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26 Cards in this Set
- Front
- Back
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1. From what do anatomic anomalies of the uterus result?
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a. From problems in the fusion f the paramesonephric (mullerian) ducts.
b. Therefore, they are often associated w/urinary tract anomalies and inguinal hernias. |
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2. Symptoms of anatomic anomalies of the uterus?
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a. Amenorrhea
b. Dysmenorrhea c. Cyclic pelvic pain d. Infertility e. Recurrent pregnancy loss f. Premature labour |
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3. How are anatomic anomalies of the uterus diagnosed?
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a. PE
b. Pelvic U/S c. CT d. MRI e. Hysterosalpingogram f. Hysteroscopy g. Laparoscopy |
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4. Tx of septated uteri and bicornuate uteri if symptomatic?
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a. Surgery
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5. Fibroid pathophys?
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a. Fibroids are benign, oestrogen-sensitive, smooth muscle tumours of unclear aetiology found in 20-30% of reproductive-aged women.
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6. What culture has the highest incidence of fibroids?
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a. Black women. 3-9x higher than white, asia, and hispanic women.
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7. Risks for fibroids?
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a. Black
b. Obesity c. Non-smoking d. Perimenopausal women. |
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8. Location of fibroids?
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a. Submucosal
b. Intramural c. Subserosal. |
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9. Fibroids in pregnancy?
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a. In pregnancy they can grow to great size.
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10. Sx of fibroids?
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a. Asymptomatic in 50-65% of pts.
b. When symptomatic, they can cause: 1. heavy or prolonged bleeding (most common) 2. Pressure 3. Pain 4. Infertility (rare) |
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11. How are fibroids typically diagnosed?
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a. Pelvic U/S
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12. Tx of fibroids (most require no tx)?
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a. Temporarily w/:
1. Provera or 2. Danazol or 3. GnRH analogues to decrease oestrogen and shrink the tumours. b. Myomectomy to resect them when future fertility is desired. |
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13. Definitive tx of fibroids?
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a. Hysterectomy in case of severe pain, when large or multiple, when causing urinary symptoms, or when evidencing postmenopausal or rapid growth.
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14. Sx of endometrial hyperplasia?
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a. A common cause of abnormal uterine bleeding.
b. Linked to endometrial cancer. c. If left untreated, endometrial hyperplasia can progress to endometrial carcinoma. |
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15. Risk factors for endometrial hyperplasia?
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a. Unopposed oestrogen exposure. Excess oestrogen w/o progesterone i.e. some birth control or in fat women (aromatization of androgens to oestrogen by adipose).
b. Both HTN and DM are independent risk factors for endometrial hyperplasia. |
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16. 4 classifications of endometrial hyperplasia?
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1. Simple hyperplasia (1% risk of progression to endometrial cancer)
2. Complex hyperplasia (3% risk of progression to endometrial cancer) 3. Atypical simple hyperplasia (8% risk of progression to endometrial cancer) 4. Atypical complex hyperplasia (29% risk of progression to endometrial cancer |
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17. Simple endometrial hyperplasia?
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a. Simplest form.
b. Represent an abnormal proliferation of both the stroma and glandual endometrial elements. |
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18. Complex endometrial hyperplasia?
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a. Consists of abnormal proliferation of the glandular endometrial elements w/o proliferation of the stromal elements.
b. In these lesions, the glands are crowded in a back-to-back fashion and are of varying shapes and sizes, but NO cytologic atypia is present. |
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19. Atypical simple endometrial hyperplasia?
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a. Involves cellular atypia and mitotic figures in addition to glandular crowding and complexity.
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20. Atypical complex hyperplasia?
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a. Most severe form of endometrial hyperplasia.
b. Progresses to carcinoma in approximately 29% of untreated cases. |
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21. In whom does endometrial hyperplasia typically occur?
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a. In the menopausal or perimenopausal woman, but may also occur in premenopausal women who have prolonged oligomenorrhea and/or are fat.
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22. Sx of Endometrial hyperplasia?
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a. Typically have long periods of oligomenorrhea or amenorrhea followed by
b. Irregular or excessive uterine bleeding. |
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23. Note: uterine bleeding in a postmenopausal woman should raise high suspicion of endometrial hyperplasia or carcinoma.
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23. Note: uterine bleeding in a postmenopausal woman should raise high suspicion of endometrial hyperplasia or carcinoma.
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24. How is endometrial hyperplasia diagnosed?
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a. By endometrial biopsy or D&C.
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25. Tx of endometrial hyperplasia?
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a. It is usually treated medically w/progestin therapy
b. Followed by resampling of the endometrium. |
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26. Tx of Endometrial hyperplasia when its atypical complex?
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a. Hysterectomy bc of 29% risk of progression to endometrial cancer.
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