Diseases of the Ovary 1

Question 1

of the primary ovarian tumors, they most likely arise from which portion of the ovary?

Answer 1

• surface epithelial (90%)

ovary consists of: surface epithelium, mesenchymal stroll cells, and germ cell

Question 2

what are three different NON neoplastic ovarian cysts?

Answer 2

• follicular cyst
• corpus luteal cyst
• endometrial cyst (chocolate cyst)
• cysts can also be found in PCOD

Question 3

follicular cysts can be caused by:

Answer 3

enrapture follicle or ruptured follicle that was immediately sealed off

Question 4

______ cysts of the ovary is caused by endometriosis (presence of endometrial tissue in the ovary)

Answer 4

chocolate; chocolate color is due to repeated cyclical hemorrhage

Question 5

chocolate cysts is/is not associated with infertility

Answer 5

chocolate cysts are associated with infertility mainly because it leads to fibrosis of the ovary

Question 6

dermoid cyst is non neoplastic/ neoplastic

Answer 6

neoplastic

Question 7

a young female presents with amenorrhea and has noticed excessive facial hair, obesity and voice changes. What is the most likely cause related to ovaries?

Answer 7

polycystic ovarian disease/syndrome

Question 8

↑/ ↓ LH and ↑/ ↓ FSH is seen in PCOD

Answer 8

↑ LH and ↓ FSH

excess androgens are converted to estrogen by the adipose tissue and this excess estrogen will inhibit the release of FSH by the pituitary and stimulates GnRH release which then causes LH release (LH ↑ and FSH ↓)

Question 9

what is the difference between hirsutism and virilization and which one is more common in PCOD

Answer 9

• hirsutism: androgen deponent male pattern of hair growth (most commonly seen in PCOD)
• virilization: androgen levels are high enough to get additional symptoms such as muscle atrophy, deepening of the voice, and clitoromegaly

hirsutism is more common in PCOD

Question 10

LH:FSH ratio seen in PCOD

Answer 10

greater than 3

Question 11

there are ↑ levels of _____ in PCOD

Answer 11

↑ estrogen and ↑ androgens

Question 12

maturing of the primordian follicle to the graffian follicle is stimulated by _____

Answer 12

FSH

Question 13

excess amounts of ______ less to insulin resistance in patients with PCOD

Answer 13

estrogen;

reason for ↑ risk for type 2 DM in patients with PCOD

Question 14

what are some complications of PCOD?

Answer 14

• endometrial cancer due to ↑ estrogen
• obesity and DM 2 due to insulin resistance and estrogen excess
• ovarian torsion
• infertility due to anovulation

Question 15

ovaries will show a large thick capsule with hypertrophied _______ cells

Answer 15

theca interna (↑ LH )

Question 16

looking for _______ (serum marker) indicates ovarian tumors/cancer

Answer 16

CA-125; it is a protein that is secreted by ovarian cancers and benign conditions as well (used to monitor response to treatment NOT dialogistic)

Question 17

________ and ______ reduce the risk of ovarian cancer

Answer 17

pregnancy and OCP’s

Question 18

choriocarcinoma arises from the ______ (component of ovary)

Answer 18

germ cell

Question 19

what diseases arise from the sex cord stroma of the ovaries?

Answer 19

Fibroma/fibrothecoma, granulosa tumor, sertoli leydig tumor

Question 20

analysis of an ovarian tumor shows columnar cells with cilia, what is the most likely diagnosis

Answer 20

serous ovarian tumor (differentiation is towards the epithelium of the Fallopian tube)

Question 21

teratoma arises from ______ (component of ovary)

Answer 21

germ cell

Question 22

mucinous ovarian tumors have ______ epithelium similar to that of ______

Answer 22

tall mucin secreting cells similar to that of the endocervix

Question 23

what is the epithelial cells seen in endometroid tumor of the ovary?

Answer 23

non ciliated columnar cells (endometrium)

Question 24

Brenner tumor has ________ epithelium

Answer 24

transitional

Question 25

serous cyst adenoma is lined by _________

Answer 25

single layer of tall columnar ciliated cells

Question 26

analysis of an ovarian tumor shows non ciliated columnar cells , what is the most likely diagnosis

Answer 26

endometroid tumor

ciliated columnar = serous

Question 27

which of the ovarian tumors are associated with a KRAS mutation?

Answer 27

mucinous tumor

Question 28

which tumor is more likely to be bilateral: serous or mucinous tumor

Answer 28

serous

Question 29

papillae with the presence of psammoma body is seen in what ovarian tumor?

Answer 29

serous tumor

mucinous tumor can have papillae but they WILL NOT HAVE psamomma bodies

Question 30

pseduomyxoma peritonei most commonly originates from _____ (organ)

Answer 30

appendix; the one that originates from a mucinous tumor fo the ovary and ruptures will resolve unlike one that originates form the appendix

Question 31

CA-125 is a surface marker for which type of ovarian tumor?

Answer 31

tumors of surface epithelial origin

Question 32

serous/mucinous cystadenocarcinoma rupture to result in pseudomyxoma peritonei

Answer 32

mucinous

Question 33

___________ cystadenocarcinoma on histology will reveal psammoma bodies (dystrophic calcification), and demonstrate invasive papillary histology

Answer 33

serous

Question 34

excess estrogen in PCOD inhibit the release of _____ (hormone) and then _____

Answer 34

FSH by the pituitary and this stimulates the release of GnRH which then acts on the pituitary to release more LH →
↑ LH and ↓ FSH

Question 35

_______ (drug) can be given to induce ovulation in patients w/ PCOD

Answer 35

clomiphene

Question 36

low grade serous tumor is associated with _______ mutations

Answer 36

KRAS/ BRAF

Question 37

high grade serous tumor is associated with _____ mutations

Answer 37

p53; high grade is type II and arises from the fimbriated end of the Fallopian tube

Question 38

papillae, polypoid changes, psamomma bodies can be seen in serous/mucinous ovarian tumor

Answer 38

serous