Lesson 6 (Part 4)

Question 1

What do hyperstimulated ovaries respond to?

Answer 1

Increased levels of hCG

Question 2

What is hyperstimulated ovaries associated with?

Answer 2

Ovulation induction

Question 3

What do ovarian blood vessels react abnormally to? (2)

Answer 3

1. hCG

2. Leak fluid

Question 4

What does hCG and leak fluid cause?

Answer 4

Ovaries to enlarged due to swelling from fluid

- if worsens fluid moves into abdomen

Question 5

What is the sonographic appearance of hyperstimulated ovaries? (3)

Answer 5

1. Bilaterally
2. Enlarged ovaries
3. Multiple cysts

Question 6

When do hyperstimulated ovaries usually resolve?

Answer 6

During pregnancy

Question 7

What risk is there with hyperstimulated ovaries?

Answer 7

Torsion

Question 8

Why is there a high risk of torsion with hyperstimulated ovaries?

Answer 8

Because they have cysts on them

Question 9

OHSS

Answer 9

Ovarian Hyperstimulation Syndrome

Question 10

What does ovarian hyperstimulation syndrome result from?

Answer 10

Fertility drugs

Question 11

What are 3 degrees syndrome meaning more than one symptom?

Answer 11

1. Mild
2. Moderate
3. Severe

Question 12

What happens in mild OHSS? (2)

Answer 12

1. Ovaries enlarged but <5cm

2. Lower abdominal discomfort

Question 13

What happens in moderate OHSS? (2)

Answer 13

1. Weight gain 5 to 10 lbs

2. Ovaries measure between 5 and 12 cm

Question 14

What can moderate OHSS cause? (2)

Answer 14

1. Nausea

2. Vomiting

Question 15

What happens in severe OHSS? (2)

Answer 15

1. > 10 lb weight gain

2. Ovaries > 12cm in diameter, multiple large, thin walled cysts

Question 16

What can severe OHSS cause? (2)

Answer 16

1. Severe abdominal pain

2. Distension

Question 17

What is severe OHSS associated with? (2)

Answer 17

1. Ascites

2. Pleural effusions

Question 18

Where should you look when you are dealing with severe OHSS?

Answer 18

In Morrisons pouch

Question 19

What is the treatment for severe OHSS? (2)

Answer 19

1. Conservative
   - replace fluids and electrolytes
2. Resolves 2 to 3 weeks

Question 20

What is theca luteal cysts associated with?

Answer 20

OHS

Question 21

HL

Answer 21

Hyperractio Luteinalis

Question 22

Hyperractio Luteinalis (2)

Answer 22

1. Abnormal response to circulating hCG

2. Patient had no ovulation induction therapy

Question 23

What are hyperractio luteinalis also known as?

Answer 23

Theca luteal in later pregnancy

Question 24

When does HL mostly occur?

Answer 24

In the 3rd trimester

Question 25

Who is HL most likely going to occur in?

Answer 25

A patient who has polycystic ovarian disease

Question 26

What is rare with HL?

Answer 26

Body fluid shifts

Question 27

Body fluid shifts

Answer 27

Ascites/pleura

Question 28

What is the sonographic appearance of HL? (3)

Answer 28

1. Bilateral
2. Enlarged ovaries
3. Multiple cysts

Question 29

What are the differences between HL and OHS? (3)

Answer 29

1. Occurs in 3rd trimester
2. Ovaries are not as large
3. Resolves spontaneously

Question 30

What are some characteristics of luteoma? (4)

Answer 30

1. Rare
2. Solid
3. Benign
4. Most asymptomatic

Question 31

What do luteinize stromal cells produce?

Answer 31

Androgens

Question 32

Who is more at risk for luteoma? (2)

Answer 32

1. Female fetus 50% risk virilization

2. Male fetus not affected

Question 33

What does luteoma look like on US? (3)

Answer 33

1. Heterogeneous
2. Mostly hypoechoic mass
3. Can be Highly vascular

Question 34

What is the most common cause of luteoma?

Answer 34

Maternal virilization