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Ahmad AL-dhlawiy, profile picture
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Mayoma

A 53-year-old female presented with severe pelvic pain and abnormal vaginal bleeding. Her medical history included 11 childbirths, gestational diabetes, asthma, and gallbladder removal. On examination, she had severe sharp pelvic pain that radiated to her back and was exacerbated by walking. Differential diagnoses included metastatic disease and endometriosis. Ultrasound, MRI, and biopsy were planned to diagnose the likely cause of leiomyoma (uterine fibroids). Treatment options discussed included medication to relieve pain and heavy bleeding or surgical procedures such as myolysis, myomectomy, or hysterectomy.

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MYOMA AHMAD AL-DHLAWIY 11110006
Contents… SOEPEL Anatomy of uterus Definition Myoma Location Risk factors Causes Symptoms Diagnosis Treatment
SOEPLE… Subject: A middle age female patient came to the hospital with severe pelvic pain and abnormal vaginal bleeding. History: A 53 year old age have 11 childeren two of them dilevered cessarion. Hyperglycemic and have a history of asthama. and Have history of removed gall bladder before 5 years.
Con’t… Pain analysis: 1. Site: in the pelvic. 2. Onset: suddenly. 3. Character: sharp. 4. Radiation: to back. 5. Associated factors: during walking. 6. Time/duration: start before 3 Months. 7. Exaggerated and relieving factors: --- 8. Severity: severe.
SOEPLE… Object: Abdominal Examination. ( HR: 106, BP: 130/90 ) Evaluation “DD”: Metastatic disease, Endometriosis. Plan: Ultasound, MRI and histopathology. Elaboration: Hysterectomy. Learning goal: leiomyoma ( Uterine fabroid ).
Anatomy…
Myoma It is a benign neoplasm of the muscular wall of the uterus composed primarily of smooth muscle.
Sign and symptoms… Prolonged Heavy menstrual bleeding. Pelvic pressure or pain. Enlargement of lower abdomen. Frequent urination. Difficulty emptying bladder. Constipation. Backache or leg pains.
Risk factors… Age. especially during the 30s and 40s. After menopause the fibroids usually shrink. Family history. If a woman's mother had fibroids, her risk of having them is about three times higher than average. Ethnic origin. African-American women are more likely to develop fibroids than white women. Obesity. the risk is two to three times greater than average. Eating habits. Eating a lot of red meat (e.g., beef). Eating plenty of green vegetables seems to protect women from developing fibroids.
Causes…  Hormonal  Genetic
Diagnosis… Ultrasound Magnetic resonance imaging (MRI) X-ray Cat scan (CT) Laparoscopy Hysteroscopy Histopathology
Treatment… Medication: Mild pain ibuprofen or acetaminophen heavey bleeding during period supplement (GnRHa) shrink fibrosis. iron
Treatment Con’t… Surgery: Myolysis Myomectomy Hystrectomy
References… Books:  Williams Obstetrics.  kumar and clarck. Websites:  http://www.womenshealth.gov  http://www.sils.com