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OB/GYN > Ovarian Disease > Flashcards

Ovarian Disease Flashcards

1
Q

What are the two most common types of pathologies of the ovaries?

A

Cysts and tumors

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2
Q

How, generally, do ovary diseases present?

A
  • Adnexal masses
  • Abdo pain/enlargement
  • Abnormal uterine bleeding
  • Bowel/bladder s/sx
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3
Q

What is the order of incidence for cancer of the Gyn in the US? (3)

A
  1. Endometrial
  2. Ovarian
  3. Cervical
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4
Q

What is the most common gyn cancer worldwide?

A

World = cervical

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5
Q

What is the order of prognosis for cancer of the Gyn? (3)

A
  1. Endometrial (best)
  2. Cervical
  3. Ovarian (worst)
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6
Q

What are the three major pathologies of the ovaries?

A
  • Cysts
  • Benign tumors
  • Malignant tumors
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7
Q

What is the most common ovarian mass in young women?

A

Follicular cysts

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8
Q

What are follicular cysts?

A

Distention of an unruptured graafian follicle. Usually regresses spontaneously

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9
Q

What is the significance of follicular cysts?

A

Insignificant unless lining granulosa cells secrete estrogen, causing endometrial hyperplasia

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10
Q

What are corpus luteum (granulosa luteal) cysts?

A

Cystic enlargement of corpus luteum with central hemorrhage.

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11
Q

What is the significance of corpus luteum cysts?

A

If ruptures, causes peritoneal reaction with fibrosis and hemorrhage mimicking endometriosis

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12
Q

True or false: corpus luteum cysts usually regress spontaneously

A

True

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13
Q

Rupture of corpus luteal cysts often mimic the s/sx of what other disease?

A

Endometriosis

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14
Q

What are the gross characteristics of corpus luteum cysts?

A

Central area of hemorrhage/necrosis

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15
Q

What are theca-lutein cysts?

A

Cysts that arise from hCG stimulation from a mole. Presents a risk of hemorrhage.

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16
Q

True or false: theca-lutein cysts are often unilateral and singular

A

False- bilateral and multiple

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17
Q

What disease are theca-lutein cysts associated with? (2)

A

Choriocarcinoma and moles

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18
Q

What are the histological characteristics of theca-lutein cysts?

A

Luteinized cells forming the inner cysts lining with adjacent surrounding theca cells

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19
Q

What are hemorrhagic cysts? Prognosis?

A

Blood vessel rupture in cyst wall, causing cyst growth with blood retention

Usually self resolving

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20
Q

What are dermoid cysts?

A

Mature, benign teratomas of germ cell line (germ cell tumor)

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21
Q

What is the most common ovarian tumor in women 20-30 years old?

A

Dermoid cysts

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22
Q

What are the odd characteristics about dermoid cysts?

A

Contains elements from all three germ layers

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23
Q

What are struma ovarii?

A

Dermoid cysts that has functional thyroid tissue, causing hyperthyroidism

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24
Q

What are the presenting s/sx of dermoid cysts?

A

Pain d/t ovarian enlargement or torsion

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25
Q

What are endometrioid cysts? Characteristics?

A

Endometriosis within ovary with cyst formation that varies with menstrual cycle

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26
Q

What are “chocolate cysts”?

A

Endometrioid cysts that are filled with dark, reddish-brown blood

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27
Q

What percent of ovarian tumors (for women ages 20-45) are benign?

A

80%

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28
Q

Why is there usually poor prognosis with ovarian neoplasms? Where does it fall in terms of cancer deaths?

A

Usually caught late

5th largest cause of cancer deaths

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29
Q

What are the s/sx of ovarian neoplasia?

A
  • Abdominal pain
  • Distention
  • GI/GU complaints
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30
Q

What are the risk factors for ovarian neoplasms? (3)

A
  • BRCA1 or 2 mutations
  • Family h/o
  • Nulliparity
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31
Q

Whom does ovarian carcinoma usually affect?

A

Women 45-65 yo

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32
Q

Which increases the risk for ovarian cancer: nulliparity or multiparity?

A

Nulliparity

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33
Q

What are ovarian neoplasms classified on?

A

Cell origin

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34
Q

What is the most common ovarian neoplasm origin?

A

Surface epithelium (70%)

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35
Q

What are serous cystadenomas?

A

Benign adenomas of the ovary.

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36
Q

What is the most common ovarian tumor?

A

Serous cystadenomas

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37
Q

In whom do cystadenomas usually occur?

A

20-50 years

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38
Q

What is the malignant form of cystadenomas?

A

Cystadenocarcinomas

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39
Q

What are the characteristics of serous cystadenomas?

A

Single, Thin walled cystic masses with serous fluid

40
Q

What is the epithelium that lines cystadenomas?

A

Fallopian like epithelium (tall, ciliated secretory columnar)

41
Q

True or false: cystadenomas are commonly unilateral

A

False-bilateral

42
Q

What is the type of epithelium of fallopian tubes?

A

Tall, ciliated secretory columnar

43
Q

Are mucinous cystadenomas usually single or multiloculated?

A

Multiloculated

44
Q

Are mucinous cystadenomas usually unilateral or bilateral? Large or small?

A

Unilateral

Large

45
Q

What is the epithelial lining of mucinous cystadenomas?

A

endocervical epithelium (tall, mucus secreting columnar epithelium)

46
Q

Are mucinous cystadenomas or serous cystadenomas more likely to become malignant?

A

Serous

47
Q

In whom do mucinous cystadenomas usually occur?

A

30-60 years old

48
Q

What is an endometrioma?

