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OB/GYN I > Ch. 44 Pathology of the Ovaries > Flashcards

Ch. 44 Pathology of the Ovaries Flashcards

1
Q

The primary role of sonography in the evaluation of ovarian masses is

A

to indicate the need for surgical or medical intervention

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2
Q

A functional ovarian cyst is NOT

A

a chocolate cyst

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3
Q

The majority of ovarian masses are

A

simple cysts

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4
Q

Of the epithelial ovarian tumors that occur before menopause, _______ are malignant

A

7%

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5
Q

Of the epithelial ovarian tumors that occur after menopause, ______ are malignant

A

33%

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6
Q

The more complex the ovarian tumor is sonographically, the _____ likely it is to be malignant

A

more

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7
Q

The presence of ascites with an ovarian tumor ______ the likelihood of malignancy

A

increases

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8
Q

Serous ovarian tumors are typically

A

large

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9
Q

______% of serous ovarian tumors are bilateral

A

50%

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10
Q

When one ovary is ______ than other one, it is considered abnormal

A

two times larger

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11
Q

Ovarian masses can be differentiated from pedunculated fibroids by

A

identifying a connection to the uterus

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12
Q

Doppler of the ovaries should be performed

A

anytime an abnormality is seen

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13
Q

The normal ovarian artery should have an RI of

A

> .4

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14
Q

______ are the most common cause of ovarian enlargement in premenopausal women

A

functional cyst

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15
Q

______ occurs when the follicle fails to rupture or degenerate

A

follicular cyst

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16
Q

_______ are usually simple cysts

A

follicular cysts

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17
Q

______ occur when the corpus luteum fails to degenerate or has excessive bleeding

A

corpus luteum cysts

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18
Q

______ are common during the 1st trimester of pregnancy

A

corpus luteum cysts

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19
Q

Follicular cysts are usually ______

A

unilateral

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20
Q

______ is sometimes used to encourage regression of follicular cysts

A

hormone therapy

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21
Q

Resolution of a corpus luteum cyst usually occurs by the ______ week of pregnancy

A

16th

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22
Q

Doppler flow to a corpus luteum cyst is

A

low resistance

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23
Q

Polycystic ovarian disease is a ______ disorder

A

endocrine

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24
Q

Polycystic ovarian disease is associated with

A

absent ovulation

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25
Q

______ arise from the broad ligament and account for about 10% of adnexal masses

A

paraovarian cysts

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26
Q

The size of a ______ does not change with the ovarian cycle

A

paraovarian cyst

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27
Q

_____ are more likely to have their shape changed by adjacent structures because they are not surrounded by ovarian tissue

A

paraovarian cyst

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28
Q

______ are bilateral, large, complex ovarian masses that are associated with molar pregnancies

A

theca-lutein cysts

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29
Q

An increased incidence of ______ is associated with the use of pergonal for infertility

A

theca-lutein cysts

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30
Q

Odd-shaped fluid collections in the abdomen may be created by

A

adhesions

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31
Q

Small simple ovarian cysts occur in female fetuses and newborns due to

A

maternal hormones

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32
Q

Simple ovarian cysts in postmenopausal women that measure _____ are not likely to be malignant

A

<5cm

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33
Q

______ is a blood test that may be used to help screen for ovarian cancer

A

CA 125

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34
Q

_______ often makes ovaries difficult to see due to blurring of tissue planes and adhesions

A

endometriosis

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35
Q

The term adenoma refers to a _____ tumor

A

benign

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36
Q

The term adenocarcinoma refers to a _____ tumor

A

malignant

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37
Q

______ is a benign tumor that is quite large and is lined with mucinous elements from teh cervix and/or bowel

A

mucinous cystadenoma

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38
Q

______ tumors often appear sonographically as multiloculated tumors with differing echogenicities within the different compartments of the tumor

