13: Benign Conditions of Uterus, Cervix, Ovary, Fallopian Tubes

Question 1

Cause of uterus didelphysis, bicornate uterus

Answer 1

Failure of paramesonephric ducts to fuse

Question 2

Cause of septate uterus

Answer 2

Incomplete dissoluation of midline fusion

Question 3

Meyer-Rokitansky-Kuster-Hauser syndrome

Answer 3

Mullerian agenesis; complete lack of uterus and vagina

Question 4

Most common cause of congenital cervical abnormalities

Answer 4

Malfusion of paramesonephric ducts

Question 5

Characteristic T-shaped uterus caused by

Answer 5

Maternal exposure to DES

Question 6

Most common neoplasm of the uterus

Answer 6

Fibroids/uterine leiomyomas

Question 7

Characteristics of fibroids

Answer 7

Spherical, well circumscribed white whorled lesions

Question 8

Most common location of fibroids

Answer 8

Intramural - arises within myometrium

Question 9

Treatment of leiomyomas

Answer 9

Estrogen + Progesterone, progesterone, Depo-Lupron (GnRH agonist); hysterectomy if severe sx

Question 10

Endometrial polyps

Answer 10

Usually benign soft friable masses, removed with hysteroscopy

Question 11

Nabothian cyst

Answer 11

Normal variant with opaque/yellowish/blue hue on surface of cervix

Question 12

Cervical polyps

Answer 12

Generally benign, usually asymptomatic, endocervical are more common and beefy red in color

Question 13

Endometrial hyperplasia

Answer 13

Overgrowth of endometrial lining usually d/t persistent unopposed estrogen; precursor to endometrial cancer

Question 14

Classify types of endometrial hyperplasia from best prognosis to worst

Answer 14

1. Simple without atypia (1% progress to cancer)
2. Complex without atypia (3%)
3. Simple with atypia (9%)
4. Comples with atypia (27%)

Question 15

Symptoms and diagnosis of endometrial hyperplasia

Answer 15

Sx: heavy. prolonged unexplained bleeding
Dx: US reveals endometrial lining greater than 4 mm thickness in postmenopausal women

Question 16

Treatment of hyperplasia without and with atypia

Answer 16

1. Without: progestin, re-sample in 3 months

2. With: hysterectomy

Question 17

Syndrome associated with rudimentary streaked ovaries and early menopause

Answer 17

Turner syndrome

Question 18

Theca-Lutein cyst

Answer 18

Bilateral, can be very large, tend to form in patients with high hCG and regress when gonadotropin levels fall

Question 19

Luteoma of pregnancy

Answer 19

Hyperplastic ovarian theca cells due to hCG stimulation; red-brown nodules, regress postpartum

Question 20

Polycystic ovarian cyst

Answer 20

Associated with chronic anovulation, hyperandrogenism, insulin resistance; enlarged ovaries with small follicles

Question 21

Most common ovarian neoplasms

Answer 21

Epithelial tumors (serous, mucinous, brenner)

Question 22

MOST COMMON benign ovarian neoplasm in PREMENOPAUSAL female

Answer 22

Dermoid cyst/benign cystic teratoma

Question 23

Most common epithelial tumor

Answer 23

Serous cystadenoma; usually benign

Question 24

Mucinous cystadenoma

Answer 24

Can become huge; most benign, can be associated with mucocele of appendix and lead to pseudomyxoma peritonei

Question 25

Brenner tumor

Answer 25

Usually benign, resemble urothelium

Question 26

Granulosa-theca cell tumors

Answer 26

Produce estrogenic components, not usually malignant, feminizing signs and symptoms

Question 27

Sertoli-Leydig tumors

Answer 27

Androgenic components, not usually malignant, virilizing effects

Question 28

Most common benign SOLID ovarian tumor

Answer 28

Fibroma

Question 29

Meigs syndrome

Answer 29

Ovarian fibroma associated with ascites and pleural effusion

Question 30

Cystic teratoma

Answer 30

Mostly benign, elements of all 3 germ layers; MOST COMMON ovarian neoplasm in all women

Question 31

Ovarian torsion

Answer 31

Complete or partial rotation of ovary on ligaments; impedes blood supply; one of the MOST COMMON gynecologic emergencies

Question 32

Primary risk factor for an ovarian torsion

Answer 32

Ovarian mass 5+ cm

Question 33

S/S of ovarian torsion

Answer 33

Acute onset of unilateral pain, nausea, vomiting