Women's Health- Ovaries Flashcards Preview

Clinical Medication: HEENT > Women's Health- Ovaries > Flashcards

Flashcards in Women's Health- Ovaries Deck (37):
1

what are the common s/s of Ovarian and adnexal Disease?

Vague GI discomfort

Pelivic pressure and pain

May be asymptomatic

2

What is the mainstay of dx of Ovarian and adnexal Disease?

Pelic examination and ultrasound

3

Ovaries are not suppose to be palpable after menopause, if they are what should you do?

Further dx!

4

Are Ovarian Tumors common?

Yes most are benign

5

Malignant ovarian tumors are the leading cause for death of the reproductive tract, what are the risk factors for developing the malignant ovarian tumors?

Family history with BRCA1 and BRCA2 gene mutation ( BRCA1 is higher risk)

6

What are the clinical manifestations of Ovarian cancer?

Most: asymptomatic

Mild nonspecific GI symptoms or pelvic pressure

Early disease- detected on routine pelvic examination

Advanced malignant disease- abdominal pain and bloating- palpable abdominal mass with ascities is often present

7

What are the laboratory findings for Ovarian cancer?

CA-125- tumor marker to distinguish between benign and malignant pelivic masses( sensitie but not specific)
Other markers
hCG
Lactate Dehydrogenase
Alpha fetoprotein

8

What imaging studies are done for Ovarian cancer?

Transvaginal ultrasound- useful for high risk women- inadequate sensitivity for screening low risk women ( helpful in dx malignancy and benign)

9

What is the treatment of Ovarian Cancer?

Surgical evaluation by Gyneocolic Oncologist

If it is malignant: complete surgical staging plus
Abdominal hysterectomy andbilateral salpingoophorectomy with omenetomy and selective lymphadenectomy and possible post op chemo

If it is benign: Tumor is removed unilateral oophorectomy

10

What is the prognosis of Ovarian cancer?

75% diagnosed with ovarian cancer in advanced stages ( 5 year survival rate 17% with distant mets, 36% with local spread, 89% with early disease)

11

Functional Ovarian Cyst:

Functional Ovarian Cyst:

12

What is a Functional Ovarian Cyst?

Variation due to normal ovulation

can be quite large, they still are usually less than 10 cm in size

generally asymptomatic unless bleeding or torsion occurs.

Most will spontaneously resolve within a few weeks but some will persist for several months.

13

There are two types of Functional Ovarian Cyst, what are they?

Follicular cyst- failure of ovulation, follicle continues to grow

Corupus Leteum cyst corpus luteum fails to involute- continues to enlarge after ovulation

14

What does a follicular cyst look like on ultrasound?

shows up as smooth thin walled, and unilocular on ultrasound

15

What do Corpus luteum cyst look like?

complex and grossly are yellow

16

Follicular Cysts:

Follicular Cysts:

17

What is the most common functional cyst?

Follicular cysts

18

What is the common size of follicular cyst?

3-8 cm

19

what are the signs and symptoms of follicular cyst and how are they normally treated?

Can be painful, generally resolve on their own over one or two cycles.

20

What if the follicular cyst do not resovle on their own?

Surgical intervention, BCP can prevent the formation.

21

What will the pelvic exam on a follicular cyst show?

Bomanual exam will have a tender painful mass.

22

What must you always r/o when thinking follicular cyst?

Pregnancy

23

Corpus Leteum Cysts

Corpus Leteum Cysts

24

What is the size of a Corpus Leteum Cysts?

Larger than 3 cm

25

What are Corpus Leteum Cysts related to?

The progesterone dominate phase of the cycle

26

How do Corpus Leteum Cysts come about?

They evolve rapidly and are hemorrhagic, may be associated with ovarian torsion- severe pain

27

What is the treatment of Corpus Leteum Cysts?

o Unless acute complications treatment is symptomatic (OCP may work)

o Laparoscopy or laparotomy usually is required to control hemorrhage into the peritoneal cavity and or detorison of the adnexa

28

Benign Ovarian Neoplasm:
• define:
• In premenopausal women:
• Post menopausal-

• Functional cysts make up the majority of ovarian masses- however 25% are nonfunctional neoplasm
• In premenopausal women 90% of these are benign
• Post menopausal- only 75% are benign

29

Theca Lutein Cyst

Theca Lutein Cyst

30

What is a Theca Lutein Cyst ?

Elevated levels of Chorionic gonadotropin, the cysts will be lined by theca cells, usally bilaterally and filled with clear straw colored fluid.

31

What are the symptoms of Theca Lutein Cyst ?

Abdominal symptpms are rare

32

Theca Lutein Cyst are associated with what?

Pregnancy, Multiple gestations, Trophoblastic disease, Clominphene use

33

Benign Ovarian Neoplams:

Tumors are often clinically silent until well developed- may be solid, cystic, or miexed and they may be functional (prdoducing sex steroids) or nonfunctional

34

What increases the malignancy of benign ovarian neoplasms?

Increased age – postmenopausal patients warrant comprehensive evaluation and follow up.

35

What are risk factors for developing benign ovarian neoplasms?

Cigarette smoking doubles the relative risk, menarche, obesity, infertility and hypothyroidism

36

What are risk factors for ovarian cancer?

o Age over 60
o Early menarche
o Late menopause
o Nulligravity infertility
o Enometriosis
o Polycystic ovarian syndrome
o Family hx of ovarian ca

37

Treatment of ovarian tumors:

Medication: OTC, Fist line NSAIDS or Narcotics

Surgery: Cystectomy with wedge resection