Chpt 25 Adenomyosis and Endometriosis || with 100% Error-free Solutions.
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Chpt 25 Adenomyosis and Endometriosis
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Chpt 25 Adenomyosis And Endometriosis
What is the prevalence of endometriosis? correct answers The prevalence of asymptomatic endometriosis is population dependent:
• 1% to 7% in women seeking elective sterilization.
• 12% to 32% among women of reproductive age with pelvic pain.
• 9% to 50% in infertile women.
• 50% amo...
Chpt 25 Adenomyosis and Endometriosis || with 100%
Error-free Solutions.
What is the prevalence of endometriosis? correct answers The prevalence of asymptomatic
endometriosis is population dependent:
• 1% to 7% in women seeking elective sterilization.
• 12% to 32% among women of reproductive age with pelvic pain.
• 9% to 50% in infertile women.
• 50% among teens with chronic pelvic pain or dysmenorrhea.
The overall prevalence of endometriosis in reproductive-age woman probably is between 3% and
10%.
The most common symptom of endometriosis is? correct answers Dysmenorrhea and pain
throughout the menstrual cycle. (25-67% of women with endometriosis.)
Dyspareunia is found in 25% and associated with uterosacral involvement.
Dyschezia.
Other common symptoms and signs of endometriosis are? correct answers Intraperitoneal
bleeding, pelvic adhesions, pelvic pain, infertility, cyclic bowel and bladder symptoms, and
inflammation.
What risk factors/associations have been implicated with development of endometriosis? correct
answers • Early menarche and short menstrual cycles—heavy consumption of alcohol and
caffeine six to seven times more prevalent among the first-degree relatives of affected women
than in the general population.
Protective factors
• Interestingly, the prevalence of endometriosis is inversely related to body mass index.
• Regular exercise and smoking may decrease the risk of endometriosis.
• Pregnancy has a protective effect that decreases with time; risk decreases with parity and
prolonged periods of lactation.
What proportion of patients has uterosacral and cul-de-sac nodularity? correct answers One-third
of all patients with endometriosis.
The mean age of diagnosis of endometriosis is? correct answers 25 and 35.
What is the best imaging technique for diagnosing endometriosis? correct answers Laparoscopy
remains the optimal method, but MRI using the fat-saturation technique has a PPV of 95% and
NPV of 50% with implants >4 mm.
Does endometriosis have an ethnic predilection? correct answers The prevalence of
asymptomatic endometriosis may be somewhat lower in Blacks and higher in Asians than in
White women.
, What are the ultrasound findings consistent with endometriosis? correct answers Cystic
structures with diffuse low-level internal echoes indicating a possible endometrioma.
Does medical treatment of minimal-mild endometriosis increase fertility? How about surgical
treatment? correct answers No. Surgical treatment may increase fertility rates; therefore, it is still
recommended at time of laparoscopy.
Does preoperative medical treatment assist in surgical treatment of endometriosis? correct
answers Yes. It softens the endometrial implants for surgical removal.
When does one achieve the highest pregnancy rates after surgical treatment? correct answers In
the first year, success is inversely related to the severity of disease.
What are the recurrence rates after surgical treatment and after medical treatment? correct
answers For surgical tx: 10% in first year and 20% in 5 years.
For medical tx: 5% to 20% per year and 40% in 5 years.
Is there any role for postoperative medical treatment? correct answers Yes. Medical treatment
after surgical treatment can delay return of symptoms with at least 6 months postoperative
medical treatment.
What is the typical classification scheme of endometriosis? correct answers • Minimal
endometriosis—Isolated superficial disease on the peritoneal surface with no significant
associated adhesions.
• Mild endometriosis—Scattered superficial disease on the peritoneal surface and ovaries,
totaling less than 5 cm in aggregate, with no significant associated adhesions.
• Moderate endometriosis—Multifocal disease, both superficial and invasive, that may be
associated with adhesions involving the fallopian tubes and/or the ovaries.
• Severe endometriosis—Multifocal disease, both superficial and invasive, including large
ovarian endometriomas, usually associated with adhesions, both filmy and dense, involving the
fallopian tubes, ovaries, and cul-de-sac.
What are the options for postoperative medical treatment? correct answers Gonadotropin-
releasing hormone (GnRH) agonist.
Danazol.
Oral contraceptives.
Letrozole.
How do oral contraceptive pills treat endometriosis? correct answers They suppress follicle-
stimulating hormone (FSH) and luteinizing hormone (LH) secretion causing decreased estrogen
production and reduced menstrual volume.
Can tubal ligation be performed as a treatment of endometriosis? correct answers No. Some
women even experience symptoms of endometriosis after hysterectomy.
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