Disorders of the Ovaries and Fallopian Tubes- Ross Flashcards
What is an adnexal mass?
a growth that occurs in or near the uterus, ovaries, fallopian tubes, and the connecting tissues. They’re usually benign, but are sometimes cancerous. Some of them are filled with fluid, and some are solid
Adnexal masses should be evaluated with what type of imaging?
U/S first
A 25 year old woman presents to you for routine annual WWE. She has had two routine vaginal deliveries and is otherwise healthy. She smokes 1 pk/day, has no GYN complaints. LMP 3 weeks ago.
PE: Left ovary enlarged to 5cm in diameter.
Which of the following is the best recommendation to this patient?
A. Order CA-125 testing
B. Order outpatient diagnostic laparoscopy
C. Order ultrasound
D. Order a CT scan of the pelvis
E. Admit to the hospital for exploratory laparotomy
C. Order ultrasound
What are functional cysts and what are the two types?
SOMETIMES A NORMAL MONTHLY FOLLICLE KEEPS GROWING, WHEN THAT HAPPENS, IT IS KNOWN AS A FUNCTIONAL CYST.
- Follicular cyst (failure of ovulation)
- Corpus luteum cyst
This is the most common type of functional cyst.
follicular cyst
A patient comes in for a routine WWE for her IUD. On U/s you notice a follicular cyst. The patient states she is asymptomatic. What is the best thing to do next?
-Watch and wait because these are usually benign and reappear in 6 weeks with U/S
A patient presents with amenorrhea and localized pain/tenderness in her lower left abdomen. You get a U/S and notice a corpus luteum cyst. What do you tell the patient the next steps are?
Watch and wait because they usually regress in 1-2 months
A patient presents with anovulation, increased hair on her face and body and she is obese. What should be at the top of your ddx?
Polycystic ovarian syndrome
What is the next step in diagnosing PCOS?
U/S
What is the treatment for PCOS?
Lifestyle changes
- OCPs can help regulate cycle abnormalities
- Metformin can help with insulin resistance and hormone control
You should NOT give patients with PCOS this med because it can cause abnormal genitalia development in males?
Spironolactone
PCOS can lead to _________ ________ which can be treated with progesterone?
endomerial hyperplasia
What are some things that can put you at risk for ovarian cancer?
- smoking
- multiple sex partners
- BRCA gene
- nulliparity (never given birth)
80& of all malignant ovarian tumors are what?
Epithelial ovarian cancers
Older women tend to get _______ ovarian cancer and young women tend to get _______ cell ovarian cancer
endometrial and germ
What are markers for ovarian cancer?
CA-125 and He4
This type of tumor accounts for 75%-85% of all epithelial ovarian neoplasms and develop from ovarian tissue and may be filled with a watery mucous
serous tumors
chocolate cysts
endometrioid tumors
noncancerous, fluid-filled cysts that typically form deep within the ovaries.
A very young patient comes in with her mom. Her mother is concerned that the patient is so young and she is beginning to hit puberty. WHat could the cause of this be?
Granulosa cell stromal tumor which produces estrogen
*pt should get an U/S
This type of stromal tumor contains lipid containing cells that produce estrogen. A common symptom is post menopausal bleeding
thecoma stromal tumor
A sertioli-leydig tumor secretes excessive amounts of ________
testosterone
This type of gynecological tumor is typically an incidental finding, does not produce hormones, occurs close to menopausal age and is a part of meig’s syndrome (triad of benign ovarian tumor, ascites and pleural effusion)
fibroma
A patient presents with acute severe abdominal pain localized to one side. How do we dx whatever this patient has?
U/S with doppler
This is a common complication of PID due to an STI
pyosalpinx (when the fallopian tube is filled with pus)
This dx is made based on presence of cervical motion tenderness, or uterine adenexal tenderness bilaterally
pelvic inflammatory disease
Treatment for PID?
Ceftriaxone + doxy +/- metronidazole