A

mucinous

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39
Q

Mucinous cystadenoma is usually

A

unilateral

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40
Q

Mucinous cystadenocarcinoma is usually

A

bilateral

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41
Q

Mucinous cystadenocarcinoma are prone to rupture, causing _____

A

pseudomyxoma peritoneum

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42
Q

______ are the second most common benign ovarian tumor and are usually unilateral

A

serous cystadenoma

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43
Q

Which is larger, serous or mucinous

A

mucinous cystadenoma

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44
Q

______ is made of septated cysts with nodules along the walls and irregular borders

A

serous cystadenoma

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45
Q

_______ is the most common ovarian cancer

A

serous cystadenocarcinoma

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46
Q

In cases of serous ovarian tumors, bilateral tumors suggest

A

malignancy

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47
Q

In cases of serous cystadenocarcinoma, ascites develops due to

A

peritoneal tumor implants

48
Q

______ is a rare, benign, fibrous epithelial tumor of the ovary

A

brenner’s tumor

49
Q

_______ is a rare, malignant tumor of the ovary that is resistant to chemotherapy

A

clear cell carcinoma

50
Q

The majority of germ cell tumors are

A

complex

51
Q

______ are germ cell tumors that arise from a single oocyte

A

dermoids

52
Q

______ are the most common tumor of the ovary

A

dermoids

53
Q

About 80% of dermoids are found in women of _____ age

A

child bearing

54
Q

______ is another name for dermoid

A

teratoma

55
Q

_______ of dermoids have cystic component

A

95%

56
Q

______ is a very rare teratoma made up of thyroid tissue

A

struma ovarii

57
Q

Teratomas are more likely to become malignant in women who are

A

over 40 year olds

58
Q

_____ often contain fat, teeth, and hair

A

dermoids

59
Q

______ is a malignant tumor that usually occurs in women less than 30 years old

A

dysgerminoma

60
Q

______ are malignant, fast growing tumors that occur in women 10-20 years of age

A

immature teratoma

61
Q

_______ tumors are usually very hypoechoic, solid, adnexal masses that occur in middle aged women

A

stromal

62
Q

_______ is a complication of fibroma tumor involving massive ascites and pleural effusion

A

meigs syndrome

63
Q

_______ is a rare ovarian tumor that secretes estrogen

A

granulosa

64
Q

_______ is usually unilateral and may resemble endometrioma

A

granulosa

65
Q

______ is an ovarian tumor that secretes androgens

A

arrhenoblastoma

66
Q

______ is a solid, usually unilateral, ovarian mass that causes amenorrhea and infertility

A

arrhenoblastoma

67
Q

______ is the lading cause of death from gynecologic malignancy in the US

A

ovarian carcinoma

68
Q

About _____ of patients suffering from ovarian carcinoma are over 50 years old

A

85%

69
Q

Ovarian cancer is easily detectable in the early stages because of early onset of symptoms

A

false

70
Q

The five-year survival rate for stage 1 ovarian cancer is

A

90%

71
Q

The five-year survival rate for stage IV ovarian cancer is

A

5%

72
Q

The strongest risk factor for ovarian cancer is

A

family history of ovarian or breast cancer

73
Q

Over _____ of women are in advanced stages of ovarian cancer by the time they see their doctor

A

70%

74
Q

______ is caused by rotation of the ovary, twisting the blood vessels closed

A

ovarian torsion

75
Q

Mrs. Smith went to the doctor because her abdomen was becoming more and more distended. Sonography demonstrated a large, septated, vascular ovarian mass, ascites, and three hypoechoic masses in the liver. What is the probable diagnosis? What stage is it?

A

serous ovarian cystadenocarcinoma, stage 4

76
Q

Mrs. Johnson went to the doctor complaining of pelvic fullness. Sonography demonstrated a large, septated ovarian mass and mild ascites. CT demonstrated no lymph node involvement, uterine involvement or distant mets. Her diagnosis was ovarian cancer. What stage was it?

