B8-024 Ovarian Cysts Flashcards
most common cause of adnexal pain
ovarian cysts
ovarian cysts most commonly present with […] cycle pain that is sharp and sudden onset
mid/late
ovarian cyst is diagnosed via
transvaginal US
physiologic cysts [2]
follicular
corpus luteum
[type of cyst]
follicle fails to rupture, usually resolves spontaneously
makes estrogen
follicular
[type of cyst]
CL fails to regress, may produce progesterone
corpus luteum
[type of cyst]
blood filled follicular or luteal cyst
hemorrhagic
[type of cyst]
lined by columnar epithlieum
secrete thick, gelatinous mucin
mucinous cystadenoma
[type of cyst]
germ cell tumor
mature teratoma
[type of cyst]
endometrial tumor on ovary
“chocolate cyst”
endometrioid
hyperechogenic inferfaces in cystic mass
mature teratoma
thin smooth wall
anechoic contents
no/few septa
simple cyst/follicular cyst
thin septations
echogenic material (mucin)
mucinous cyst
fishnet weave
fine reticular pattern
hemorrhagic cysts
thick walled
homogenous
may have calcifications
endometrioma
thick septations
possible malignancy
caused by failure of mature follicle to rupture and ovulate
may produce excess estrogen
follicular cysts
caused by failure of corpus luteum to involute after ovulation
may produce excess progesterone
corpus luteal cyst
if a patient is pregnant and undergoes corpus luteal cystectomy, what needs to be done to prevent miscarriage?
exogenous progesterone support
“string of pearls” on transvaginal US
PCOS
medications that can be used to manage symptoms of PCOS, but are mutagens [3]
spironolactone
propecia
flutamide (also hepatotoxic)
20-40% of women with PCOS have […] syndrome
metabolic syndrome (insulin resistance)
what co-morbidity is likely to be present in a patient with PCOS
insulin resistance
most appropriate initial laboratory test in suspected PCOS
free testosterone concentration
he says. I don’t think this is true IRL
excruciating pain on bimanual exam (chandelier sign) is associated with [3]
PID
ectopic pregnancy
tubo-ovarian abscess
helps to differentiate PID from appendicitis
bimanual exam (chandelier sign)
diagnosis of adnexal torsion is done via what imaging modality?
color flow doppler
adnexal torsion requires prompt laparoscopy as the tissue is only viable for […] hours
6
cervical motion tenderness may indicate [2]
PID
ectopic pregnancy
cervical motion tenderness
lower abdominal tenderness
adnexal tenderness
is a classic triad of…
PID
diagnosis of PID requires
UA
wet prep
cervical cultures
acute, colicky pain beginning in the flank and radiating to groin
pain out of proportion to physical findings
kidney stone