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brenner tumor and sonographic appearance
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-uncommon
-solid -epithelial -2% of neoplasms -over 40 age group -estogenic-present w/ irregular bleeding -rare assoc w/ meig's syndrome -echogenic mass w/ small cystic spaces |
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dermoids
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-unilateral
-reproductibve age -benign -contain hair, fat, teeth, bone -superior to fundus -usually benign, but have malignant potential, and can mimic other malignant patholigy, aso are surgically removed. |
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what is ovarian carcinoma? what are the clinical symptoms of it?
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-disease that whispers
-postmenopausal -high mortality rate due to late detection -95% epithelial origin CLINICALLY: -vague abdominal pain or discomfort -bloating -urinary frequency -constipation -weight change-ascites -asymptomatic |
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thecoma
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-benign, solid unilateral mass
--menopausal and post menopausal -estrogen producing -unilateral |
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what is the clinical presentation, and sonographic appearence of ovarian torsion?
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Clinical:
-acute unilateral pain-RLQ pain may mimic appendicitis -nausea -vomiting -palpable adnexal mass SONOGRAPHICALLY: -absent or decreased blood flow -dialated vessels along rim -free fluid in cul de sace -surgical emergency |
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focal calcification
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-stroma reaction due to infection or hemorrage
-benign -a calcification may be in the inital or early manifestation of a neoplasm, so follow up is necessary |
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PID stages
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EDOMETRITIS:
-thich heterogenous endometrium -fluid in endometrial canal STAGE 2-SALPINGITIS: -tubular shaped distension -cogwheel sign -acute or chronic -hydro, hemato, pyosalpinx STage3:tubo-ovarian abscess: -usually bilateral -pyosalpinx and adhesions and fixed pelvic peritonitis -fitz hugh curtis syndrome |
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sonographic dysgerminoma
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-solid homogenous and irregular definition
-foci of necrosis and cystic degeneration -radiosensitive -remove ovary -female seminto male - |
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common malignant tumor of childhood
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DYSGERMINOMA:
-ages 10-30 -rapidly growing -metastatic spread via the lymph system -highly radiosensitive |
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serous cystadenocarcinoma
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-malignant
-multilocular -90% of ovarian cancers -may contain debris -up to 20 cm - |
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abnormal pouch of douglas fluid
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-ascites
-ruptured ectopic -ruptured cyst; hemorrhagic cyst -clinical signs of infection |
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what dp androblastomas look like songraphically? what is a differential diagnosis for them?
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SONOGRAPHICALLY:
-solid w/ cystic components -lobulated -encapsulated -2-30 cm in size -unilateral DIFF DX: fibroid(need to distinguish origin) |
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arrenoblastoma: what is it, when does it occur, what is the clinical appearence?
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-sertoli-leydig tumor/androblastoma
-"sir" or"andro"=masculinizing -25-45 yrs. -ammenorrhea dn infertility |
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what are the types of sex cord stromal tumors? what sets them apart from other ovarian neoplasms?
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-fibroma
-thecoma -granulosa cell tumor -sertoli leydig tumor(arrenoblastoma) -meigs syndrome (all solid) |
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What are theca lutein cysts associated with, and what is the sonographic appearence of them?
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ASSOCIATED WITH:
-GTD- -ovarian hyperstimulation due to infertility drugs -RH incompatibility -multiple pregnancies -diabetes SONOGRAPHIC: --bilateral -multilocular cysts -thin walled -large |
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pseudomyxoma peritoni
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-associated w/ mucin producing tumors of the bowel and mucinous cystadenoma and cystadenocarcinoma
-produce thick gelatin material -metastatic implants may present as thick, solid mass adjacent to the adominal wall and bowel. -other implants may appear on the peritnela surface as focal echogenic implants. |
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PID risk factors
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-infection and inflammation of reproductive organs and peritoneal surfaces
-usually retrograde source -risk factors: -increases sexual activity IUCD users, smoking |
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what pelvic diseases are bilateral?
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(steps)+CA
s-stein-leventhal(PCOS) t-theca lutein cysts e-endomtetriosis p-PID s-salpigitis mets-krukenberg ovarian CA |
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what are the cliical symptoms of acute and chronic TOA? what is the sonographic appearence of it?
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ACUTE:
-nausea -vomitting -abdominal pain -leukocytosis -fever, chills -abdominal distension -high erythrocyte sedimentation rate(ES) CHRONIC: -asymptomatic -vaguly symptomatic SONOGRAPHICALLY: -loculations w/ irregular borders |
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what is the clinical presentation, and sonographic appearence of polycystic ovarian disease?
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clinically:
-hirsuitism -obesity -infertility -oligomenorrhea SONOGRAPHIC: -normal or enlarged ovaries>12.5 -bilateral -multiple tiny cysts(string of pearl sign) -absence of dominant follicle |
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what is a theca lutein cyst, and what are the symptoms of it?
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-cuased by increase b-hCG
-multiple cysts which means enlarged ovaries(up to 20cm) Symptoms: Nausea and vommitting |
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what is the clinical and songoraphic appearance of hydrosalpnx?
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CLINICAL:
-colicky pain -asymptomatic-incidental finding -B-hCG useful to differentiate from ectopic SONOGRAPHICALLY: -anechoic fluid filled tube that is enlarged and fusiform(sausage shaped) -uni/biateral -tube normally tapers where it enters uterus and enlarges distally. |
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dysgerminoma
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-rare
-malignant -young people(10-30) -unilateral -rapid growth -spred by: -rupture of capsul;e -peritoneal spread -lyphatic routes |
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PCOS
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-follicles located on the periphery of a 20-30yr old
-benign -Dysfunctional hormone cycles -increased blood levels of LH/FSH -25% will have normal appearing ovaries |
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TOA
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tubo-ovarioan abscess:
-pus from fallopin tube communicates w/ ovary -gonorrheal or nonvenereal -sucessful treatment w/ antibiotic therapy |
