Gynecology- Ovarian & other repro tract abnormalities

Question 1

What features of an adnexal mass would be concerning for malignancy

Answer 1

postmenopausal age
chronic or worsening pain
mass symptoms (bloating, constipation)

Question 2

Best initial evaluation of an adnexal mass

Answer 2

pregnancy test and pelvic ultrasound

Question 3

U/S findings for a malignant adnexal mass

Answer 3

Complex (solid and cystic)
Irregular
Thickened internal septations

Question 4

U/S findings for a benign adnexal mass

Answer 4

simple ovarian cyst with normal Doppler flow

Question 5

Physiologic corpus luteum cyst

Answer 5

Benign cyst related to recent ovulation in premenopausal women. Can present with mittelschmerz.

Question 6

Best next step in management for a benign adnexal mass

Answer 6

physiologic ovarian cyst resolve spontaneously. Observation and repeat examination in 6wks.

Question 7

ovarian cyst aspiration

Answer 7

ALWAYS WRONG ANSWER

cytology not diagnosis and spillage can increase cancer staging if malignant

Question 8

Next step for malignant adnexal mass on u/s

Answer 8

Undergo CT to asses for mets.

Can guide use of adjuvant chemo prior to surgical staging.