Ovarian Abnormalities Flashcards
(27 cards)
How do you make the diagnosis of PCOS?
You need 2/3 of the following
-Amenorrhea or irregular menses
-Signs of hirsutism
-Polycystic ovaries on US
What are the diagnostic testing options for PCOS?
Pelvic US
Free Testosterone
High Androgens and obesity
What is seen on pelvic US in PCOS?
Bilaterally enlarged ovaries with multiple cysts
What happens to free testosterone in PCOS?
Elevated secondary to high androgens
What is caused by High androgens and obesity in PCOS?
Increased estrogen formation outside the ovary: stimulates LH secretion an inhibits FSH secretion so LH;FSH ration >3:1
How does treatment of PCOS begin?
Weight loss
What is added to PCOS treatment for patients who do not wish to conceive?
OCP to control the amount of estrogen and progestin in the body
What is added to PCOS treatment for patients who do wish to conceive?
Letrozole is first line
Clomiphene Citrate is second line
What is an ovarian torsion?
Ovary rotates around the infundibulopelvic ligament compromising its own blood supply
When to suspect ovarian torsion?
Women of reproductive age who have sudden onset unilateral pelvic pain and an ovarian cyst of mass often with N/V
What can Tranvaginal Us show in ovarian torsion?
Decreased or absent blood flow to the affected ovary
How do you treat an ovarian torsion?
Emergency Laparoscopy or Laparotomy
What are acute presentations of ovarian cancer?
Pleural effusion, bowel obstruction: indicates late disease and poor prognosis
What are subacute presentations of ovarian cancer?
Abdominal pain or an adnexal mass: can occur early or late in disease
What are common symptoms of ovarian cancer?
bloating/feeling full quickly
Urinary urgency and frequency
pelvic pain
abdominal pain
How is ovarian Cancer diagnosed?
Pelvic US or CT followed by biopsy to confirm the diagnosis
What is the most common histologic subtype of Ovarian tumor?
Serous
How do you treat Serous ovarian tumors?
Chemo + surgery
What tumor marker is (+) in serous ovarian tumors?
Ca-125
What type of ovarian tumor is associated with Turner syndrome?
Dysgerminoma
What tumor marker is (+) for Dysgerminoma?
LDH
What is the histologic appearance of a Dysgerminoma?
Fried-egg appearance
What tumor marker is (+) for an ovarian yolk sac tumor?
AFP
What is the histological appearance of a yolk sac tumor?
Schiller-duval bodies: resemble primitive glomeruli
