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Ovarian Flashcards

(54 cards)

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1
Q

3 layers of ovarian tissue

A

epithelian
stromal
germ

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2
Q

each layer of ovarian tissue can produce what kinds of tumor

A

cysts
benign
malignant
solid

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3
Q

what are risk factor for ovarian cyst

A 
Infertility Tx
Tamoxifen
Pregnancy in 2nd trimester when hCG peaks
Hypothyroidism
Cigarette smoking
Tubal ligation
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4
Q

what is the most common type of functional cyst

A

follicular

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5
Q

characteristics of endometriomas

A

blood filled cysts from ectopic edometrium
called chocolate cysts
Triad: Dysmenorrhea, dysparenuia, menorrhagia

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6
Q

malignant cells most oftenly arise from what tissue layer?

A

epithelium (mesothelium)

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7
Q

what will the history of a person with ovarian cysts be like

A

torsion or rupture that causes severe pain: sudden sharp unilateral pain. This may be brought on by exercise, trauma, coitis
May have difficult bowel movements, frequent urination, irrgeular menses, dysparenuia
Can cause puberty to happen early in girls
Abdominal bloating or fullness

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8
Q

what will the history of a woman with polycystic ovary syndrome be like

A

hirsutism, infertility, oligomenorrhea, obesity, acne tenesmus

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9
Q

what will exam be like for ovarian cysts

A

may be tender to palpation

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10
Q

what is the cancer antigen for ovaries

A

CA125

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11
Q

what is ovarian torsion

A

occurs when the ovary flips over

cuts off blood supply to ovary

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12
Q

what is the median age for ovarian torsion

A

28 years old

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13
Q

what is presentation like for ovarian torsion

A

2/3 on the right side

acute unilateral sharp pain, vomiting with onset of pain, pelvic mass, leukocytosis and fever

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14
Q

what type of test would you want to do for ovarian torsion

A

U/S with color doppler

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15
Q

what is the Tx for ovarian torsion

A

removal of ovary

can untwist if done immediately

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16
Q

women with PCOS have abnormalities with what?

A

metabolism of androgen and estrogen

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17
Q

what will PCOS look like on the ovaries

A

bilaterally enlarged
spherical rather than ovoid
multiple 1cm follicles
string of pearls appearance

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18
Q

How is PCOS dx made

A

2 of the following:
Polycystic ovaries
signs of androgen excess: acne, hirsutism, temporal balding, male pattern hair loss
menstrual irregulatieis: oligomenorrhea or polymenorrhea

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19
Q

what will PE be like for a pt with PCOS

A 
excess body hair, acne, alopecia, increased muscle mass, deepening voice
Obesity
Acanthosis nigricans,
HTN
Enlarged ovaries
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20
Q

what is the Tx for PCOS

A 
diet and exercise
Meds for anovulation
hirsutism
Acne
Endocine consult
surgery
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21
Q

what is the meigs syndrome triad

A

ascities
pleural effusion
benign ovarian fibroma

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22
Q

what guides the diagnosis and tx of patient

Study These Flashcards
A

type of mass and age of the patient

23
Q

why is it hard to diagnose ovarian cancer

Study These Flashcards
A

presentation is vague

24
Q

RF for ovarian cancer

Study These Flashcards
A

older age
early menarch 50
Caucasian>Hispan>African Americans
Infertility

25
what factors are protective for ovarian cancer
OCP | breast feeding
26
how is ovarian cancer dx'd
U/s elevated CA-124 elevated Inhibin B
27
which causes increased risk for familial ovarian cyst?
``` Fm Hx BRCA 1 BRCA 2 Ashkenazi Jews, French Canadians Icelandic descent ```
28
what is the Tx of ovarian cancer
Surgery Chemo Marker Ca-125
29
uterine prolapse stage 0
no prolapse
30
uterine prolapse stage 1
cervix is in the upper 1/2 of vagina
31
uterine prolapse stage 2
cervix is 1cm above or below hymen remnants
32
uterine prolapse stage 3
cervix is >1cm below hymen remnants but the uterus is still at least 2cm in the vagina canal
33
uterine prolapse stage 4
uterus is outside the vaginal canal
34
what are RF for uterine prolapse
more than 2 vaginal deliveries | age, obesity, chronic cough, repetitive heavy lifting
35
what are the symptoms of uterine prolapse
vaginal fullness, pressure, heaviness, presence of soft reducible mass in vagina, urinary complaints
36
Leiomyoma
commmon in women over 40, african american | menorrhagia is usually due to submucosal firboids
37
Leiomyoma pathology
arise from smooth muscle usually benign tumors tissue exam need for dx
38
Leiomyoma presentation
``` menorrhagia fullness in pelvic area increased abdominal girth Freq. urination low back pain ```
39
how are leiomyoma dx'd
``` U/S MRI CT hyterosalpingogram Sonohyterogram ```
40
what is the Tx for leiomyoma
watchful waiting operative hysterectomy Embolization monitor 3mth, 6mths, yearly
41
How is embolization used to tx fibroids
using arterial catherization, synthetic emboli are introduced to the artery feeding the fibroid
42
What uterine cancer has what
precursor lesion | endometrial hyperplasia that thickens endometrium and causes heavier period
43
how does uterine cancer present
menorrhagia metrorrhagia post menopausal bleeding
44
risk factors for endometrial hyperplasia
``` obesity Anovulation DM HTN Age Nulliparity ```
45
What affects endometrial hyperplasia
unopposed estrogen w/o estrogen which can progress to cancer
46
how is endometrial hyperplasia tx'ed
add extra progesterone during luteal phase | (methoxyprogesterone) during days 16-25 for 3 months
47
what is the MC endometrial cancer
uterine cancer | has good prognosis d/t being found in early stages
48
what are the 2 types od uterine cancer pathology
80% are type 1 d/t unopposed estrogen stimulation, endometrial hyperplasia type II estrogen independent
49
what are the RF for uterine cancer
``` age, obesity, DM, HTN, Nulliparity, Late menopause, Early menarch Hx of Breast CA Tamoxifen Estrongen alone PCOS ```
50
what are the Sx of uterine cancer
abnormal menses 80% postmenopausal bleeding classic presentation: obese, nuliparous, infertile, HTN, DM, white
51
how is uterine cancer dx'd
U/S endometrial biopsy D&C-definitive procedure
52
what is the treatment for uterine cancer
``` surgery: Hysterectomy B/L salpingoopherectomy Radiation progesterone therapy ```
53
how often should a patient with uterine cancer follow up
every 3-4 mths for first 2yrs | then 6mths for next 3yrs then annually
54
what should each post cancer tx include
pelvic exam pap smear lymph node survery Cxry annually

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