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Repro. Med 2 > Ovarian D/O and Infertility > Flashcards

Ovarian D/O and Infertility Flashcards

1
Q

what are benign functional ovarian d/o

FYI CARDS, just know these are functional and the rest are non-functional

A

Follicular cyst
Corpus luteum cyst
Theca lutein cyst

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2
Q

what benign non-functional ovarian d/o

MORE FYI CARDS

A 
Cystadenoma (mucinous or serous) 
Tubo-ovarian abscess (TOA)
Endometrioma (chocolate cyst)
Mature Teratoma (Dermoid)
Paraovarian cyst or fibroid
Polycystic ovary
Ovarian/Adnexal Torsion
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3
Q

what are malignant ovarian d/o

A

Epithelial
Non-epithelial
Germ cell/Sex Cord Stromal tumor

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4
Q

___ are the most frequent cystic structure in normal ovary and usually effects ____ (age group)

A

Follicular Cyst

reproductive = ovulatory women

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5
Q

a follicular cyst occurs with persistent (unovulated, mature) follicle fills with ____ or immature follicle failing to undergo ___

A

fluid

atresia

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6
Q

what are s/s of follicular cysts

A

asymptomatic
large = heavy feeling, dull pain
delay menses

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7
Q

what may severe pain with a follicilar cyst indicate

A

hemorrhage
rupture
torsion

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8
Q

how do you dx follicular cysts

A

pelic exam

transvag. U/S

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9
Q

what exam finding indicate a benign ovarian cyst

A

2-8 cm
unilateral
mobile
mild/ no pain

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10
Q

What U/S findings suggest a benign ovarian cyst

A

<8 cm
unilocular
simple fluid flled
thin walls, no nodules

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11
Q

how can you treat ovarian disorders

A

expectant
OCP
surgery

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12
Q

____ are Less common than follicular cysts and results from intrafollicular bleeding after ovulation. They are Associated with normal endocrine function or prolonged secretion of P*

A

Corpus Luteum Cyst

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13
Q

Corpus Luteum Cyst are usually ___-___ cm and have the same sxs and complications as follicular cysts

A

3-10

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14
Q

_____ are the Least common physiologic ovarian cyst they are (Almost/Never) always bilateral*
Can be massive, up to __-__ cm with multiple cysts
Arise from prolonged or excess stimulation of ovaries by endogenous or exogenous Gn**

A

Theca Lutein Cysts

Always

20-30

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15
Q 
Theca Lutein Cysts;
Symptoms?
Ultrasound findings?
Complications:?
Management:?
A

Symptoms: pelvic pressure

Ultrasound findings: multiple thin-walled cysts bilaterally

Complications: rare incidence of torsion/rupture*

Management: conservative, spontaneously regress

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16
Q

___ are Benign tumor of ovarian surface epithelium, lined by simple epithelium that is serous or mucinous. they are the MOST COMMON benign ovarian neoplasms

A

Cystadenoma: Serous or Mucinous

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17
Q

___ are filled with pale yellow serous fluid, usually unilocular

A

Serous cystadenoma:

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18
Q

___ are filled with sticky mucin, tend to be multiloculated

A

Mucinous Cystadenoma

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19
Q

how do you dx Cystadenoma: Serous or Mucinous

A

U/S

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20
Q

how do you tx Cystadenoma: Serous or Mucinous

A

surgical removal w/ staging

appendectomy

21
Q

___ are Infectious disorder of the upper genital tract (PID) creating an inflammatory mass involving the fallopian tube and ovary
Often bilateral due to ascending infection

A

Tubo-ovarian abscess

22
Q

Tubo-ovarian abscess s/s

A

Symptoms of PID

Adnexal pain and mass

23
Q

complication of Tubo-ovarian abscess

A 
sepsis 
rupture 
tubal occlusion
infertility
ectopic pregnancy
chronic pelvic pain due to adhesions
24
Q

how do you tx Tubo-ovarian abscess?

A

IV abx

25
Q

___ is a an ovarian cystic mass arising from growth of ectopic endometrial tissue within the ovary. Typically contain thick brown tar-like fluid (“chocolate cyst”) and are often densely adherent to surrounding structures.

