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94 Cards in this Set
- Front
- Back
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What is a fibroid
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Benign tumor of uterine smooth muscle
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Fibroid Types
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Submucosal
Intramural Subserosal Peduncluated |
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Intramural
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Deforming the myometrium
Most Common |
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Sunmucosal
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Erode into the Endometrial cavity
Least Common but most likely to produce symptoms |
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Subserosal
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Lay on edge of uterus most likely to become pedunculated
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Pedunculated
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Asymptomatic can cause pressure on adjacent organs
Can twist at their stalk |
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Cervical Myomas
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Rare, can obstruct internal OS
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Broad Ligaments
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Very Rare, mimics other adnexal masses
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Fibroid %
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25-50%
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Fibroids most frequent ages
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30-40
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Asymptomatic %
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10-30
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Most common tumor of pelvis
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Fibroid
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Fibroids increase
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Uterine size , especially with estrogen stimulation
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Infertility problem % with Fibroids
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10
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Fibroid Symptoms
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Heavier menstrual clots, anemia , pain, pressure, feeling full, abdomen or back pain, frequent urination or constipation, infertility or miscarriage
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Fibroid classic appearance
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Hypoechoic, homogenous, well-defined
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Internal echoes in fibroids caused by
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calcium content
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Anechoic areas in fibroids caused by
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necrosis, cystic degeneration
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Calcification and hemorrhage present in
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older women
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Fibroid vascularity
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predictor of growth
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Fibroid Treatment
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Hormonal therapy
Hysterectomy or Myomectomy Embolization -PVA |
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adenomyosis
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endometrial tissue lie within the myometrium
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adenomyosis aka
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Internal Endometriosis
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Adenomyosis coexist with
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External endometriosis
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External Endometriosis
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Endometrial tissue located outside the uterus
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Clinical symptoms for a patient with AAA
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back pain, pulsatite mass, burit, incidental
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Adenomyosis bleeds
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and blood accumulates in glands creating small fluid collections inside the uterine wall
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Endometrial tissue may lead to
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Swelling--> uterus becomes larger and globular
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Most commonly adenomyosis is mistaken for
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Uterine fibroids
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Adenomyosis Symptoms
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Asymptomatic
Triad- uterine enlargement, pelvic pain and heavy menstrual bleeding |
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Adenomyosis diagnosed by
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hysterosalpinogram
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Leimyosarcoma
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Rare cancerous tumor of the smooth muscle cells
Soft tissue carcinoma attacks the fat and muscle celsl |
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Leiomyosarcoma commonality
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Extremely uncommon
7/ 1 million |
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How is Leiomyosarcoma usually discovered
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Enlargement of uterus after menopause
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Leiomyosarcoma appears
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cystic degeneration within inhomogenous uterine mass
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Gartners duct cyst
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develop in the space occupied by gartner's duct on side walls of vagina
this duct usually disappears after birth |
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Nabothian cyst
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Most common cervical finding
results from chronic cervicitis in middle aged women |
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Nbothian cyst appearance
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cystic and multiple
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cervix polyps
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Projectile growth originating from the mucosal surface of the cervix
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Cause of cervix polyps
seen in ? |
infections
in women over 20 who had children |
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cervical stenosis
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partial or total narrowing of the cervix which can lead to obstruction in areal of internal OS |
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Cervical carcinoma begins
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in the lining of the cervix
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Most common cervical ca
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squamous cell
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cervical ca appearance
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bulky cervix may invade bladder
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Proliferative endometrium size
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2-6mm
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Periovulatory Endometrium size
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6-8mm
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Secretory Endometrium size
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8-15mmFalse
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Pre
Post Hormone replacement Endo size |
15mm
8mm 15mm |
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Endometrial Hyperplasia
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endometrium becomes thickened
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Hyperplasia linked to
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Too much estrogen, or imbalance of estrogen and progesterone
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Hyperplasia most common symptom
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Bleeding pre and post menopausal
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Hyperplasia sono appearance
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focal or diffuse endometrial thickening
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Endometrial hyperplasia treatment
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oral contraceptives/ D and C
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Endometrial polyps
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Overgrowth of endometrial tissue in the uterus
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Eendometrial polyps common in what age
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in menopause
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Endometristis occurs
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post partum
after surgical procedure |
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Endometristis appearance
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irregular prominent endometrium
fluid in cavity/ gas |
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Endometrial adhesions caused by
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trauma or surgery
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Endometrial Adhesions
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bridging band that distorts the cavity/ thin membranes
difficult to detect without fluid in cavity |
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Endometrial carinoma common during
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postmenopausal years 80%
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Endometrial carcinoma associated with
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Estrogen stimulation
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Most common endometral carcinoma
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Adenocarcinoma
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Endometrial carcinoma Stages
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1- confined to endometrium
2- spread to cervix 3- outside the uterus but within pelvis 4- outside the pelvis |
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Endometriosis
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endometrial tissue grows outside the uterus and attaches to other organs in the abdominal cavity such as ovaries and fallopian tubes
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Most common cause of pelvic pain
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Endometriosis
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Endometriosis %
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2-10% of women of reproductive age
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endometriomas
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implants can form endometrial cysts and may progress to become larger in size
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Endometriomas are filled with
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"chocolate cysts"
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Endometriomas burst
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material spills into pelvis and adhesions develop
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Most common way to diagnose endometriosis
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laparoscopy
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PID results from
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ascending microorganisms from vagina and cervix
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Second most serious complication of STD
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pid
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PID is a spectrum of
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infections
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Most frequent infection in women
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PID
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Ectopic pregnancy rates in women with PID
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12-15% HIGHERTrue
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Tubal occlusion occurs at a rate
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12-50%
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Chronic pelvic pain incidence in women with PID
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18%
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Symptoms of PID
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bilateral lower abdominal pain
vaginal discharge irregular bleeding lower abdomen tender |
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pPID appearance
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pelvic margins obliterated
fluid in cul-de-sac increased vascularity |
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Endometritis occurs
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Post partum
after instrumentation invasion |
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Endometritis appearance
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thickening or fluid in the endometrium
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Stones in cbd |
Choledochalithiasis |
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Salpingitis
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can be acute chronic or subacute
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Salpingitis appearance
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Dialated fallopian tubes
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Pyosalpinx
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fallopian tube is swollen and filled with material
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Pyogalpinx appearance
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enlarged irregular sausage shaped walls are thickened
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Hydrosalphinx
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material within the pyosalpinx may gradually liquefy and become serous in content
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hydrosalphinx appearance
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sausage shaped with thin walls
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Tubo-ovarian abscess
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Severe form of PID that invloves the ovary and fallopian tube on one or both sides
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Tubo-ovarian abscess appearance
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complex, multiloculated
margins poorly defined patient extremely tender |
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Peritonitis
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Involvement of the bladder, ureter and or bowel
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Peritonitis appearance
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gas bubbles within abscess from bowel
loculated areas of fluid |
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oophoritis
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enlarged ovaries with ill defined margins
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TOA
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thick walled masses with low signal intensity
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