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OB/GYN Board Review > GYN > Flashcards

GYN Flashcards

1
Q

ovarian ligament

A

extends from cornua of the uterus to the medial aspect of the ovary

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2
Q

round ligament

A

arises in the cornua of the uterus and extends to the pelvic sidewalls

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3
Q

what forms the posterior boundary of the false pelvis?

A

iliac bones and base of sacrum

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4
Q

functional layer of the endo-

A

is the echogenic inner lining of the endo- that sheds during menses
(only this layer is included in measurement)

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5
Q

basal layer of endo-

A

the hypoechoic fluid layer within endo- (NOT included in endo measurement)

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6
Q

asherman syndrome

A

intrauterine adhesions ablating the endometrial lining caused by previous endo- infection or D&C

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7
Q

cystic teratoma

A

dermoid tumor of the ovary; typically found superior to the UT fundus; arises from the wall of a follicle; may contain fat, hair, skin, and teeth

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8
Q

leimyoma

A

uterine fibroid; most common uterine mass; intramural (most common location), submucosal (causes bleeding), and subserosal

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9
Q

serous cystadenoma

A

epithelial neoplasm; 2nd most common benign tumor of the ovary; typically contains septations

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10
Q

adenomyosis

A

benign invasive growth of endometrium into the myometrium;

RISK FACTORS: multiparity, elevated estrogen levels, and D&C

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11
Q

stromal tumors

A

Fibroma (rare)

Thecoma (produces estrogen)

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12
Q

dysgerminoma

A

malignant germ cell neoplasm; most common ovarian malignancy in childhood
Related to: precocious puberty, pelvic pain, assoc, with AFP and hCG levels

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13
Q

endometrium measurements with the phases

A

secretory phase: 7-14 mm
late proliferatory phase: 6-10 mm
early menstrual phase: 4-8 mm

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14
Q

graafian follicles

A

mature follicle that secretes estrogen

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15
Q

corpus luteum

A

yellow body formed from the graafian follicle after ovulation
produces estrogen and progesterone

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16
Q

menopause hormone levels

A

follicular stimulating hormone is slightly elevated, progesterone and estrogen is decreased

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17
Q

ovarian follicular phase coincides with what phase of the endo?

A

proliferation phase

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18
Q

failure of the mullerian ducts to develop

A

results in uterine agenesis

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19
Q

hematometra

A

an abnormal accumulation of blood in the endometrial cavity in a premenarche pt.

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20
Q

what is a dysgerminoma

A

most common ovarian malignancy in childhood and is a possible cause for precocious puberty

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21
Q

symptoms of adenomyosis

A

uterine tenderness (esp. during menstruation), pelvic pain, menorrhagia, dysmenorrhea, uterine enlargement, and cramping

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22
Q

intramural

A

myometrial location

most common site for fibroids

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23
Q

submucosal

A

endometrial location
least common site for fibroids
most likely location to cause symptoms

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24
Q

uterine arteries arise from

A

hypogastric arteries

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25
Q

uterine corpus

A

the upper muscular portion of the UT

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26
Q

cervix to corpus ratio during postmenopause

A

1:1 (equal in size)

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27
Q

what do the ovaries attach to

A

mesovarian portion of the broad ligament

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28
Q

ovarian volume

A

lowest during the luteal phase

highest during the periovulatory phase

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29
Q

blood supply to endometrium

A

spiral arteries (which arise from the radial arteries, that branch off of arcuate arteries)

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30
Q

uterosacral ligaments

A

extend from the superior cervix to the lateral margins of the sacrum

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31
Q

round ligaments

A

arise in the uterine cornua, extending from the fundus to the pelvic sidewall

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32
Q

junctional zone

A

the innermost layer of the myometrium

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33
Q

estradiol

A

reflects the activity of the ovaries
steadily rise during pregnancy
important when monitoring ovulation induction therapy

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34
Q

luteinizing hormone

A

secreted by the anterior pituitary gland to stimulate ovulation
helps form the corpus luteum

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35
Q

cumulus oophorus

A

“daughter cyst”
a hyperechoic focus within a mature follicle
ovulation generally will occure within the next 36 hrs after visualiztion of the cumulus oophorus

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36
Q

hypothalamus

A

produces luteinizing hormone releasing factor

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37
Q

theca lutein cysts

A

results from increased levels of hCG
occur in pts with hyperstimulation, or pregnancy
hormone dependent

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38
Q

secretory phase

A

demonstrates the greatest endometrial thickness (fluid-filled endo-)