A

stage 1

77
Q

What are the three main sonographic categories of ovarian mass

A

cystic, complex, solid

78
Q

What characteristics must be present to classify an ovarian cyst as a simple cyst

A

anechoic, smooth walled, posterior enhancement

79
Q

Abnormal doppler waveforms of ovarian vessels can be seen in what conditions besides cancer

A

ectopic pregnancies, corpus luteum cysts, PID, endometriosis

80
Q

Describe the two possible explanations for how endometriosis happens

A
  1. reflux out of the tubes and plants in pelvic area outside the uterus
  2. stem cells develop into endometrial tissue due to hormonal stimulus or irritation
81
Q

What lab values need to be investigated when there is a suspected germ cell tumor of the ovary

A

AFP and hCG

82
Q

Sally went to the emergency room with extreme pain in the right side of her pelvis. Sonography demonstrated a large, hypoechoic right ovary with no doppler signal. What was the probable diagnosis

A

ovarian torsion

83
Q

Result from persistent corpus luteum or abnormal follicle that fails to rupture

A

functional cysts

84
Q

Sonographic appearance of a functional cyst

A

simple or complex cyst 1-10cm in size

85
Q

If a cyst larger than 6cm persists longer than 8 weeks, ________

A

surgery is usually considered

86
Q

Usually functional in premenopausal women. MUST be anechoic, smooth walled and demonstrate posterior enhancement

A

simple cyst

87
Q

Mass with both cystic and solid components

A

complex ovarian mass

88
Q

Any tumor may have cystic components, so must demonstrate whether a cystic lesion is

A

complex or simple

89
Q

Masses made up of solid material

A

solid ovarian mass

90
Q

Solid ovarian masses can be difficult in diagnosis due to variations in

A

normal ovarian size

91
Q

When one ovary is ________ of the other, it is suspicious for solid ovarian mass

A

twice the size

92
Q

In women under 40, ________ complex ovarian masses are malignant

A

1 in 15

93
Q

In women over 40, _______ are malignant

A

1 in 3

94
Q

Premenopausal patients and patients on cyclic HRT should be scanned in the

A

1st 10 days of their cycle

95
Q

Resistive Index=

A

systolic peak-diastolic velocity/systolic

96
Q

Pulsatility Index=

A

systolic peak-diastolic/mean velocity

97
Q

Usually unilateral and 1-8cm in size, thin walled, simple cysts, regresses on their own

A

follicular cysts

98
Q

Infertility, oligomenorrhea, hirsutism, obesity, patients develop body hair, facial hair and lower voice

A

stein-leventhal syndrome

99
Q

Enlarged ovaries with multiple tiny cysts around periphery of ovary, “string of pearls sign” always bilateral

A

stein-leventhal syndrome

100
Q

10% of adnexal masses, no ovarian tissue around them

A

paraovarian cysts

101
Q

Arise from the ovary- associated with molar pregnancy, multiple gestation, high hCG levels

A

theca-lutein cysts

102
Q

Located in the omentum-upper abdomen

A

omental cyst

103
Q

located in midline abdominal wall peritoneum superior to the bladder

A

urachal cysts

104
Q

15% of postmenopausal patients have small simple ovarian cysts (<3cm)

A

simple cysts in post menopausal women

105
Q

______% of endometriosis cases affect the ovaries

A

80

106
Q

Focal collection of ectopic endometrial tissue, often located in the ovary. Focal, well defined cystic, complex or solid with post enhancement CHOCOLATE CYST

A

endometrioma

107
Q

Cysts with thick septations and areas of solid tissue are often

A

malignant

108
Q

Arises from surface epithelium that covers the ovary

A

epithelial tumors

109
Q

Epithelial tumors account for _______ of all ovarian neoplasms and _______ of all ovarian malignancies

A

65-75%, 90%

110
Q

Mucinous cystadenocarcinoma is found in ______ of menopausal women

A

10%

111
Q

Endometroid tumors are almost always ________ and _______ are bilateral

A

malignant, 25-30

112
Q

Transitional cell, also called fibroepithelioma, rare and usually bening

A

brenner tumor

113
Q

Types of stromal tumors

A

granulosa cell tumor, fibroma, thecoma, sertoli-leydig cell tumor

114
Q

Usually occurs in childhood and young adulthood, associated with adnexal masses

A

ovarian torsion

115
Q

With ovarian torsion, which ovary is more likely to torse? What does it mimic?

A

Rt ovary 3 times more likely than left, appendicitis

OB/GYN I (13 decks)

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