Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Block 9 - Reproductive and Endocrine Disease > ASF - Ovary and Fallopian Tubes (Bruner) > Flashcards

ASF - Ovary and Fallopian Tubes (Bruner) Flashcards

1
Q

What is the most common disorder of the fallopian tubes?

A

Salpingitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Salpingitis is usually a component of which disease of the female reproductive tract?

A

Pelvic Inflammatory Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A 24-year-old female patient presents to her gynecologist to discuss recent bouts of pelvic pain and vaginal discharge. Her temperature is 99.4F. During the pelvic exam, you notice no vaginal or cervical abnormalities, but there is a thick, yellow discharge coming out of the cervix. You perform the bimanual exam and the patient experiences pain on palpation of the adnexa. What is the underlying cause of this patient’s symptoms?

A

Bacterial infection that has spread to the fallopian tubes

This patient has salpingitis, inflammation of the fallopian tubes. It is commonly associated with PID. It can be caused by a bacterial infection that travels from the vagina, through the uterus, and into the fallopian tubes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most common cause of pelvic inflammatory disease?

A

Gonorrhea infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a puerperal infection and how does it relate to PID?

A

Puerperal infections occur after birth or after abortion. These can spread and lead to PID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pelvic inflammatory disease is the most common cause of what two conditions?

A

Ectopic pregnancy and infertility

Chronic inflammation causes scarring and fibrosis of the fallopian tubes and uterus. This leads to improper implantation of the embryo or failure of the egg to travel from the ovary through the fallopian tube.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A sexually active 15-year-old female complains of lower abdominal pain and a foul-smelling vaginal discharge. She mentions that she and her boyfriend decided to have unprotected sex 3 weeks prior to her appointment. During the pelvic examination, you notice a red, inflamed cervix with a green, fishy smelling discharge. The patient complains of intense pain when you feel the cervix during the bimanual exam. If left untreated, what would this patient be at high risk of developing?

A

Infertility or ectopic pregnancy

This patient has PID caused by a bacterial infection that has spread from the vagina to the cervix and uterus.

Persistent PID causes fibrosis of the female reproductive tract, which interferes with pregnancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is pelvic inflammatory disease (PID) treated?

A

Antibiotics and pain medication

PID is caused by bacterial infection of the female reproductive tract. The only treatment is to prescribe antibiotics to get rid of the infection. Pain meds can be given to lessen symptoms until infection clears.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common age range for PID to occur?

A

15-24

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 4 primary clinical features of polycystic ovarian syndrome (PCOS)?

A
  1. Persistent anovulation
  2. Obesity
  3. Hirsutism
  4. Virilism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is hirsutism and how does PCOS cause it?

A

Hirsutism is unwanted male-pattern hair growth in women, typically on the face, chest, and back.

PCOS increases the number of ovarian follicles within the ovary, which increases androgen production. Excess androgens lead to hirsutism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does PCOS cause oligomenorrhea/amenorrhea?

A

PCOS is characterized by an increase in sex hormones. Excess estrogen causes proliferation of the endometrium. Normally, progesterone would enter here and signal the secretory phase. However, high estrogen to progesterone ratios prevent this from happening. This causes the excess endometrial tissue to shed and bleed out of the normal cycle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A 22-year-old female with persistent abdominal and pelvic pain is admitted to the ICU following a bout of severe hyperglycemia. Glucose was present in her urine and her blood glucose levels were 532 mg/dL. Her glucose levels have not responded to exogenous insulin injection. Her BMI is 34. During the physical exam, what might you expect to see on her chest and abdomen?

A

Hair

This patient most likely has PCOS, a condition that can cause insulin resistance, obesity, abnormal menstruation, and hirsutism (male-pattern hair growth of face, chest, abdomen, and back).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the two conditions of PCOS that are caused by an increased luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio?

A

Hirsutism and cyst formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most common cause of anovulatory infertility?

A

PCOS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some of the risk factors for developing epithelial derived tumors of the ovary?

