Ovaries path I Flashcards

1
Q

what are follicular cysts

A

common
form if no LH surge and cyst does’t rupture to release its egg, continues to grow and forms cyst
usually reabsorb after 2-3 menstrual cycles

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2
Q

what causes a corpus luteum cyst

A

if opening from released egg seals off the subsequent corpus luteum can grow into a cyst

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3
Q

what can occur with corpus luteum cyst

A

may hemorrhage or udnergo torsion

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4
Q

what is an endometrioma

A

chocoloate cysts from repeated menstural cycles

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5
Q

youn women with sudden unilateral low abdominal pain

A

torision of ovary

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6
Q

what do you have to rule out if suspect torsion of ovary

A

ectopic pregnancy

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7
Q

what is Tx for torsion of ovary

A

surgery to unwind ot remove

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8
Q

what is the #1 cause of torsion of ovary

A

teratoma

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9
Q

risk factors for ovarian torsion

A

increased length of ovarian ligament/large ovary

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10
Q

What are components of polycystic ovary disease

A

oligomenorrhea
hyperandrogenism: hisutisms, inc muscle mass, large clitoris, baldness, acne
polycystic ovaries
obesity, acanthosis nigricans, DM, insulin R, premature ASD, high cholesterol

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11
Q

what disease do you rule out for PCOD

A

thyroid problems, pituitary problems

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12
Q

what is stromal hyperthecosis

A

overlaps with PCOD
both ovaries enlarged with hormonally active ovarian stroma
most common in postmenopausal women
virilizaiton may be striking

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13
Q

how does ranking of hirsutism work

A

scale 0-4, 4 being the most hair

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14
Q

if suspect PCOD what are labs to order

A

Testosterone levels at 8 am
24 hr urine cortisol levels
DXM suppression test

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15
Q

definition of infertility

A

failure to conceive after 1 year of sex

> 6mo if >35 y.o

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16
Q

what is fecundity

A

likeliehood of pregnancy over time
25-50% <3 mo
85% in 1 yr

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17
Q

what can cause pale infertility

A

endocrine, poor sperm

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18
Q

23 y.o female complaining of infertility

labs to order

A

day 21 P
3 ng/mL= recent ovulation
endometrial Bx

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19
Q

if 23 y.o infertile patient is anovulatory what could be causes of infertility

A

PCOS: increased androgen, ovarian cysts

PRL levels, TSH, FSH

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20
Q

if 23 y.o infertile patient does have ovulation what could be cause of infertility and what lab do you do.

A

hysterosalpingogram to see if blocked or patent
blockage could be PID or mechanical
if patent could be endometriosis, uterine masses, lesion… etc

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21
Q

what lab level will determine if 40 y.o F has ovarian failure

A

if day 3 FHS levels are increased

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22
Q

majoirty of malignant ovarian tumors are what type

A

serous tumors, surface epithelial

cystadenomas, borderline tumors, adenocarcinomas type I and III

23
Q

what are the types of surface epithelial tumors of ovaries

A

serous
mucinous
endometroid

24
Q

what are the sex cord-stromal tumors of ovaries

A

granulosa, fibrothecomas and sertoli-leydig tumors

25
what are the germ cell tumors of ovaries
teratoma, dysgerminoma, endodermal, sinus (yolk sac)
26
second most common malignant ovarian tumors
endometroid tumors- adenocarcinoma type I and II
27
when are ovarian cancers discovered
late presentaiton because often asymptomatic
28
what are the hereditary assocaitions with ovarian cancer
BRCA 1 and 2 | lynch II syndrome MSH2
29
prognosis of ovarian cancer really depends on what
stage
30
which ovarian cancers are mroe commonly b/l
serous and endometrial
31
What is used to follow already Dx ovarian cancer
CA-125
32
what decreases risk of ovarian cancer
tubal ligation, BCP
33
wehre do most serous ovarian CA arise
distal fallopian tube
34
what is a serous cystadenoma
benign common | lined by single layer epithlium
35
what is a serous borderline carcinoma
more cytologic atypia but NO invasion usually spread to peritoneum good survival
36
what is a serous adenocarcinoma
INVASIVE type I is low grade- slow progression type II is aggressive high grade and presents late (if mets <10 % survival
37
histo of serous adenocarcinoma
single cells that line cyst wall and ciliated | fallopian tube also ciliated
38
what classifies "borderline"
in between category | no evidence of invasion
39
Tx for borderline carcinomas
remove
40
what is exophytic serous carcinoma
surface ovary covered by neoplas
41
what is cystic serous carcinoma
surface of ovary is smooth because neoplasm inside
42
serous adenocarcinoma can have what unique histo cahracteristic that is pathoneumonic
psammomma bodies
43
most mucinous tumors are benign or malignant
benign
44
what utation is assoc with mucinous tumors or ovaries
KRAS
45
what is pseudomyxoma peritonei
mucinous ascites with metastatic tumor on peritoneal surfaces
46
what are endometroid tumors type II markers
p53, CDH1, MI
47
what are the endometroid tumors type I markers
PTEN and KRAS and beta cetenin
48
mutation assoc with clear cell carcinoma of ovaries
PTEN mutations or loss of heterozygosity PIK3CA mutation
49
high grade serious carcinomas and high grade endometroid carcinomas are assoc with what mutations
p53 | BRCA1
50
cytological markers for high grade serous carcinoma of ovary
p53 WT1 Pax8 ER+
51
cytologic markers for low grade serous carcinoma of ovary
WT1 Pax8
52
cytologic markers for endometroid carcinomas of ovary
ER + PAX8+ WT negative!
53
cytologic markers for clear cell carcinoma of ovary
HNF beta+ negative WT! ER negative!
54
cytologic markers for mucinous carcinomas of ovary
CK20+ ER negative! WT negative!