Pelvic Scan Documentation & Benign Uterine Pathology

Front 1

"Exophytic" or "pedicle" and arises from a stalk.

Back 1

Pedunculated Fibroid.

Front 2

Fibroid that can mimic an Adnexal mass and have to make sure its not an ovarian mass.

Back 2

Pedunculated Fibroid

Hint 2

**Look at Adnexal area.

Front 3

Fibroid that hangs off the edge and will move with the uterus; Must see connection with uterus with blood flow.

Back 3

Pedunculated Fibroid

Front 4

A.k.a. "Myometrial" Located in the most common location for a fibroid, the Myometrium.

Back 4

Intramural Fibroids

Front 5

Aysmptomatic fibroid and looks like a cluster of grapes

Back 5

Intramural Fibroid

Front 6

Fibroid lying directly beneath the endometrium and often projecting into the cavity.

Back 6

Submucosal Fibroid

Front 7

Symptoms of fibroid: Menorrhagia, Dysmenorrhea, & PMB.

Back 7

Submucosal & Intracavitary fibroids

Front 8

Fibroid that may lead to Anemia and affect fertility

Back 8

Submucosal Fibroid

Front 9

True or False: If there are no fibroids in the endometrial cavity they will be Aymptomatic.

Back 9

True

Front 10

Fibroid originating from and lying entirely in the endometrium.

Back 10

Intracavitary Fibroid

Front 11

Easiest Fibroid to remove by Myomectomy. Can do a DNC and no cutting is involved.

Back 11

Intracavitary Fibroid

Front 12

Fibroid that feels like having "labor pains".

Back 12

Intracavitary Fibroids.

Front 13

Fibroid that's located close to the outer, peritoneal surface of the Uterus.

Back 13

Subserosal Fibroid

Front 14

Fibroid that can cause pain & pressure against adjacent fibroids.

Back 14

Subserosal Fibroids

Front 15

Fibroids within the round or broad ligaments

Back 15

Interligamentous Fibroids.

Front 16

What are characteristics of a fibroid?

Back 16

Leiomyolipoma , Calcification (Hyaline degeneration), & degeneration.

Front 17

What is Leiomyolipoma?

Back 17

A fatty fibroid.

Front 18

What is a fibroid that calcifies?

Back 18

Hyaline degeneration

Front 19

What happens when a fibroid degenerates?

Back 19

The mass outgrows its blood supply, necrosis takes place, causes pain, complex/cystic areas develop, may contain calcifications w/in.

Front 20

What is Leiomyosarcoma?

Back 20

A malignant degeneration of a fibroid.

Hint 20

Very rare (.2%), very rapid growth in post-men women.,

Front 21

What are treatments for fibroids?

Back 21

Myomectomy, Hysterectomy, Angiographic embolization, Observation for growth.

Front 22

What is Endometrial Hyperplasia

Back 22

Excessive thickening of the endometrial tissue or proliferation of the Endometrial tissue.

Front 23

What does proliferation mean?

Back 23

Cells multiplying and growing

Front 24

What are causes of Endometrial Hyperplasia?

Back 24

Unopposed Estrogen & Tamoxifen Therapy

Front 25

When is unopposed estrogen used?

Back 25

Women who have had an oophorectomy or are postmenopausal.

Front 26

What is a common cause for DUB & PMB & Endometrial cancer?

Back 26

Unopposed Estrogen

Front 27

When is Tamoxifen Therapy used & what is it?

Back 27

Used in postmenopausal pts w/breast CA., It's a hormonal drug that stim. the endo- so patients are more prone to endo polyps, fibroids, CA.

Front 28

What is the diagnosis for Endometrial Hyperplasia?

Back 28

When endometrial msmt is greater then 14mm in premen & post-menopausal women on HRT, and if >8mm in post-menopausal women not on HRT.

Front 29

Clincal symptom of Endometrial Hyperplasia?

Back 29

Irregular bleeding

Front 30

What is the differential diagnosis for Endometrial Hyperplasia?

Back 30

Early Intrauterine pregnancy, Secretory Endometrium, Estrogen replacement therapy, Endo- polyps or fibroids, Endo CA.

