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Y3 - Repro > Ovarian Pathology > Flashcards

Ovarian Pathology Flashcards

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1
Q

What are ovarian cysts?

A

Fluid-filled sacs in the ovaries

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2
Q

What are the types of ovarian cysts?

A

Follicular cysts
Corpus lutem cyst
Dermoid cyst
Serous cyst adenoma

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3
Q

What is the other name for dermoid cysts?

A

Mature cystic teratomas

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4
Q

What is the pathology of dermoid cysts?

A

Usually lined with epithelial tissue and may contain skin appendages, hair and teeth

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5
Q

What is the main complications of ovarian cysts?

A

Increase the risk of ovarian torsion

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6
Q

What can rupture of serous caystadenomas cause?

A

Pseudo-myxoedema peritonei - where cancer cells produce abundant mucin or gelatinous ascites

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7
Q

What are chocolate cysts?

A

Cysts on the ovaries in endometriosis

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8
Q

What is the presentation of ovarian cysts?

A

Can be asymptmoatic

Non-specific symptoms similar to ovarian cancer

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9
Q

What is the presentation of a ruptured ovarian cyst?

A

Sudden onset pelvic pain
Pain tends to subside after a few hours
Precipitated by intercourse or strenuous activity
Tender lower abdomen

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10
Q

What is the main investigation for ovarian cysts?

A

Ultrasound scan

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11
Q

What USS result shows a simple cyst?

A

Unilocular

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12
Q

What USS result shows a complex cyst?

A

Multilocular

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13
Q

What USS result shows a ruptured cyst?

A

Free fluid in the pelvic cavity

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14
Q

What is the next step in management for post-menopausal women with ovarian cysts?

A

Referral to gynaecology for assessment to exclude malignancy

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15
Q

What investigations are done to rule out malignancy in ovarian cysts?

A

FNA

Explorative laparoscopy

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16
Q

What is the management of small (<5cm) simple ovarian cysts in patients <35 years

A

Conservative approach
Repeat USS arranged for 8-12 weeks
Referral if persistent

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17
Q

What is the management of symptomatic ovarian cysts?

A

Cystectomy or oophorectomy

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18
Q

What are the types of ovarian cancer?

A 
Serous
Endometroid
Mucinous
Clear cell 
Transitional type
Granulosa cell
Theca/Leydig cell
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19
Q

What is the most common ovarian cancer?

A

Serous carcinoma

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20
Q

What is a Brenner tumour?

A

Transitional type tumour
Benign
Coffee-bean nucleus

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21
Q

What ovarian tumour is oestrogen producing?

Study These Flashcards
A

Granulosa cell

22
Q

What ovarian tumour is androgen producing?

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A

Theca/Leydig cell

23
Q

What are risk factors for ovarian cancer?

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A 
Increasing age - post-menopausal
Nulliparous
Increased number of menstrual cycles (early menarche, lat menopause, use of IUD)
Obesity
Family history
Use of HRT
24
Q

Which family history syndromes increase risk of ovarian cancer?

Study These Flashcards
A 
BRCA 1 and 2
Lynch syndrome (HNPCC)
25
What factors are protective against ovarian cancer?
COCP Multiparity Breastfeeding Hysterectomy and tubal ligation
26
Which cancers commonly spread to the ovaries?
Breast Pancreas Stomach GI
27
What is Krukenberg tumour?
Metastatic disease of the ovary that is gastric in origin and has signet ring cells
28
What is the presentation of ovarian cancer?
Mass - swelling, bloating, abdominal distension Pressure symptoms - bladder urgency, frequency Irregular bleeding Pelvic pain GI disturbance leg oedema DVT SOB (pleural effusion) Non-specific - fatigue, malaise, weight loss, decreased appetite
29
With what presentation should you be very suspicious of ovarian cancer?
IBS-like symptoms in a post-menopausal woman
30
What are the main investigations for ovarian cancer?
CA-125 Ultrasound Diagnostic laparoscopy
31
What other factors cause a high CA-125?
Endometriosis Menstruation Benign ovarian cysts
32
What is the Risk of Malignancy Index?
``` Menopausal status x ultrasound features x CA-125 Premenopausal = 1 Postmenopausal = 3 No ultrasound features = 0 One US feature = 1 >1 US features = 3 Absolute level of Ca-125 ```
33
What ultrasound features are indicative of ovarian cancer?
``` Multiloculated Solid areas Bilaterality Ascites Metastasis ```
34
What is the risk of ovarian cancer if RMI <30?
3%
35
What is the risk of ovarian cancer if RMI is >250?
Over 75% | Rever to gynae
36
What is the staging system for ovarian cancer?
Figo Staging 1 - limited to the ovaries 2 - spread to pelvic organs but limited to the pelvis 3 - spread beyond pelvis but confined to abdominal peritoneum 4 - distant metastases
37
What are some sites that ovarian cancer spreads to?
Liver | Lungs
38
What is the management of ovarian cancer?
If fit - surgery for maximal tumour debulking If fertility required - unilateral sapling-oophorectomy Stage 2+ - radiotherapy in addition to surgery
39
What is ovarian torsion?
Partial or complete torsion of the ovary on it's supporting ligaments Blood supply may become compromised
40
What is adnexal torsion?
If the fallopian tube is involved in ovarian torsion
41
What are risk factors for ovarian torsion?
``` Ovarian mass (90% of cases) Reproductive age Pregnancy Ovarian hypestimulation syndrome PCOS ```
42
What is the presentation of ovarian torsion?
``` Abdominal pain - sudden onset - deep-seated - colicky Vomoiting Distress, tachycardia Fever in the minority Adnexal tenderness of vaginal examination ```
43
What USS signs are indicative of ovarian torsion?
Whirlpool sign | Free fluid
44
What is the management of ovarian torsion?
Laparoscopy - diagnostic and therapeutic
45
What are the criteria for PCOS?
2 of: Polycystic ovaries Oligomenorrhea or amenorrhoea Hyperandrogenism (acne, hirsutism, male pattern baldness)
46
What conditions are associated with PCOS?
Obesity Hypertension Hyperlipidaemia Insulin resistance
47
What is the presentation of PCOS?
``` Menstrual disturbances Hyperandrogenism Obesity Acanthosis nigricans (due to insulin resistance/hyperinsulinemia) Subfertility Diabetes mellitus Thrombosis - stroke, TIA, coronary artery disease Obstructive sleep apnoea ```
48
What is the management for period irregularities in PCOS?
COCP
49
What is the management for fertility in PCOS?
``` BMI <35 Metformin Clomiphene citrate - stimulates ovulation Gonadotrophins IVF ```
50
What is the function of metformin in PCOS?
Improves insulin resistance | Improves ovulatory function

Y3 - Repro (13 decks)

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