A

Endometrioma (Chocolate Cyst)

26
Q

what are s/s of Endometrioma (Chocolate Cyst)

A

asymptomatic
pelvic pain
dysmenorrhea
dyspareunia

27
Q

what are complications of Endometrioma (Chocolate Cyst)

A

infertility

rupture

28
Q

how do you tx Endometrioma (Chocolate Cyst)?

A

observation

surgical

29
Q

___ are a benign neoplasm containing tissue from all three germ layers ie:
Ectoderm (skin, appendages: hair, teeth, sebaceous material), Mesoderm And Endoderm

A

Mature Cystic Teratoma (Dermoid)

30
Q

Mature Cystic Teratoma (Dermoid)* are the most common benign neoplasm in women ____ (age group)
__-__% bilateral

A

< 35 y/o including adolescents

10-15% b/l

31
Q

how do you tx a Mature Cystic Teratoma (Dermoid)

A

surgery

32
Q

____ are Ovaries with multiple cysts associated with PCOS. The most common cause of hyperandrogenism and chronic anovulation.

A

Polycystic ovary

33
Q

Polycystic ovary occurs in __-__% of reproductive age females

A

4-12%

34
Q

what are sxs related to?

A

HYPERANDROGENEMIA
- acne, hirsutism, alopecia

REPRODUCTIVE D/O
- irregular menses, anovulation, infertility, endometrial hyperplasia

METABOLIC DISTURBANCES
- obesity, insulin resistance, hyperinsulinemia

35
Q

what re the dx criteria for Polycystic ovary

A

(need 2 out of 3 criteria):

  • Oligoovulation or anovulation
  • Hyperandrogenemia
  • Polycystic ovaries diagnosed by ultrasound
36
Q

how do you treat Polycystic ovary

A

OCP
Metformin
progesterone
mechanical hair removal for hirsutism

37
Q

__ is a simple epithelial-lined cyst (rarely complex) or benign fibroid adjacent to the ovary, usually within the broad ligament
Incidence: approx. 10% of benign adnexal cysts, most common ___-___ year old

A

Paraovarian cyst or fibroid

30-50y.o.

38
Q

how do you tx Paraovarian cyst or fibroid

A

observe if small

surgery to remove

39
Q

____ is the rotation of the ovary or the ovary and FT to such a degree as to occlude the vascular supply (can be partial/intermittent or complete resulting in necrosis)

A

Ovarian (Adnexal)Torsion

40
Q

what age group is Ovarian (Adnexal)Torsionmost common?

A

reproductive aged women

41
Q

what are sx of Ovarian (Adnexal)Torsion

A

severe unilateral pain

N/V

42
Q

T/F: Ovarian (Adnexal)Torsion can be dx using a TUS with Doppler flow studies

A

T

43
Q

how do you tx Ovarian (Adnexal)Torsion

A

emergent surgery

44
Q

what are U/S findings that suggest a malignant adnexal mass?

A
  1. Thick septations
  2. Papillary projections or nodules into the lumen of a cyst
  3. Cystic and solid components
  4. Increased overall volume of the ovary
  5. Increased Doppler measurement of blood flow
45
Q

what are serum tumor markers in ovarian d/o

A

CA 125

HE4

46
Q

these descriptions fit which ovarian tumor marker?

Decreased specificity especially in premenopausal women
Increased in many benign conditions including endometriosis, leiomyoma, PID and pregnancy

A

CA 125

47
Q

these descriptions fit which ovarian tumor marker?

Has improved specificity over CA 125
Not elevated in endometriosis or other benign conditions

A

HE4

48
Q

what does ROMA or RMI stand for?

A

Risk of ovarian malignancy algorithm

Risk of Malignancy Index

49
Q

what clinical characteristics require a woman to be referred to a GYN oncologist

A

Elevated CA 125 level

  • > 35 in postmenopausal woman
  • > 200 in premenopausal woman

Ascites

Nodular or fixed pelvic mass

Evidence of abdominal or distant metastasis

FHx of one or more first-degree relatives with ovarian or breast cancer

Repro. Med 2 (12 decks)

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