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ENRP trimmed deck > Benign and Malignant Conditions of the Uterus, Cervix, Fallopian Tubes, and Ovaries (Moulton) > Flashcards

Benign and Malignant Conditions of the Uterus, Cervix, Fallopian Tubes, and Ovaries (Moulton) Flashcards

1
Q

What are the most common neoplasm of the uterus and are characterized by benign tumors derived from localized proliferation of smooth muscle cells of the myometrium?

A

Uterine leiomyomas (Fibroids)

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2
Q

While they are usually asymptomatic, symptomatic fibroids can cause?

A

1) Heavy uterine bleeding
2) Pelvic pressure/pain
3) Infertility

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3
Q

Symptomatic fibroids are the most common indication for?

A

Hysterectomy

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4
Q

What race has a 2-3 fold increase risk of leiomyomas?

In terms of childbearing, what increases risk?

A

1) African American

2) Nulliparity

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5
Q

Fibroids rarely form before __1__ or enlarge after __2__.

They enlarge most frequently during __3__?

This is due to __4__ playing a huge role in its development by stimulating the proliferation of smooth muscle cells.

A

1) Menarche
2) Menopause
3) Pregnancy
4) Estrogen

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6
Q

What are characterized as spherical, well circumscribed, white firm lesions with a whorled appearance on cut sections?

A

Leiomyomas (fibroids)

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7
Q

Fibroids arise within the __1__.

This is why __2__ fibroids are the most common.

A

1) Myometrium

2) Intramural

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8
Q

Which type of fibroid has the highest incidence of infertility?

A

Submucosal fibroids

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9
Q

The most common presenting symptom of leiomyoma is?

A

Heavy bleeding

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10
Q

If a palpated mass moves with the cervix is it highly suggestive of a carcinoma?

A

No, it is highly suggestive of fibroid

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11
Q

What is usually the first therapeutic option for leiomyomas?

A

Estrogen + Progesterone combination OCPs

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12
Q

A hysteroscopic myomectomy can be performed to remove which type of fibroids?

A

Submucosal fibroids

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13
Q

What is the definitive surgical therapy for fibroids?

A

Hysterectomy

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14
Q

What procedure leads to necrosis of the fibroid due to microspheres/polyvinyl alcohol particles occluding the artery feeding the fibroid?

A

Uterine artery embolization

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15
Q

What soft friable polyps can cause menorrhagia, spontaneous, or post menopausal bleeding?

A

Endometrial polyps

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16
Q

While saline hysterosonography & hysteroscopy allows for better detection of endometrial polyps, ultrasound may reveal focal thickening of the ____?

A

Endometrial stripe

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17
Q

While most endometrial polyps are benign hyperplastic masses, they need to be removed with hysteroscopy since ____ may also present as polyps.

A

Endometrial hyperplasia and carcinoma

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18
Q

What cervical cyst appear opaque with a yellowish or bluish hue?

A

Nabothian cyst

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19
Q

Nabothian cyst result from __1__ metaplasia in which a layer of superficial __1__ epithelial cells entrap a layer of __2__ cells beneath its surface.

A

1) Squamous

2) Columnar

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20
Q

What are the most common benign growths on the cervix?

A

Ectocervical and endocervical polyps

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21
Q

Which cervical polyp are more common and are beefy red in color?

Which are pale in appearance?

A

1) Endocervical polyps

2) Ectocervical polyps

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22
Q

Endometrial hyperplasia represents an overabundance growth of the endometrial lining usually as a result of persistent unopposed ____.

A

Estrogen

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23
Q

What syndrome can cause endometrial hyperplasia?

What estrogen producing tumor can cause endometrial hyperplasia?

What can cause endometrial hyperplasia due to peripheral conversion of androgens to estrogens in cells that are abundant in this condition?

What drug used in the treatment in breast cancer can cause endometrial hyperplasia?

A

1) PCOS
2) Granulosa theca cell tumors
3) Obesity
4) Tamoxifen

24
Q

Can endometrial hyperplasia be a precursor to endometrial cancer?

A

Yes

25
Q

What are the ways that endometrial hyperplasia is categorized?

Which category has the highest change of progressing into cancer?

A

1) Simple vs complex and with/without atypia

2) Complex hyperplasia with atypia

26
Q

What symptom does endometrial hyperplasia cause?

A

Intermenstrual, heavy or prolonged bleeding that is unexplained

27
Q

With simple and complex endometrial hyperplasia WITHOUT atypia treat with __1__ and resample in 3 months.

Simple and complex endometrial hyperplasia WITH atypia is best treated with __2__.

A

1) Progestin

2) A hysterectomy

28
Q

What term includes the ovaries, fallopian tubes, upper portion of the broad ligament, and mesosalpinx?

A

Adnexa

29
Q

What may lead to shortened, distorted or clubbed fallopian tubes?

A

DES (diethylstilbestrol)

30
Q

Follicular, Lutein cyst, Hemorrhagic cyst, and Polycystic ovaries are categorized as?

A

Functional cysts

31
Q

Follicular Cysts are lined by one or more layers of __1__ cells.

They develop when a(n) __2__ fails to rupture.

A

1) Granulosa

2) Ovarian follicle

32
Q

Corpus Luteum Cysts may develop if the corpus luteum becomes __1__, larger than 3 cm and fails to regress normally after __2__ days.

