Not true bout Endometriosis:
Correct Answer: Common in low socio-economic group
Description: Ans: D (Common in...) Laproscopy is the gold standard in diagnosis of endometriosis.It is both diagnostic & therapeutic"- Shows Gynaecology 16th/415"Sampson gave implantation theory of endometriosis in 1922 "- Shows Gynaecology 16th/ 409"Endometriosis possibly interferes with tubal motility and function. It may inhibit ovulation and because of dyspareunia there is reduced frequency of sexual intercourse. Other causes of infertility are luteinized unruptured follicular (LUF) syndrome, increased prolactin and corpus luteal phase defect, nonovulation and tubal blockage. Prostaglandin affects the tubal motility & causes corpus luteolysis too. The macrophages in the peritoneal fluid engulf the sperms or immobilize them "Shaw 16th/414"Dysmenorrhoe is the most common symptom"- Shaw 16th/413ENDOMETRIOSISOccurrence of functioning endometrial tissue (both glands + stroma) outside the cavity of uterus.Age group:30 -40years (Most common)0 jeffcoate 7th/368Seen in high socio-economic status because of late marriage13 & late child bearing13,Most common in nulliparous females'3. -Jeffcoate 7th/369- 370; Shaw 14rh/420Familial predisposition (risk is seven times higher if a first degree relative has diseases. Risk is further increased in homozygous twins).It is a hormlome dependant condition (Estrogen dependant.Site: It can occur anywhere in the body. Most common site is ovary (30-40%, 2nd most common site is pouch of douglasPathology:Peritoneum: Earliest lesion is red petechial, later becoming cystic, dark brown, blue black in appearance called as Powder burn appearance/ Gun shot appearance.Ovary: Ch aracteristic bilateral0 cyst? or endometrioma (which is a true cyst0 with columnar lining epithelium)deg. Beneath the epithelium are large cells with brown cytoplasm due to ingested pigments like hemosiderin called as Pseudoxanthoma ceils. Cyst contains tarry brown fluid'. Shaw 14/e, p 421Peritoneal cavity : Contains yellow brownb fluid which has prostaglandin responsible for the pain of endometriosis.Symptoms: Patients present with a characteristic triad of:infertilityProgressively increasing dysmenorrheaDyspareuniaDyspareunia : Occurs when POD and rectovaginal septum are involved.Menstrual irregularities : Like menorrhagia, polymenorrhea are seen.Premenstrual spotting may occur and is more likely to be associated with endometriosis than with luteal phase inadequacyOther symptom : Chronic pelvic painr pain during defecation. Intermittent pyrexia and urinary symptoms.
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Gynaecology & Obstetrics
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