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39
Q

ovarian luteal phase coincides with what endometrial phase

A

secretory phase

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40
Q

what are the endometrial phases

A

menstrual
proliferation
secretory

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41
Q

menoxenia

A

defines any abnormality relating to menstruation

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42
Q

brennor tumor

A

benign tumor arising from fibroepithelial tissue
estrogenic in nature
associated with Meig’s syndrome

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43
Q

meigs syndrome

A

a term used to describe a combination of pleural effusion, ascites, and an ovarian mass

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44
Q

krukenberg tumors

A

metastatic lesions most commonly resulting from primary gastric carcinoma
Other primary structures: breast, large intestines, and appendix

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45
Q

peritoneal inclusion cysts

A

caused by adhesions trapping normal secretions produced by the ovary
Symptoms: lower abd. pain and palpable mass, septated fluid collections surrounding ovary

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46
Q

straight arteries

A

“basal arteries”
branch of radial arteries
basal layer

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47
Q

spiral arteries

A

“coiled arteries)
branch of radial arteries
decidual layer (can slough)

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48
Q

left ovarian vein

A

drains into the left renal vein (not IVC)

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49
Q

round ligaments

A

support uterine fundus

uterine cornua to labia majora b/t the folds of the broad ligament

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50
Q

fossa of waldeyer

A

ovarian fossa

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51
Q

mesovarian ligament

A

connects the ovaries to the broad ligament

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52
Q

germinal epithelium of waldeyer

A

outer layer of the ovary

cortex that contains the follicles

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53
Q

cryptomenorrhea

A

monthly symptoms of menstruation without bleeding

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54
Q

metrorrhagia

A

irregular menstrual bleeding between periods

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55
Q

causes of dysfunctional uterine bleeding (DUB)

A

fibroids, adenomyosis, endometrial polyps, endo- hyperplasia, and endo- carcinoma

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56
Q

co-existing congenital anomalies along with the UT

A

kidneys/urinary co-existing anomalies

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57
Q

what is adenomyosis

A

invasion of endo- tissue into the myometrium
1. Focal “Adenomyoma”
2. Diffuse
affects older, multiparous women

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58
Q

menometrorrhagia

A

heavy and prolonged bleeding between periods

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59
Q

leiomyosarcoma

A

malignant counterpart of the leimyoma

more common in peri/post-menopausal women

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60
Q

precocious puberty

A

pubertal dev’t before the age of 8

  1. True: assoc. with intracranial tumors or idiopathic
  2. Pseudo: linked with ovarian, adrenal, and liver tumors
61
Q

sex-cord stromal tumors

A

ovarian tumors that arise from the gonadal ridges
estrogen producing tumors
Includes: thecomas, granulosa cell tumors and fibromas
Assoc. with Meig’s Synd.

62
Q

thecoma

A

benign sex-cord stromal tumor
assoc. with meigs syndrome
most often found in postmenopausal women

63
Q

granulosa cell tumors

A

most common estrogenic tumor (sex-cord stromal tumor)
more common in postmenopausal women
have malignant potential

64
Q

fibroma

A

benign sex-cord stromal tumor
assoc. with meigs syndrome
most common in middle age women

65
Q

brenner tumor

A

“transitional cell tumor”
rare and benign
small, solid, hypoechoic unilateral tumors

66
Q

endometrioma

A

“chocolate cyst”
blood containing tumor that forms from the implantation of ectopic endo- tissue (endometriosis)
most often found on the ovary
most often seen in reproductive years

67
Q

serous cystadenocarcinoma

A

most common malignancy

may have elevated CA-125

68
Q

mucinous cystadenocarcinoma

A

assoc. with “pseudo-myxoma pertonei” —> intraperitoneal extension of mucin
often resembles ascites

69
Q

krukenberg tumor

A

malignant ovarian tumor that metastasized from the GI tract
bilateral
assoc. with ascites

70
Q

sertoli-leydig cell tumor

A

“androblastoma”
malignant sex-cord stromal tumor
assoc. with hirsutiusm and abnormal menstruation
women

71
Q

dysgerminoma

A

most common germ cell tumor

women

72
Q

yolk sac tumor

A

2nd most common malignant germ cell tumor
poor prognosis
femailes

73
Q

hormone replacement therapy increases the risk of

A 
endo- carcinoma
breast cancer
HTN
thromboembolism 
possible diabetes
74
Q

endometrial atrophy

A

most common cause of post-menopausal bleeding

75
Q

endometrial hyperplasia

A

“an enlargement”
occurs in post-meno women and reproductive age women
presents as a thick endo > 8mm

76
Q

what is endometrial carcinoma linked to?

A 
hormone replacement therapy
nulliparity
obesity
stein-leventhal syndrome (PCOS)
estrogen producing ovarian tumors 
use of tomoxifen
77
Q

asherman syndrome

A

presence of intrauterine adhesions within the uterine cavity that results from scar formation after a D&C
doesn’t allow implantation
adhesions may cause amenorrhea, pregnancy loss, or infertility

78
Q

fitz-hugh curtis syndrome

A

extensive form of PID that also affects the stomach, liver, and diaphragm

79
Q

conditions causing female infertility

A 
PID
congenital uterine malformations 
endometriosis
PCOS
tubal causes
asherman syndrome
fibroids
80
Q

mullerian anomalies

A 
congenital uterine malformations
unicornuate
bicornuate
septate
didelphys
81
Q

stein-leventhal syndrome

A

PCOS
amenorrhea
hirsutiusm
obesity

82
Q

androblastoma

A

sertoli-leydig cell tumor
malignant sex-cord stromal tumor
assoc. with hirsutuism and abnormal menstruation
women

83
Q

luteal phase deficiency

A

endometrial causes of infertility
endometrium may not develop appropriately in the luteal phase of the cycle as a result of decrease progesterone production by the ovary

84
Q

clomid

A

drug used to stimulate the pituitary gland to secrete increased amounts of FSH, which encourages the dev’t of multiple follicles on the ovaries
increased risk of torsion

85
Q

which of the following neoplasms is most likely associated with meigs syndrome

A

fibroma

86
Q

which hormone is responsible for inducing ovulation during a normal menstrual cycle

A

luteinizing hormone

87
Q

obturator internus muscle

A

are adjacent to the lateral walls of the urinary bladder

88
Q

iliopsoas muscles

A

lateral landmarks of the true pelvis lying lateral and anterior to the obturator internus muscle

89
Q

suspensory ligaments

A

extend from lateral aspect of the ovary to the pelvic sidewalls

90
Q

broad ligaments

A

extend from the lateral aspect of the UT to the pelvic sidewalls
contain the blood vessels and nerves

91
Q

failure of the mullerian ducts to fuse

A

will result in uterine didelphys

92
Q

partial failure of the mullerian ducts to fuse

A

result in bicornuate UT

93
Q

blood supply to ovaries

A

ovarian and uterine arteries

94
Q

cervix to corpus ratio during premenarche

A

2:1

95
Q

dextroflexion

A

uterine body is displaced to the right of the cervix

96
Q

levoflexion

A

uterine body is displaced to the left of the cervix

97
Q

muscles that form the pelvic floor

A

levator ani and piriformix muscles

98
Q

muscles located laterally in the true pelvis

A

obturator internus and iliopsoas muscles

99
Q

obturator internus muscles

A

border the lateral walls of the urinary bladder

100
Q

levator ani muscles

A

lie lateral to the vagina

101
Q

ureterocele

A

prolapse of the distal ureter into the bladder

102
Q

tunica albuginea

A

outer covering of the ovary

103
Q

septate UT
vs.
bicornuate, unicornuate and didelphys UT

A

displays a normal uterine contour with separation in endometrial cavity
vs.
demonstrate an abnormal contour to the fundus

104
Q

mullerian ducts

A

the UT is derived from the fused caudal portion of the paired mullerian ducts

105
Q

max. endo measurement during menarche

A

14 mm

106
Q

progesterone

A

hormone produced by the corpus luteum
increases during the endometrial secretory phase and ovarian luteal phase
increases after ovulation

107
Q

during what phases is the endometrial lining the thinnest?

A

early proliferation or late menstrual phase

108
Q

blastocyst

A

implants into the endo

the trophoblastic tissue of the blastocyst secretes hCG

109
Q

hematocolpos

A

abnormal accumulation of blood within the vagina in premenarche pts.

110
Q

subserosal

A

perimetrial uterine fibroid location

on the serosal surface of the UT

111
Q

polycystic ovarian syndrome

A

PCOS
“string of pearls”
result from endocrine imbalance — causes chronic anovulation/infertility
Findings: irregular menses, hirsutuism, obesity, and infertility)

112
Q

mucinous cystadenoma

A

epithelial neoplasm
typically multilocular
can become very large
contains internal debris generally

113
Q

perimetrium

A

the external or serosal layer of the UT

114
Q

endometriosis

A

a condition occurring when active endometrial tissue invades the peritoneal cavity

115
Q

endometriomas

A

“chocolate cysts”

collectionsf of extravasted endo tissue

116
Q

GIFT
ZIFT
IVF

A

“Gamete Intrafallopian Transfer” —> mixes oocytes with sperm added to the fallopian tube
ZIFT places a zygote in the fallopian tube
IVF placles embryos in the endometrium

117
Q

uterine arteries

A

branches of right and left internal iliac arteries
supplies UT, fallopian tube, and ovaries
course along lateral aspect of UT (w/i broad ligament)
Branches: arcuate, radial, and straight and spiral arteries

118
Q

hypogastric artery (uterine blood supply)

A

4 branches:

obturator, umbilical, uterine-vaginal, superior vesicle arteries

119
Q

internal iliac artery (uterine blood supply)

A

gives rise to the uterine and ovarian arteries

120
Q

corpus

A

uterine body

121
Q

adenomyosis

A

ectopic endometrial tissue within the myometrium

122
Q

internal iliac veins (uterine blood supply)

A

drain the pelvic organs and muscles

123
Q

ovarian hyperstimulation syndrome

A

generally seen in pts. undergoing fertility treatments

ascites and pleural effusion may also be found

124
Q

right ovarian vein

A

drains directly into the IVC

125
Q

vesicouterine pouch

A

anterior cul de sac

anterior to the UT

126
Q

broad ligaments

A

supports UT, tubes, and ovaries
suspends the UT anteriorly,posteriorly, and laterally
located at the lateral aspect of UT to the side walls of the pelvis

127
Q

suspensory ligament

A

infundibulopelvic

supports ovaries and tubes

128
Q

cardinal ligament

A

supports the cervix

129
Q

uterosacral ligament

A

supports the UT

130
Q

cumulus oophorus

A

a group of closely associated granulosa cells in which the ovum is contained (w/i the graafian follicle)
may resemble a daughter cyst

131
Q

menorrhagia

A

abnormally heavy and prolonged menstruation

132
Q

mullerian ducts develop what structures

A

UT, vagina, and fallopian tubes

133
Q

hematometra

A

an accumulation of blood within the UT

most commonly caused by an imperforate hymen

134
Q

hydrocolpos

A

vagina is distended with simple, anechoic fluid

more often seen in neonatal period

135
Q

hydrometrocolpus

A

collection of fluid from the vagina that extends into the UT

136
Q

theca lutein cysts

A

largest and least common of fun’tal cysts
found in increased levels of hCG
common concurrent conditions = gest. trophoblastic disease and ovarian hyperstimulation syndrome
bilateral and multilocular

137
Q

cystic teratoma

A

“dermoid”
most common benign ovarian tumor
results from retention of an unfertilized ovum that differentiates into 3 germ cell layers
contains thyroid tissue, bone, hair, sebum, fat, cartilage, and teeth
“tip of the iceberg”

138
Q

serous cystadenoma

A

benign tumor of ovary
women in 40s/50s
bilateral
contains septations

139
Q

mucinous cystadenoma

A

larger than serous cystadenoma (can reach up to 50 cm)
internal debris
benign tumor within the ovary

140
Q

which side does ovarian torsion typically occur?

A

right side

most common cause is ovarian cyst/mass)

141
Q

postmenopausal endometrium

A

normal = 5 mm

on hormone replacement therapy = 8 mm

142
Q

endometrial carcinoma

A

most common female genital tract malignancy
PMB is the most common clinical presentation
most common form of adenocarcinoma

143
Q

tubo-ovarian complex
vs.
tubo-ovarian abscess

A

fusion of the ovaries and dilated tubes ovary and tube are still distinguishable
vs.
unable to distinguish between ovary and tube

144
Q

which endometrial phase demonstrates the greatest dimension?

A

early secretory

145
Q

which vessel provides the best imaging landmark for locating the ovaries?

A

internal iliac arteries

146
Q

pt. with hx of dysmennorhea and UT tenderness. The uterine myometrium appears diffusely inhomogeneous, it is indicative for what?

A

adenomyosis

147
Q

a localized hypoechoic adnexal mass is present on serial sonograms with bilateral ovarian cysts of different sizes, is indicative of what?

A

endometrioma

148
Q

which rare benign ovarian neoplasm occurs most often in post-meno women?

A

thecoma

OB/GYN Board Review (8 decks)

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