Pathophysiology
Increasing parity and a diet of green vegetables reduces risk of fibroids.
Alcohol consumption and obesity increase the risk of fibroids.
OCPs have this effect on fibroid development and growth.
What is no effect?
Long acting progestin-only methods may be protective.
The preferred first line imaging for patients with suspected fibroids.
Pelvic ultrasound.
This medical treatment is contraindicated in patients with a type 0, 1, or 2 fibroid
What is a progesterone secreting IUD
The EMMY trial comparing UAE to hysterectomy showed no improvement from baseline in patients undergoing UAE for these types of symptoms.
What are bulk symptoms?
After the spread of leiomyosarcoma during Dr. Amy Reed's laparoscopic hysterectomy in Boston, the FDA recommended limited use of this technique for tissue extraction.
What is uncontained power/electromechanical morcellation?
Symptoms of fibroids are classified into these three categories.
What are AUB, bulk symptoms (pain or pressure), or reproductive dysfunction.
Of methods used to evaluate the extent of submucosal invasion, this modality is the most sensitive.
Pelvic MRI
This medical treatment that reduces HMB by 50% in patients with fibroids has the advantage of not providing contraception.
Tranexamic Acid
While limited to uteri less than 14 weeks in size, this procedure has guarded success in patients with AUB-L.
What is endometrial ablation; HydroThermablator?
Risk factors for recurrence after myomectomy include younger age, not becoming pregnant postoperatively, and this.
Multiple versus solitary fibroids
In pregnancy, fibroids have the least effect on which of the following: placental abruption, postpartum hemorrhage, cesarean delivery, or fetal growth restriction.
What is fetal growth restriction?
A submucosal fibroid that is exactly 50% invading the cavity is considered this subtype in the FIGO subclassification system.
Type 2
GnRH agonists usually reduce fibroid size by up to 50% within this time frame?
What is three months?
Fibroids of these three types are a relative contraindication when considering UAE.
Types 0, 1, 7
Women undergoing hysterectomy enter menopause this much sooner on average than women who preserve their uterus.
One year
This steroid hormone is considered to have the most important effect on fibroid development and growth.
What is progesterone?
In patients with fibroids and AUB, endometrial biopsy is indicated for any of these three reasons.
What are
1) irregular bleeding
2) abnormal bleeding not responsive to medical treatment
3) suspected sarcoma or other malignancy
Along with improvement in vasomotor symptoms, add back therapy reduces the risk of this side effect in patients taking elagolix.
What is decreased bone mineral density?
The FIRSTT trial compared UAE to this prone-position procedure and found that UAE had greater improvement in quality of life and fewer re-interventions within three years.
What is MRI guided focused ultrasound?
Fibroids causing this often asymptomatic finding require surgical treatment, usually hysterectomy.
hydronephrosis
Inherited mutations in this gene result in hereditary leiomyomatosis and renal cell carcinoma syndrome.
What is fumarate hydratase?
These leiomyoma variants show atypical nuclei but no risk of recurrence if removed completely at the time of hysterectomy.
Leiomyoma with bizarre nuclei
Ulipristal acetate while widely used in Europe to decrease both bulk and bleeding symptoms for fibroids, did not receive FDA approval due to this adverse event.
What is hepatic failure?
Transcervical radiofrequency ablation causes fibroid dissolution through this mechanism.
Coagulative necrosis
This is the only preoperative characteristic associated with increased reinfusion of autologous blood salvage systems used during abdominal myomectomy.
Uterine size greater than 15 weeks