Front 31

What are Endometrial Polyps?

Back 31

A mass attached to the endometrial cavity by a stem or pedicle.

Hint 31

Made up of endometrial tissue covered by epithelium. Peak age 40-49. Hyperechoic area in endo-

Front 32

What is the ultrasound appearance of Endometrial polyps?

Back 32

Hyperechoic areas w/in endo-, indistinguishable for endo- hyperplasia, irregular endo- contour seen after menses.

Front 33

Contain a "feeder vessel" which provides blood supply to this pelvic anomoly?

Back 33

Endometrial Polyps

Hint 33

Fibroids don't have this characteristic.

Front 34

What is Sonohysterography?

Back 34

Used for confirmation of endometrial polyps or fibroids.

Hint 34

Saline is infused into the endometrium using a cathater thats passed thru cervical canal under u/s guidance. 97% effective in diagnosis.

Front 35

T or F: Polyps have more color going into them then Fibroids?

Back 35

False. Fibroids are made of muscle so they will have more color on them.

Front 36

T or F: Fibroids are more hypoechoic then Polyps?

Back 36

True. Polyps are more Hyperechoic.

Front 37

A.k.a. "inclusion" or "Retention" cyst

Back 37

Nabothian Cyst

Front 38

What are characteristics of a mass documentation?

Back 38

Landmarks, measurement, characteristics.

Front 39

Characteristics that should be included in documentation of a mass:

Back 39

Mass contour and echotexture, sound transmission, solid/liquid, septations within?, Nodularity present? (excrescence), Mobile?,

Front 40

What are type of probe is used for TAS?

Back 40

3.5-5.0Mhz Curved Linear Array Transducer

Front 41

What type of probe is used for TVS?

Back 41

5.0-13.0MHz endocavitary transducer.

Front 42

Advantages for using TAS

Back 42

Panoramic view

Front 43

Advantages for using TAS

Back 43

Displacement of bowel

Front 44

Advantages for using TAS

Back 44

patients of all ages

Front 45

Advantages for using TAS

Back 45

can see mid-abdominal pathology

Front 46

Advantages for using TAS

Back 46

better visualization

Front 47

Advantages for using TAS

Back 47

Full bladder technique

Front 48

Advantages for using TAS

Back 48

Wider field of view

Front 49

Advantages for using TAS

Back 49

More accurate measurements

Front 50

Disadvantages for using TAS

Back 50

Adnexal structures difficult to visualize

Front 51

Disadvantages for using TAS

Back 51

Bowel/colon/recutum can mimic a mass

Front 52

Disadvantages for using TAS

Back 52

Fine detail of masses cannot be delineated

Front 53

Disadvantages for using TAS

Back 53

uncomfortable prep

Front 54

Disadvantages for using TAS

Back 54

large patient size is limiting

Front 55

Disadvantages for using TAS

Back 55

Limited visualization of retroverted or retroflexed uterus

Front 56

What are Indications for doing Transvaginal Sonography (TVS)?

Back 56

Gynecological survey, 1st trimester pregnancy, Suspected Ectopic, Emergent situation, Intrauterine pathology, Fertility studies, difficulting obtaining TAS images.

Front 57

What type of procedure do you use gluteraldehyde disinfectant for?

Back 57

TVS

Front 58

TVS Advantages

Back 58

Resolution is greatly improved

Front 59

TVS Advantages

Back 59

More specific information

Front 60

TVS Advantages

Back 60

No exam prep needed -- bladder does not need to be full.

Front 61

TVS Disadvantages

Back 61

Narrow or stenotic cervix

Front 62

TVS Disadvantages

Back 62

Obesity, limited probe manipulation

Front 63

TVS Disadvantages

Back 63

May be difficult to tolerate due to level of pain

Front 64

TVS Disadvantages

Back 64

pelvic masses >10cm may be difficult to visualize

Front 65

TVS Disadvantages

Back 65

Limited visualization of retroverted or retroflexed uterus

Front 66

TVS Disadvantages

Back 66

May be limiting due to patient age (premenarchal/ postmenopausal)