A
  • Increasing age
  • Estrogen-related: early menarche (<12), infertility, nulliparity, late onset menopause (>50)
  • Obesity (BMI > 30)
  • Family history: breast or ovarian cancers or familial ovarian cancer syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is main cause of transformation of ovarian tissue to malignancy?

A

Chronic uninterrupted ovulation

Surface epithelium transforms and entraps follicles within the ovarian cortex. Metaplasia occurs, which exposes cells to DNA damage and replicative stress that leads to cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are 5 protective factors for preventing development of an ovarian epithelial tumor?

A
  • Oral contraceptives
  • Decreasing ovulation: Multiparity and Breast feeding
  • Interruption of nutrients/migration of cancer cells: Tubal ligation and hysterectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the 5th most lethal malignancy in women in the US, even though it can be cured if caught in early stages?

A

Epithelial-derived ovarian tumors (mucinous, endometrioid, or serous)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is CA-125 and which type of ovarian cancer does it correllate with in terms of progression and regression?

A

Cancer-antigen 125 is a glycoprotein that is secreted by coelomic epithelium of the ovary.

CA-125 is present in 80% of epithelial-derived cancers of the ovary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A 32-year-old patient meets with her gynecologist to discuss the results of her recent blood test to determine her CA-125 levels. After looking at her lab work, you notice that she does have high CA-125 levels. You have a diagnosis in mind, but remember there is one test you need to perform yourself before ordering further testing. What test is this?

A

Transvaginal ultrasound of the ovary

Patients with high levels of CA-125 and abnormal morphology of the ovaries have a very high risk of getting ovarian cancer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some late symptoms of ovarian cancer?

A
  • Back pain
  • Urinary frequency
  • Constipation
  • Fatigue
  • Menstrual change
  • Dyspareunia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

In general, masses that are mobile, smooth, and unilateral will tend to be considered what?

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

You are working with a fresh frozen sample of an ovarian tumor. On visualization, you notice that the tumor is lumpy and solid. When looking at the patient history, the clinician noted that the mass was firm and immobile on examination. More than likely, will this mass be considered malignant or benign?

A

Malignant

Immobile, irregular surface, and solid all tend to indicate malignant tumors.

25
Q

What is a common associated feature with benign tumors that can be seen on a transvaginal ultrasound of the ovary?

A

Calcification

26
Q

What are the 3 categories that most surface epithelial tumors can be classified as?

A
  1. Benign
  2. Borderline
  3. Carcinoma
27
Q

Which type of surface epithelial tumor of the ovary is the most common?

A

Serous tumor

28
Q

What is the clinical term for a benign serous tumor?

A

Cystadenoma

29
Q

What is the clinical name for a malignant serous tumor of the ovary?

A

Cystadenocarcinoma

30
Q

What are two gross pathologic findings you would see if a patient with a benign serous tumor (cystadenoma) had her ovaries removed?

A
  1. Smooth walls
  2. Yellow-fluid filled sac surrounding ovary
31
Q

What distinguishes a borderline serous tumor from a benign and malignant one?

A

Has characteristics of both benign and malignant tumors

Smooth walls, papillary architecture, some areas of cysts, some areas of solid tumor.

32
Q

What are Psammoma bodies?

A

Concentric, lamellated calcifications within papillary carcinomas

Very common in malignant serous tumors of the ovary

33
Q

What are the typical gene mutations present in individuals that develop low-grade serous carcinoma?

A

KRAS or BRAF mutations

Sometimes TP53, but rare

34
Q

What are the typical gene mutations leading to high-grade serous carcinoma?

A

TP53 only

35
Q

How does high-grade serous carcinoma of the ovary typically begin and progress?

A

Steps:

  1. Tubal epithelium undergoes dysplasia
  2. Serous Tubal Intraepithelial Carcinoma (STIC)
  3. High-grade serous carcinoma
36
Q

How does low-grade serous carcinoma typically begin and progress?

A

Steps:

  1. Inclusions within ovarian epithelium
  2. Benign serous cystadenoma
  3. Borderline serous tumor
  4. Low-grade serous carcinoma
37
Q

In patients with serous tubal intraepithelial carcinoma (STIC), where are cancerous cells located and how do cancerous cells typically spread?

