Ovarian Disorder

Question 1

Give three protective factors for ovarian cancer

Answer 1

Multiparty
COCP
Breast feeding

Question 2

Which genes are implicated in ovarian cancers?

Answer 2

BRCA1&2

Question 3

What is lynch syndrome?

Answer 3

Hereditary syndrome associated with increased risk of colorectal and endometrial cancers (TCCs)

Question 4

Where is the BRCA1 gene found?

Answer 4

Chromosome 17

Question 5

Where is the BRCA2 gene found?

Answer 5

Chromosome 13

Question 6

Describe a simple ovarian cyst

Answer 6

Regular, smooth

Contains only fluid

Question 7

What is a complex ovarian cyst?

Answer 7

Irregular

Solid material and blood may be found in

Question 8

What is the typical size of a follicular cyst?

Answer 8

<3cm

Question 9

What is the typical size of a corpus luteal cyst?

Answer 9

<5cm

Question 10

What is a “chocolate cyst”?

Answer 10

Endometrioma

Question 11

What is a theca luetin cyst a consequence of?

Answer 11

Raised hCG

Question 12

What is the most common type of ovarian tumour?

Answer 12

Serous cystadenoma

Question 13

In which groups to mature cystic teratomas present?

Answer 13

Young women

Pregnancy

Question 14

Which tissues may cystic teratomas contain?

Answer 14

Teeth, hair, skin, bone

Question 15

What is a mature cystic teratoma otherwise known as?

Answer 15

Dermoid cyst

Question 16

Which type of tumour is a cystic teratoma?

Answer 16

Germ cell

Question 17

Which type of tumour is a fibroma?

Answer 17

Sex-cord stromal

Question 18

What is Meig’s syndrome?

Answer 18

Fibroma
Ascites
Pleural effusion

Question 19

What causes Lynch syndrome?

Answer 19

Mismatch in repair of the genome due to microsatellite instabilities

Question 20

Why is CA125 not measured in premenopausal women?

Answer 20

Several benign triggers for increase

Question 21

What should be measured in cysts/tumours in women under 40?

Answer 21

LDH
AFP
hCG

Question 22

What are the most common hormonal abnormalities found in PCOS?

Answer 22

Excess LH

Insulin resistance

Question 23

Where is LH produced?

Answer 23

Ant pituitary

Question 24

What is LH produced in response to?

Answer 24

GnRH

Question 25

How does insulin resistance contribute to PCOS?

Answer 25

High insulin levels suppress sex hormone binding globulin so higher levels of circulating androgens

Question 26

What are the main clinical features of PCOS?

Answer 26

``` Oligo/amenorrhoea Hirsutism Acne Obesity Chronic Pain Depression Infertility ```

Question 27

What is acanthosis nigrans?

Answer 27

Darkened skin which occurs secondary to insulin resistance

Question 28

How is PCOS investigated?

Answer 28

Test/SHBG/LH/FSH/progesterone levels | USS

Question 29

What do investigations show in PCOS?

Answer 29

``` High testosterone Low SHBG Raised LH Normal FSH Low progesterone USS shows polycystic ovaries ```

Question 30

How is infertility in PCOS treated?

Answer 30

Clomifene and metformin

Question 31

How can hirsutism in PCOS be treated?

Answer 31

Anti-androgen

Question 32

Give examples of anti-androgen

Answer 32

Cyproterone Spironolactone Finasteride

Question 33

Which topical treatment can be used to treat hirsutism?

Answer 33

Eflornithine

Question 34

How can menstrual abnormalities be treated in PCOS?

Answer 34

COCP | Dydrogesterone