Differential Diagnoses - Pelvic Masses Flashcards
(46 cards)
t or f: ovarian masses less than 5 cm that are not suspicious of malignancy and asymptomatic are often observed - no surgical intervention needed
TRUE - larger cysts (greater than 5 cm) can be considered for surgical resection
which ovarian cysts are the most common functional cysts?
follicular cysts
what is the physiology behind the development of a follicular cyst?
failure of rupture or incomplete resorption of the ovarian follicle is what results in the cyst
what are the contents of a follicular cyst?
estrogen-rich fluid (ovarian cyst is granulosa cell lined)
t or f: follicular cysts are typically asymptomatic when small (less than 5 cm)
TRUE
what is the greatest risk for ovarian torsion?
large size
t or f: follicular cyst pain tend to be bilateral
FALSE - unilateral abdominal and pelvic pain with abrupt pain indicating possible ovarian torsion
what is a sign on US that indicates ruptured ovarian cyst?
fluid in the cul-de-sac
t or f: no treatment is necessary for most functional cysts
TRUE - most will resolve spontaneously within two months
t or f: OCP may aid in the resolution of ovarian cysts for symptomatic patients
TRUE - chronically symptomatic cysts can also be managed with OCP
what must be done if an ovarian cysts does not resolve on its own within two months?
laparotomy/laparoscopy to evaluate/rule out neoplasm/endometriosis
what are the two types of lutein cysts?
corpus luteal and theca lutein
bilateral theca lutein cysts are often seen in what situation?
molar pregnancies due to increased BHCG levels
what is the physiology of the corpus luteum cyst?
When a follicle does release its egg, the ruptured follicle begins producing large quantities of estrogen and progesterone in preparation for conception. This changed follicle is now called the corpus luteum. Sometimes, however, the escape opening of the egg seals off and fluid accumulates inside the follicle, causing the corpus luteum to expand into a cyst.
what type of adnexal pain is produced by corpus luteum cysts?
unilateral
what is the physiology behind a theca lutein cyst?
increased levels of HCG causes follicular overstimulation and leads to the development of these cysts
t or f: theca lutein cysts are often multiple and bilateral
TRUE
what is the etiology of the development of TOA (most of the time)?
abscess involving the ovary and fallopian tube is most often a consequence of PID
what kind of antibiotics should be used to treat TOA?
TOA is a polymicrobial process of broad-spectrum antibiotics should be used
how does primary TOA develop?
as a result of a complication of an ascending infection of the reproductive tract
how does secondary TOA develop?
as a result of something such as bowel pert or from general intraperitoneal spread of infection (TOA can also result in association with pelvic surgery or malignancy)
what is one way to know that the pelvic was in fact a TOA?
the quick response to antibiotic treatment
what is the treatment for TOA that does not respond to antibiotics?
laparoscopic or US guided drainage
what is the medical term for chocolate cysts?
endometriomas