A

Mass arising from growth of ectopic endometrial tissue

49
Q

What are the presenting s/sx of endometrioma? (3)

A

Pelvic pain
Dysmenorrhea
Dyspareunia

50
Q

How do endometriomas usually present on US?

A

Complex mass

51
Q

What are Brenner tumors?

A

Uncommon adenofibroma with nodules of transitional type epithelium in a dense fibrous stroma

52
Q

Uncommon adenofibroma with nodules of transitional type epithelium in a dense fibrous stroma = what ovarian tumor?

A

Brenner tumor

53
Q

What is the epithelium of Brenner tumors?

A

Transitional epithelium in a dense, fibrous stroma

54
Q

What are the gross characteristics of Brenner tumors?

A

Pale-yellow-tan in color, and appears encapsulated

55
Q

What are the histologic characteristics of Brenner tumors with H and E staining

A

Transitional epithelium + Coffee bean nuclei

56
Q

Coffee bean nuclei in the thyroid = ?

A

Papillary thyroid carcinoma

57
Q

Are brenner tumors benign or malignant? Unilateral or bilateral?

A

Benign

Unilateral

58
Q

What are the histological characteristics of papillary, follicular, medullary, and anaplastic thyroid carcinomas?

A
  • Papillary = Orphan annie eyes, coffee bean, psammoma bodies
  • Follicular = Follicles
  • Medullary = sea of amyloid
  • Anaplastic = anaplastic cells
59
Q

What are ovarian fibromas? Benign of malignant?

A

Bundles of spindle shaped fibroblasts

Benign

60
Q

What are the s/sx of fibromas?

A

Pulling sensation in the groin

61
Q

What is Meig’s syndrome? (3)

A

Triad of:

  • ovarian fibroma
  • Ascites
  • Hydrothorax
62
Q

What are thecomas?

A

Like granulosa cell tumors–may produce estrogen

63
Q

What are the usual s/sx of thecomas? Why?

A

Abnormal uterine bleeding in a postmenopausal woman d/t estrogen production from the tumor

64
Q

What is the most common ovarian malignancy?

A

Serous cystadenocarcinomas

65
Q

Are Serous cystadenocarcinomas usually unilateral or bilateral?

A

bilateral

66
Q

What are the histological characteristics of Serous cystadenocarcinomas?

A

Psammoma bodies

67
Q

What are the histological characteristics of Serous cystadenocarcinomas?

A

Tumor showing papillary growth, hyperchromatic cells, and psammoma bodies

68
Q

Tumor showing papillary growth, hyperchromatic cells, and psammoma bodies= what tumor?

A

Serous cystadenocarcinomas

69
Q

What are the histological characteristics of Mucinous cystadenocarcinomas? (3)

A
  • Complex architecture
  • Nuclear atypia
  • Stromal invasion
70
Q

What are the differences between mucinous and serous cystadenocarcinoma?

A

Mucinous has a complex architecture with nuclear atypia

71
Q

What is pseudomyxoma peritonei? What causes this?

A

Intraperitoneal accumulation of mucinous material from mucinous cystadenocarcinoma ovarian or appendiceal tumor

72
Q

What are immature teratomas?

A

Rare, aggressive solid tumor consisting or primitive or embryonic elements, often neuroectoderm

73
Q

Are immature teratomas usually aggressive or not?

A

Aggressive

74
Q

Mature teratomas are more likely to contain what type of endocrine tissue?

A

Thyroid tissue

75
Q

What are granulosa cell tumors?

A

Malignant tumors of granulosa cell, which actively produce estrogen

76
Q

What is the most common sex cord stromal tumor? In whom do these usually occur?

A

Granulosa cell tumor

Women in 50s

77
Q

What are the s/sx of granulosa cell tumors? Why?

A

Abnormal uterine bleeding and breast TTP d/t estrogen/progesterone production

78
Q

What are call-exner bodies? What tumors are these seen in?

A

Primordial follicles that are small, eosinophilic and fluid filled spaces that are often seen in granulosa cell tumors

Often seen in Granulosa cells tumors

79
Q

What are dysgerminomas?

A

a type of germ cell tumor; it usually is malignant and usually occurs in the ovary

80
Q

In whom are dysgerminomas usually present in?

A

Adolescents

81
Q

What are the histological characteristics of dysgerminomas?

A

“Sheets of fried egg cells”

82
Q

What are the tumor markers of dysgerminomas? (2)

A

hCG

LDH

83
Q

“Sheets of fried egg cells” on histology = what ovarian tumor?

A

Dysgerminoma

84
Q

What are choriocarcinomas?

A

malignancy of trophoblastic cells

85
Q

How common are choriocarcinomas?

A

Rare

86
Q

What is the relation between choriocarcinomas and theca-lutein cysts?

A

Increases the frequency of the cyst

87
Q

Are chorionic villi present with choriocarcinomas

A

No

88
Q

What organ do choriocarcinomas usually met to?

A

Lungs

89
Q

What is the prognosis for choriocarcinomas?

A

Very responsive to chemo

90
Q

What are yolk sac tumors?

A

Aggressive tumors of ovaries or testes

91
Q

What is the most common tumor in male infants?

A

Yolk sac tumors

92
Q

What are the gross characteristics of yolk sac tumors?

A

Yellow, friable, solid mass

93
Q

What are the histological characteristics of yolk sac tumor?

A

“Schiller-Duval bodies”

94
Q

What is the tumor marker of yolk sac tumors?

A

AFP

95
Q

What are Krukenberg tumors?

A

GI malignancy which mets to the ovaries, causing a mucin-secreting signet cell adenocarcinoma

OB/GYN (33 decks)

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