Female Pelvis 2 Flashcards
to be ovarian cyst must be >______ mm
> 9mm
larger cysts are likely if mother had (3)
Toxemia, diabetes, Rh isoimmunization
4 types of cysts
follicular
corpus luteal
theca lutein
paraovarian
follicular cystshave what fluid
clear serous fluid
corpus luteal are what fluid
serous or hemorrhagic fluid
theca lutein caused by
GTD or clomid/clomiphene
where are paraovarian cysts
in broad ligament or fallopian tubes
ovarian torsion is usually the result of
ovarian cyst or tumor
who is at risk for ovarian torsion
pre pubertal girls
3 symptoms of O torsion
abdo pain
N&V
leukocytosis
sono apperance of torsion (5)
unilateral enlargement fluid in cul de sac cyst/tumor twisted vascularular medical (wirlpool/target sign) absence of flow alone is not reliable
hemorrhagic cyst sono appearance (4)
heteromass
thick walls
separations
fluid in culldesac
PCOD also called
stein leventhal syndrome
clinical features of PCOD (5)
Hirsutism Irregular menstrual bleeding Associated with obesity and diabetes increased incidence of endometrial carcinoma Infertility
mean ovarian volume of PCOD
14cc
Follicle size in PCOD
0.5-0.8cm
when do most ovarian neoplasms occur
at puberty
is ascites common in children with ovarian neoplasms
less so than in adults
3 catagories of primary tumors
germ cell
epithelial cell
stromal cell
5 types of germ cell
Benign teratoma Dysgerminoma Embryonal carcinoma Endodermal sinus tumors Choriocarcinoma
3 types of epithelial cell
Serous and mucinous cystadenoma and cystadenocarcinoma
3 types of stromal cell
Granulosa theca cell tumor
Arrhenoblastoma
Gonadoblastoma
apperance of benign teratoma (4)
Predominantly cystic with or without mural nodule
Solid masses
Complex lesions with fat-fluid or hair-fluid levels
Calcifications
dysgerminoma description (4)
Malignant
Large, solid, encapsulated
Rapidly growing
Hypoechoic areas from hemorrhage, necrosis
epithelial group appearance
Cystic masses with septa of variable thickness
Often difficult to differentiate on US between these 4 types of tumors
granulosa cells are associated with
feminizing effects and precocious puberty (estrogen producing)
are granulose theca cell tutors malignant or benign
benign
what cells are gonadoblastomas made out of
germ, stromal and sex cord cells
are neoplasms of the uterus and vagina common
no, but more common in the vagina than uterus
more likely to be malignant than benign
highly malignant germ cell tumor of vagina
endodermal sinus tumor
where do rhabdomyosarcoma arise from and are they malignant
uterus or vagina
and yes they malignant
clinical presentation of rhabdomyosarcoma (3)
Age at presentation 6-18 months old
Vaginal bleeding
Protrusion of polypoid cluster of masses (sarcoma botryoides)
4 endocrine abnormalities with primary amenorrhea
Gonadal dysgenesis
Chromosomal abnormalities
Decreased hormonal states
Testicular feminization
most common form of gonadal dysgenesis
turners syndrome
turners syndrome description (4)
45, XO karyotype
Delayed or absent puberty
Short statue, webbed neck
Renal and CV problems
sono of turners syndrome
Ovaries may not be seen
Streak ovaries
Prepubertal uterus
testicular feminization description
Sex-linked recessive abnormality End-organ insensitivity to androgens Phenotypic females with 46,XY karyotype Absent uterus and ovaries Ectopic testes
define precocious puberty
Development of secondary sexual characteristics, gonadal enlargement, & ovulation before age 8 yrs
other descriptors of precocious puberty
Uterus enlarged with postpubertal shape
fundus/cx ratio - 2:1 to 3:1
Prominent endometrium
Ovarian volume > 1cc, with functional cysts
central type precocious puberty description
True precocious puberty
Gonadotropin dependent
increased FSH & LH
increased Estrogen
cause of central type precocious puberty
idiopathic
sometime intracranial tumor
peripheral type precocious puberty description
Pseudoprecocious puberty
Gonadotropin independent
increase Estrogen,
decrease FSH, LH
cause of peripheral type precocious puberty
ovarian tumor
