Diagnosis and significance of ov cysts in post menopause

Question 1

3 ways cysts can present in the post menopause

Answer 1

• Acute pain (torsion or rupture of a cyst) requiring immediate evaluation
• Identified during gynaecological investigations
• incidentally, while undergoing investigations by other specialties for nongynaecological condition

Question 2

High risk of ovarian cancer if pt has a first-degree relative (mother,father,sister,brother,
daughter or son) affected by cancer within a family with

Answer 2

• Two or more with ovarian cancer, who are first-degree relatives of each other
• One with ovarian cancer at any age and one with breast cancer diagnosed under age 50 years who are first-degree relatives of each other
• One with ovarian cancer at any age and two with breast cancer diagnosed under age 60 years
  who are connected by first-degree relationships
• Three or more with colon cancer, or two with colon cancer and one with stomach, ovarian, endometrial, urinary tract or small bowel cancer in two generations. One of these cancers must be diagnosed under age 50 years and affected relatives should be first-degree relatives of each other
• One with both breast and ovarian cancer

Question 3

Sensitivity in detection of ov cancer by physical examination

Answer 3

15-51%

Question 4

Ca125

Answer 4

• Raised in 80 % of ovarian cancers
• Cut off 30 iu/ml
• Sensitivity of 81%
• Specificity of 78%

Question 5

Conditions with lower Ca125

Answer 5

• Caffeine intake
• Hysterectomy
• Smoking

Question 6

Conditions that cause high Ca125

Answer 6

• Tuberculosis,
• Cirrhosis
• Hepatitis
• Pancreatitis
• Peritonitis
• Pleuritis
• Primary tumours that metastasise to the peritoneum (breast, pancreas, lung, and colon cancer)