A

Originate in the fallopian tubes (mainly in parts with fimbriae)

Chunks of neoplastic cells fall off of the fallopian tube epithelium. These cells fall onto the ovary and induce tumor growth. They can also spread to the abdomen in this way.

38
Q

True or False: Primary ovarian mucinous carcinomas are common.

A

False

Most of the time, mucinous carcinomas will originate elsewhere and spread to the ovaries. This is especially true if the tumors are bilateral.

39
Q

What does a gross specimen of an ovary with a mucinous tumor appear like on the outside and on the inside?

A

Outside - smooth wall, enlarged

Inside - large, multiloculated cystic lesions

40
Q

How could you differentiate between histological sections of benign and malignant mucinous tumors?

A
  • Benign - single layer of columnar epithelial cells with lots of apical mucin
  • Malignant - solid growth with atypical cells, no mucin, loss of glandular architecture, and necrosis
41
Q

What type of tissue do endometrioid tumors closely resemble on histologic section?

A

Endometrium

Tall, pseudostratified columnar epithelium and many tubular glands

42
Q

True or False: Benign and borderline endometrioid tumors are uncommon.

A

True

Most endometrioid carcinomas will be malignant.

43
Q

What risk factor causes some women to get endometrioid tumors of the ovary 10 years earlier than the typical age of onset?

A

Endometriosis

44
Q

A 32-year-old patient visits an oncologist complaining of abdominal pain and an altered menstrual cycle. It is found that she has an endometrioid carcinoma of the ovary. Radiologists have staged this cancer as a Stage III. What does this mean and what is her % 5-year-survival rate

A

Stage 3 means that the cancer has spread throughout the abdomen.

5-year-survival rate is 20-50%

45
Q

What is a stage 2 endometrioid carcinoma?

A

Tumor that is confined to the pelvis

70-80% 5-year-survival rate

46
Q

What is stage 4 endometrioid carcinoma and what is this patient’s 5-year-survival rate?

A

Cancer that has spread to the abdomen and outside of the abdomen

1-5% 5-year-survival rate

47
Q

On your oncology rotation, your attending mentions that the next patient you will be visiting has stage 1 endometrioid carcinoma of the ovary. What makes this tumor a stage 1, and what is her 5-year-survival rate?

A

Stage 1 means the tumor is confined to the ovary and has not spread.

90-95% 5-year-survival rate

48
Q

Which BRCA gene tends to confer a higher risk of getting breast and ovarian cancers than the other?

A

BRCA1

BRCA2 is actually more common in familial breast cancer that afflicts men.

49
Q

What is Lynch Syndrome and what cancers is it associated with?

A

Hereditary non-polyposis colorectal cancer (HNPCC)

Associated with high rates of breast, ovarian, colon, and endometrial cancers

50
Q

Which age group predominantly gets germ cell tumors of the ovary?

A

Children and young adults

51
Q

Most germ cell tumors are considered to be of what type?

A

Teratoma

52
Q

What are the 3 types of teratomas?

A

Mature (benign), monodermal (specialized), and immature (malignant)

53
Q

Which cell type do teratomas usually arise from?

A

Ovum that has gone through its 1st meiotic division

54
Q

What is the typical appearance of a teratoma?

A

Cystic with a wall composed of squamous epithelium, hair shafts, and sebaceous glands

55
Q

What is a Rokitansky Protuberance and which type of ovarian cancer is it typically found in?

A

Calcifications and tooth structures within the cyst wall of a teratoma

56
Q

Of the 1% of teratomas that undergo malignant transformation, which type of cancer do they tend to become?

A

Squamous cell carcinoma

57
Q

What is Struma ovarii and what type of paraneoplastic syndrome does it cause?

A

Mature thyroid tissue within the ovary

Can cause hyperthyroidism

58
Q

What is the name of the teratoma that is associated with intestinal epithelium?

A

Carcinoid

59
Q
A

Block 9 - Reproductive and Endocrine Disease (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions