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radiology > GYN > Flashcards

GYN Flashcards

1
Q

salpingitis isthmica nodosa

A

AUNT MINNI

-nodular scarring prox 2/3 FT

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2
Q

cervical cancer important staging

A

IIA-beyond cervix but no parametrical invasion=sx

IIB-parametral involvement but no ext to pelvic side wall-crx/rad

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3
Q

parametrium

A

fibrous band separating supravaginal cerix from bladder. ext btw layers of broad lig

  • imp bc uterine a runs inside-CRX > sx once invaded
  • invasion? loss of T2 dark ring normally surrounding cervix
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4
Q

org of met to:

  • ant wall upper 1/3
  • pst wall lower 1/3
A
  • upper genital

- GI

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5
Q

cervical/vaginal cysts

A
  • nabothian
  • gartner
  • bartholin
  • skene-periurethral glands –> recurr UTIs, obstruction
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6
Q

embryologic org: mullerian duct, wolffian duct, UG sinus

A
  • MD-uterus, FT, upper 2/3 vag
  • WD-vd, sv, epididymis
  • UG sinus-prostate, lower 1/3 bag
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7
Q

arcuate uterus

A

mild smooth concavity of uterine fundus (instead of normal straight/convex)

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8
Q

critical endometrial stage

A

2 (cervical stroma invasion)-high risk LN mets

-IA (<50%) –> IB (>50%) also increase risk LN mets

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9
Q

endometrial cancer img

A

-T1 iso, T2+ish, hypoenh, DW+

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10
Q

cumulus oophorus

A

collection of cells in mature dominant follicle signaling imminent ovulation)

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11
Q

fertility mds

A

clomiphene citrate

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12
Q

theca lutein cysts ass

A
  • multifetal pregn
  • gestational trophoblastic dx
  • ovarian hyperstimulation syndrome
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13
Q

thecae lutein cysts physio

A
  • functional cyst rel to overstep from b-hcg

- large 2-3cm cysts w/ ML/spokewheel app

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14
Q

ovarian hyperstimulation syndrome

A
  • effusions
  • ascites
  • shock
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15
Q

next step: ovarian cyst on CT and US, size cut off

A

-CT: 3cm (premeno) & 1cm (post meno) cutoffs for US

US: 7 cm (premeno), 5 cm (post meno)-for 3mo f/u

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16
Q

max ovarian volume in post meno woman

A

6mL

-8cc at 40 –> 1cc at 70

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17
Q

fibroid types

A

hyaline-MC
hypercellular-resp well to embo
lipoleiomyoma

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18
Q

img hyaline fibroid

A

-T1/2 dark, homog enh

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19
Q

img hyper cellular fibroid-

A

T1-
T2+ (tightly packed SM cells)
-homog enh

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20
Q

img lipoleiomyoma

A

T1+, T2+, high rim enh

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21
Q

fibroid degeneration types

A
  • none enh (dead tissue), ex: myxoid minimally
    1) hyaline (Classic)-fibroid outgrows bs –> accumulation proteinaceous tissue (var, but usually T1/2(-)
    2) red (corneous)-venous thrombosis during pregnancy. T1 bright rim (classic)
    3) myxoid-uncommon. T1-, T2+, minimal enh
    4) cystic degen-uncommon. T1-, T2+, no enh
22
Q

normal myometrial junctional zone

A

<5mm

23
Q

tamoxifen on endom

A

polyps
HP
cancer

24
Q

T2 shading

A

T2 shortening (darkening) of a lesion that is T1 bright

25
Q

endometrioma cancer risk

A
  • endometroid

- clear cell

26
Q

next step: ovarian solid nodule w/o flow

A
  • US-r/o dermoid

- if not dermoid-call sx

27
Q

serous vs mutinous cystadenocarcinoma

A
  • serous-UL (fewer sept), BL, papillary prj, ascites =mets

- mucinous-ML, pseudomyxoma peritonea, pap prj less common

28
Q

adult big abd mases

A

ovarian
desmoid
sarcoma

29
Q

ovarian cancer rfs

A

-smoking known for mucinous

30
Q

endometroid ovarian cancer

A

2nd MC

  • BL 15%
  • from endometrial cancer (25%) or from endometrioma
31
Q

order of ovarian cancer incidence

A

1) serous
2) endometroid
3) mutinous

32
Q

hydrosalpinx signs

A
  • “cogwheel”=normal longitudinal folds bc thickening
  • “string sign-incomplete septae
  • “waste sign”-tubular mass w/ indentation of its opposing walls-differentiates hyrdosalpinx from ovarian mass”
33
Q

ovarian fibroma & fibrothecoma

A
  • benign tumor of middle aged women
  • T2- band (vs fibroid)
  • no Ca (vs brenner tumor)
34
Q

Meigs syndrome

A
  • ascites
  • pleural eff
  • benign ovarian tumor (fibroma mc)
35
Q

Fibromatosis

A

tumor like enlargement of ovaries due to ovarian fibrosis

  • 25 yo girl
  • ass-omental fibrosis, sclerosis peritonitis
  • bw for T2 sign=black garland sign
  • mx-+/- sx
36
Q

brenner tumor/ovarian transitional cell carcinoma

A
  • ovarian epithelial tumor 50-70yo

- Ca v common (vs fibroma/fibrothecoma)

37
Q

struma ovarii

A
  • subtype of ovarian teratoma containing thyroid tissue rel to hyperTh
  • img: dark thick colloid in otherwise T2+ cyst
38
Q

ovarian mets

A

10%

  • colon, gastric, breast, lung, CL ovary
  • krukenburg-from GI (usually stomach)
39
Q

peritoneal inclusion cyst

A

passive (lad of walls) fluid filled mass that conforms to shape of pelvis and surr ovary

40
Q

gestational trophoblastic dx types

A
  • complete (70%)-entire placenta, no fetus, diploid karyotype.
  • partial (30%-partial placenta, triploidy fetus
41
Q

img gestational trophoblastic dx

A
  • complete: 1st TM=snowstorm, highly vas. 2nd TM-bunch of grapes (cysts)
  • partial: enlarged placenta; mult diff anechoic lesions. +/-fetal parts
  • theca lutein cysts
42
Q

complications gestational trophoblastic dx

A
  • hyperemesis (b-hcg)
  • future mole
  • invasive (myom)
  • chorioCA-myom, parametric, hematog to body
43
Q

invasive myom appearance

A

-masses, dilated vess, areas of hem/necr

44
Q

choriocarcinoma-what, hx, img, rx

A
  • only trophoblasts (no villous)
  • myo/parametrium and hematog spread
  • v vasular (bleed like stink!)
  • b-hcg rise 8-10 wks after evaluation molar pregn
  • mx-MTX
45
Q

endom polyp vs subendo fibroid vs endom cancer

A

poly:

  • hyper or hypoechoic
  • acute angles
  • stalk w/ central vessel
subendo fibroid:
broad base
-obtuse angle
-MF per vascularity
-htpoecho w/ overlying hyperechoi endom

cancer:

  • flat, irregular; can be polypoid
  • myom invasion
46
Q

size of nodules in an endometrioma concerning for malignancy

A

3mm

47
Q

US dx accuracy of endometrioma

A

90% (same as MRI)

48
Q

azzopardi syndrome

A

testicular Ca not associated with mass, ie: burnt out testicular cancer

49
Q

classic vs limited testicular microlithiasis

A

class 5+ Ca in img. Ass with GCT (limited <5, not ass)

50
Q

theca lutein cysts in setting of molar pregnancy

A

20-60%
resolve 6-8 wks after involution
-ass w/ increased risk gestation trophoblastic mal

51
Q

junctional zone invasive endom CA or vs invasive mole vs adenomyosis

A

disrupted rather than thickened

radiology (31 decks)

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