A

1) Cystic

2) 14

33
Q

Hemorrhagic cysts are more likely to cause symptoms and are caused by hemorrhage in the ____ 2-3 days after ovulation.

A

Corpus luteum cyst

34
Q

Theca-lutein cysts are usually bilateral, can become large (>30 cm) and may develop in patients with high serum levels of?

What can cause high levels of this?

A

1) hCG

2) Pregnancy, choriocarcinoma, or hydatidiform molar pregnancy

35
Q

__1__ is caused by a hyperplastic reaction of the ovarian theca cells secondary to prolonged hCG stimulation during pregnancy.

They appear as __(color)__ nodules.

A

1) Luteoma of pregnancy

2) Reddish-brown

36
Q

What cysts are associated with chronic anovulation, hyperandrogenism and insulin resistance?

A

Polycystic ovarian cysts

37
Q

Polycystic ovarian cysts causes increased __1__ levels that promote __2__ secretion from the ovarian theca cells, leading to elevated levels of ovarian derived __3__ and __3__.

Then the peripheral conversion of __2__ to estrogen results in elevated estrogen levels that then suppress __4__ from the pituitary gland

A

1) LH
2) Androgen
3) Androstenedione and testosterone
4) FSH

38
Q

If the polycystic ovarian cysts are asymptomatic and the patient is premenopausal, you can place them on __1__ in order to suppress__2__ levels and prevent development of other cysts.

A

1) OCP’s

2) Gonadotropin

39
Q

If the polycystic ovarian cysts are symptomatic and the patient is premenopausal, you must first rule out?

A

1) Ectopic pregnancy
2) Torsion
3) Tubo ovarian abscess

40
Q

As a group which benign neoplastic ovarian tumors are the most common?

What are the tumors that make up this group?

A

1) Epithelial ovarian neoplasms

2) Serous cystadenoma, mucinous cystadenoma, and Brenner tumors

41
Q

Epithelial tumors are thought to derive from the __1__ cells lining the peritoneal cavity and also the lining from the surface of the ovary.

Mucinous ovarian tumors cytologically resemble the __2__ epithelium.

Endometrioid ovarian tumors resemble the __3__.

Serous ovarian tumors resemble the lining of the __4__.

A

1) Mesothelial
2) Endocervical
3) Endometrium
4) Fallopian tubes

42
Q

What are the most common epithelial ovarian tumors (75%)?

A

Serous cystadenoma

43
Q

What can be found histologically in serous cystadenomas but are more common in malignant serous cystadenocarcinomas?

A

Psammoma bodies

44
Q

Mucinous cystadenoma are the second most common epithelial tumor, can attain a huge size filling the entire pelvis/abdomen, and are associated with a mucocele of the __1__.

They can rarely lead to __2__, which is a condition in which numerous benign implants are seeded onto the surface of the bowel & other peritoneal surfaces producing large quantities of mucus.

A

1) Appendix

2) Pseudomyxoma peritonei

45
Q

Brenner tumors are small smooth solid ovarian neoplasms that are usually benign with a large fibrotic component that encases __1__ cells that resemble __2__ cells of the bladder.

33% of cases these tumors are associated with __3__ epithelial elements.

A

1) Epithelioid
2) Transitional
3) Mucinous

46
Q

What are the sex-cord stromal benign neoplastic cysts?

A

1) Fibromas
2) Granulosa-theca cell
3) Sertoli-Leydig

47
Q

If the ultimate differentiation of cell types occurring in the tumor is feminine then the tumor is feminine and becomes a __1__ cell tumor.

If the cells take on a masculine differentiation then the tumor becomes a __2__ tumor.

A

1) Granulosa-theca

2) Sertoli leydig

48
Q

Which sex cord-stromal ovarian tumor can cause precocious menarche, premenarchal uterine bleeding, menorrhagia and breast tenderness?

A

Granulosa-theca cell tumors

49
Q

15% of Granulosa-theca cell tumors have an associated ____ cancer.

A

Endometrial

50
Q

Which sex cord-stromal ovarian tumor can cause hirsutism, temporal baldness, deepening of the voice, and clitormegaly?

A

Sertoli leydig tumors

51
Q

What is the most common benign solid ovarian tumor?

They are made up of interlacing bundles of?

A

1) Fibroma

2) Fibrocytes

52
Q

What syndrome can ovarian fibromas cause?

What is this syndrome characterized by?

A

1) Meigs syndrome

2) Ascites and right pleural effusion (hydrothorax)

53
Q

What is the germ cell benign neoplastic cyst and it is the single most common benign ovarian neoplasm in a premenopausal female?

A

Mature cystic teratoma (Dermoid)

54
Q

Rupture of a cystic teratoma or mucinous tumor can result in ____.

A

Peritonitis

55
Q

What tumor serum marker is used to monitor ovarian tumors, especially in postmenopausal women?

A

CA-125

56
Q

Epithelial benign ovarian tumors are usually managed with unilateral ____.

A

Salpingo-oophorectomy

57
Q

If mucinous cystadenoma tumor is diagnosed perform an ____ secondary to possible coexistence of a mucocele in this organ.

A

Appendectomy

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