Chapter 41: study guide
In a post-hysterectomy patient, the normal vaginal cuff should not exceed ______ centimeters (cm).
2.1
What sonographic characteristic is the most common finding in the endometrial carcinoma?
Abnormal thickening of the endometrial cavity, usually with irregular bleeding in perimenopausal and postmenopausal women.
What is a benign disease that is commonly diffuse, an ectopic occurrence of endometrial tissue and cause a thickened uterine wall?
Adenomyosis.
The size and shape of the normal uterus is related to?
Age, hormonal status, and parity
Patients on tamoxifen therapy have an increased risk of?
An increased risk of endometrial carcinoma, hyperplasia, and polyps has been reported in patients on tamoxifen therapy.
What is AVM and what does it mean? How do AVM's come to be and where do they usually form?
Arteriovenous malformation. A vascular plexus of arteries and veins without an intervening capillary network. AVM's usually form from sort of trauma in the uterus. AVM's usually form in the myometrium.
What 3 ways can adenomyosis be classified?
Asymmetric, symmetric, and focal.
How are AVM and D&C related?
Dilation and curettage may lead to catastrophe hemorrhage.
What is D&C and what does it mean?
Dilation and curettage. Scraping with a curet to remove the contents of the uterus, as is done following inevitable or incomplete abortion, to produce abortion, to obtain specimens for use in diagnosis, and to remove growths, such as polyps.
Adenomyosis is a the ectopic?
Occurrence of endometrial tissue within the myometrium and is more common in the posterior aspect.
What are the clinal signs and the sonographic findings in endometrial hyperplasia?
Patients can be asymptomatic, have uterine bleeding, and both premenopausal and postmenopausal can have endometrium thickness. Sonographically, the endometrium is usually diffusely thick and echogenic with well-defined margins.
What are the clinal signs and the sonographic findings in endometrial polyp?
Patients can be asymptomatic, or they may present with uterine bleeding. Sonographically, polyps appear toward the end of the luteal phase and are represented by a hypoechoic or isoechoic region within the hyperechoic endometrium.
What are the clinal signs and the sonographic findings in endometritis?
Patients have intense pelvic pain. Sonographically, the endometrium appears prominent, irregular, or both, with a small amount of endometrial fluid.
What are the clinal signs and the sonographic findings in endometrial carcinoma?
Patients present uterine bleeding and postmenopausal bleeding shows and endometrial thickness (double layer) of less than 5 mm. Sonographically, a thickened endometrium.
What are the clinal signs and the sonographic findings in adenomyosis?
Patients present with heavy, painful abnormal menses, and the uterus is found to range from normal to three times normal size. Sonographically it might me difficult to visualize adenomyosis. The most common findings are diffuse uterine enlargement, thickening of posterior myometrium, indistinct border between the endometrium and myometrium, and myometrial cysts.
Why does adenomyosis tissue not bleed?
Rises from the stratum basalis.
What is the sonographic appearance of hydrometra?
Sonolucent fluid collection in the uterine canal.
Which leiomyoma causes the highest risk of complications during delivery?
Submucosal.
What are the types of fibroids and their sonographic findings?
Submucosal: displacing or distorting the endometrial cavity with subsequent irregular or heavy menstrual bleeding. Intramural: confined to the myometrium (most common type) Subserosal: projecting from the peritoneal surface of the uterus Myomas usually demonstrate uterine enlargement or irregular uterine wall contour with a heterogeneous myometrial texture pattern.
How do the lesions seen in focal adenomyosis differ from fibroids?
They lack the hypoechoic border.
How do adenomyosis and endometriosis differ?
Thought to be the same process, endometriosis is defined as outside of the uterus.
D&C is used to diagnose what?
To diagnose cervical or uterine malignancy, control dysfunctional uterine bleeding, effect an abortion, complete an incomplete abortion, aid in evaluating infertility, and relieve dysmenorrhea.
Where does endometrial hyperplasia develop from?
Unopposed estrogen stimulation.
A Gartner's duct cyst may be found where?
Vagina.
How can adenomyosis be treated?
With hormone therapy.
A clinical sign of _____ is intense pelvic pain? It occurs most often in association with PID, postpartum, or instrument invasion.
Endometritis
What are the clinical signs of leiomyoma.
Enlarged uterus and profuse and prolonged bleeding pain.
How would you describe a diffusely adenomyotic uterus?
Globular with a more symmetrical enlargement than fibroids.
How would a patient present clinically with adenomyosis?
Heavy, painful, abnormal periods, physical exam would have a uterus up to 3x its normal size.
On ultrasound, what is the characteristic appearance of a degenerating leiomyoma?
Heterogeneous.
The endometrium should be measured from ______ layer to ______ layer.
Hyperechoic, hyperechoic
What is the most common site for leiomyoma to occur?
Intramural (confined to the myometrium, the most common type)
What are the normal thickness of endometrium at different ages and cycles?
Menstrual: 2-3 mm. Early proliferative: 4-6 mm. Periovulatory: 6-8 mm. Secretory 8-15 mm.
The most common cause of uterine calcification is?
Myomas.
What does adenomyosis look like sonographically?
Diffuse uterine enlargement, thickening of the posterior myometrium, looks like swiss cheese or "moth eaten," can mimic myomas if focal areas are present
What is thought to cause adenomyosis?
Bearing children, previous uterine trauma, c-section, dilation and curettage (anything that compromises the natural barrier)
Which condition is described as a hyperechoic protrusion of the epithelium of the cervix that may be broad based or pedunculated?
Cervical polyp.
What is most likely the result of an acquired condition with obstruction of the cervical canal?
Cervical stenosis.