Ovaries and Fallopian Tubes

Question 1

Graafian follicle releases the egg in response to a surge of what hormone?

Answer 1

LH

Question 2

Describe the arrangement of cells surrounding the oocyte of a graafian follicle

Answer 2

Oocyte surrounded by granulosa cells (and liquid center), surrounded by a layer of theca cells, surrounded by the ovarian stroma

Question 3

What structure forms following the release of the oocyte?

Answer 3

The corpus luteum (formed from the remaining wall of the graafian follicle

Question 4

LH acts on _________ cells to release _____ (hormone)

Answer 4

LH acts on theca cells to release androgens

Question 5

FSH acts on ___________ cells to release _________ (Hormone)

Answer 5

FSH acts on granulosa cells to convert androgens to estradiol

Question 6

Which hormone induces the LH Surge?

Answer 6

Estradiol

Question 7

What is a luteal cyst?

Answer 7

Unruptured graafian follicle or a ruptured follicle that immediately seals

Forms a cyst filled with serous fluid

Question 8

PCOS is characterized by excess secretion of what hormone?

Answer 8

Androgens

Question 9

What causes the excess androgen release in PCOS?

Answer 9

Increased secretion of LH

LH:FSH is >2:1

Question 10

Why is FSH decreased in PCOS?

Answer 10

High androgens –> high estrone (in adipose tissue) –> decreased FSH (which normally stimulates the conversion of androgens to estradiol)

Question 11

How does low FSH lead to cysts in PCOS?

Answer 11

low levels of FSH leads to follicular degeneration and cyst formation

Question 12

Women with PCOS are at risk for what cancer? WhY?

Answer 12

Endometrioid endometrial carcinoma - due to presence of high unopposed estrogen

Question 13

What drug is given to infertile women with PCOS to help rebalance their hormones?

Answer 13

Metformin

Question 14

The vast majority of all ovarian caEncers arise from which cell type?

Answer 14

Surface epithelial cells

Question 15

What age group gets ovarian cancer arising from surface epithelium?

Answer 15

20+

Question 16

WHat age group gets ovarian cancers arising from germ cells?

Answer 16

0-25+ years old

Question 17

Name three tumors that arise from the stromal cells

Answer 17

Fibromas
Granulosa-Theca cell tumors
Sertoli-Leydig tumors

Question 18

Choriocarcinomas arise from which cell type?

Answer 18

ovarian germ cells

Question 19

Endodermal sinus tumors arise from which ovarian cell type?

Answer 19

Germ cells

Question 20

Dysgermomas arise from which ovarian cell type?

Answer 20

Germ cells

Question 21

Describe the histology of a benign serous ovarian tumor

Answer 21

Single layer of tall columnar cells

Question 22

Describe the histology of a benign mucinous ovarian tumor

Answer 22

Mucin producing epithelial cells

Question 23

Are serous or mucinous malignant tumors more likely to be bilateral?

Answer 23

Malignant serous tumors are more likely to be bilateral.

Malignant mucinous tumors are usually unilateral

Question 24

What is the name of the concentrically laminated concretions commonly seen in ovarian tumors?

Answer 24

Psammoma bodies

Question 25

Name three risk factors for cystadenocarcinomas

Answer 25

nulliparity, family hx, germline mutations of tumor suppressor genes

Question 26

5-10% of ovarian cystadenomas are familial and associated with germline mutations of which genes?

Answer 26

BRCA1, BRCA2

Question 27

Do mucinous or serous cystadenomas have a better prognosis?

Answer 27

Mucinous

Question 28

WHat is the tumor marker used to mark recurrence of ovarian cystadenocarcinomas

Answer 28

CA-125

Question 29

Are brenner tumors benign or malignant?

Answer 29

Usually benign

Question 30

What is the histology of Brenner tumors?

Answer 30

Nests of transitional-type epithelium, resembling that of the urinary tract Urothelium!

Question 31

What is a dysgerminoma?

Answer 31

Germ cell neoplasm that has not undergone any differentiation

Question 32

What are embryonal carcinomas?

Answer 32

Germ cell tumors that have undergone only primitive differentiation

Question 33

What two carcinomas arise from germ cells that have differentiated into extraembryonic tissue?

Answer 33

Choriocarcinomas | Endodermal sinus tract carcinoma (Yolk sac carcinomas)

Question 34

What are teratomas?

Answer 34

Germ cell tumors that have undergone differentiation into embryonic tissue

Question 35

What is struma ovarii?

Answer 35

Special type of teratoma that has functional thyroid tissue --> can lead to hyperthyroidism

Question 36

The immature tissue in immature teratomas generally arise from what type of cells?

Answer 36

neural

Question 37

What is the best way to treat a dysgerminoma?

Answer 37

Radiation They are VERY radiation sensitive!

Question 38

What is the main tumor marker for dysgerminomas?

Answer 38

LDH

Question 39

Are yolk sac tumors benign or malignant?

Answer 39

Malignant

Question 40

WHat is the characteristic histology seen in yolk-sac tumors?

Answer 40

Schiller-Duval bodies- "glomeruli-like"

Question 41

What is the tumor marker used in yolk-sac tumors?

Answer 41

AFP

Question 42

What is the prognosis of choriocarcinoma?

Answer 42

Malignant, metastatic, often fatal

Question 43

What is the tumor marker for choriocarcinoma?

Answer 43

hCG

Question 44

What is the characteristic histology of granulosa cell tumors?

Answer 44

Call-exner bodies

Question 45

What are the hormonal implications of granulosa cell tumors

Answer 45

Excess estrogen

Question 46

A post-menopausal woman with endometrial hyperplasia and an ovarian mass has....

Answer 46

Granulosa cell tumor

Question 47

Sertoli-Leydig cell tumors produce which hormone?

Answer 47

androgen

Question 48

How do sertoli-leydig cell tumors affect young girls?

Answer 48

It blocks female sexual development in children

Question 49

Describe the Meigs Syndrome associated with Thecoma-fibromas

Answer 49

Right sided pleural effusions Ascites Ovarian mass

Question 50

Which are the most common mets to the ovaries?

Answer 50

Krukenberg tumors- from gastric cancers

Question 51

Cancer of the fallopian tube can be of what two types?

Answer 51

Serous or endometrioid type

Question 52

What are the two most common tumors derived of the ovarian epithelial cells?

Answer 52

Serous or Mucinous cysts -Can be benign (cystadenoma) or malignant (cystadenocarcinoma)

Question 53

BRCA1 mutations are associated with which type of ovarian cyst?

Answer 53

Serous cystadenoma | cystic, filled with clear fluid, derived from surface epithelial cells

Question 54

15% of patients with endometrioid carcinoma of the ovary also has what malignancy?

Answer 54

Endometrioid carcinoma of the endometrium