questions 1

Adenomyosis

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Topic updated on 10/31/16 10:10am

Snapshot
  • A 43-year-old woman G3P2A1 complains of increasing, worsening pain with menses along with progressively heavier menstrual blood loss. Pelvic exam reveals an asymmetrical enlarged uterus that felt soft and boggy. Serum β-HCG is negative. Transvaginal sonogram showed an enlarged uterus with a thickened posterior myometrium. Because she did not respond to medical therapy she underwent a hysterectomy with complete resolution of her symptoms.
Introduction
  • A benign condition of endometrial tissue within the myometrium of the uterine wall 
    • results in uterine enlargement
  • Epidemiology
    • usually presents late in reproductive years
Presentation
  • Symptoms
    • worsening pain with menses
    • progressively heavier menstrual blood loss
Imaging
  • Transvaginal sonogram
    • reveals an enlarged, soft, and tender uterus
Studies
  • Myometrial biopsy
    • shows normal-appearing endometrial glands within the myometrium 
Treatment
  • Surgery
    • hysterectomy
      • indications
        • severe symptoms that have failed non-operative management


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Qbank (1 Questions)

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(M1.RP.1) A 40-year-old female presents to her gynecologist with dysmenorrhea, menorrhagia, and pelvic pain. The patient is not taking any medication and has no evidence of fever. Transvaginal sonogram reveals an enlarged, soft, and tender uterus, and uterine biopsy shows normal-appearing endometrial glands within the myometrium. Which of the following is the most likely diagnosis in this patient: Topic Review Topic

1. Adenomyosis
2. Endometriosis
3. Endometritis
4. Leiomyoma
5. Endometrial carcinoma

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