B8-024 Ovarian Cysts

Question 1

most common cause of adnexal pain

Answer 1

ovarian cysts

Question 2

ovarian cysts most commonly present with […] cycle pain that is sharp and sudden onset

Answer 2

mid/late

Question 3

ovarian cyst is diagnosed via

Answer 3

transvaginal US

Question 4

physiologic cysts [2]

Answer 4

follicular
corpus luteum

Question 5

[type of cyst]
follicle fails to rupture, usually resolves spontaneously
makes estrogen

Answer 5

follicular

Question 6

[type of cyst]
CL fails to regress, may produce progesterone

Answer 6

corpus luteum

Question 7

[type of cyst]
blood filled follicular or luteal cyst

Answer 7

hemorrhagic

Question 8

[type of cyst]
lined by columnar epithlieum
secrete thick, gelatinous mucin

Answer 8

mucinous cystadenoma

Question 9

[type of cyst]
germ cell tumor

Answer 9

mature teratoma

Question 10

[type of cyst]
endometrial tumor on ovary
“chocolate cyst”

Answer 10

endometrioid

Question 11

hyperechogenic inferfaces in cystic mass

Answer 11

mature teratoma

Question 12

thin smooth wall
anechoic contents
no/few septa

Answer 12

simple cyst/follicular cyst

Question 13

thin septations
echogenic material (mucin)

Answer 13

mucinous cyst

Question 14

fishnet weave
fine reticular pattern

Answer 14

hemorrhagic cysts

Question 15

thick walled
homogenous
may have calcifications

Answer 15

endometrioma

Question 16

thick septations

Answer 16

possible malignancy

Question 17

caused by failure of mature follicle to rupture and ovulate
may produce excess estrogen

Answer 17

follicular cysts

Question 18

caused by failure of corpus luteum to involute after ovulation
may produce excess progesterone

Answer 18

corpus luteal cyst

Question 19

if a patient is pregnant and undergoes corpus luteal cystectomy, what needs to be done to prevent miscarriage?

Answer 19

exogenous progesterone support

Question 20

“string of pearls” on transvaginal US

Answer 20

PCOS

Question 21

medications that can be used to manage symptoms of PCOS, but are mutagens [3]

Answer 21

spironolactone
propecia
flutamide (also hepatotoxic)

Question 22

20-40% of women with PCOS have […] syndrome

Answer 22

metabolic syndrome (insulin resistance)

Question 23

what co-morbidity is likely to be present in a patient with PCOS

Answer 23

insulin resistance

Question 24

most appropriate initial laboratory test in suspected PCOS

Answer 24

free testosterone concentration

he says. I don’t think this is true IRL

Question 25

excruciating pain on bimanual exam (chandelier sign) is associated with [3]

Answer 25

PID
ectopic pregnancy
tubo-ovarian abscess

Question 26

helps to differentiate PID from appendicitis

Answer 26

bimanual exam (chandelier sign)

Question 27

diagnosis of adnexal torsion is done via what imaging modality?

Answer 27

color flow doppler

Question 28

adnexal torsion requires prompt laparoscopy as the tissue is only viable for […] hours

Answer 28

6

Question 29

cervical motion tenderness may indicate [2]

Answer 29

PID
ectopic pregnancy

Question 30

cervical motion tenderness
lower abdominal tenderness
adnexal tenderness

is a classic triad of…

Answer 30

PID

Question 31

diagnosis of PID requires

Answer 31

UA
wet prep
cervical cultures

Question 32

acute, colicky pain beginning in the flank and radiating to groin
pain out of proportion to physical findings

Answer 32

kidney stone