Endometriosis and Adenomyosis

True about endometriosis is

A. A benign but it is locally invasive
B. Neoplastic disease
C. A premalignant lesion
D. Malignant lesion

Endometriosis can influence fertility by all except

A. Scarred fallopian tubes
B. Luteolysis due to double LH peak
C. Hyperprolactinemia
D. Impaired implantation of a pregnancy

Proposed theories for endometriosis include all except

A. Allergic reaction
B. Lymphatic spread
C. Immunologic
D. A chronic inflammatory process

All are risk factors for endometriosis except

A. Women having short cycles
B. Daily consumption of alcohol
C. Black women
D. Early menarche

True about ectopic endometrium in endometriosis is

A. Ectopic endometrium is more resistant to apoptosis
B. Profuse steroid receptors are seen in the ectopic endometrium
C. More obvious secretory changes seen
D. Ectopic endometrial tissue lacks glands

Lateral parametrial endometriosis causes voiding problems due to

A. Inferior hypogastric plexus involvement
B. Dysfunctions of the pelvic floor muscles
C. Pelvic pain
D. Ureteral stenosis

In shorts

  • Endometriomas: the lining epithelium of the cyst may be absent or flattened (cuboidal) or replaced by granulation tissue. There may be presence of large polyhedral phagocytic cells, laden with blood pigment—hemosiderin (pseudoxanthoma cells). The cyst wall is composed of fibrous tissue and compressed ovarian cortex.
  • Pelvic endometriosis: Typically, there are small black dots, the so-called ‘powder burns’ seen on the uterosacral ligaments and pouch of Douglas.
  • Painful lesion: Lesions penetrating more than 5 mm are responsible for pain, dysmenorrhea and dyspareunia. The “powder burns” lesions produce more prostaglandin F (PGF) and hence are more painful.
  • Serum marker CA 125: A moderate elevation of serum CA 125 is noticed in patients with severe endometriosis. It is not specific for endometriosis, as it is significantly raised in epithelial ovarian carcinoma

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