Menstrual Disorders and Ovarian Disease

Question 1

pain in association with menstruation

Answer 1

dysmenorrhea

Question 2

Cause of primary dysmenorrhea

Answer 2

excess of prostaglandin E2 alpha in the endometrium

Question 3

Difference between age onset of primary versus secondary dysmenorrhea

Answer 3

primary is common in women in late teens/early 20s whereas secondary is common in all ages

Question 4

First line therapy for primary dysmenorrhea

Answer 4

prescription strength NSAIDs (naproxen) 2 days prior to onset of menses and throughout

Question 5

Group of physical, mood, and behavioral changes that occur in a regular, cyclic relationship to the luteal phase of the menstrual cycle

Answer 5

premenstrual syndrome

Question 6

What is important about the symptomatology of premenstrual syndrome?

Answer 6

cyclic occurrence of the symptoms

Question 7

Severe form of PMS in which emotional sx are much more prominent

Answer 7

Premenstrual Dysphoric Disorder (PMDD)

Question 8

What patient populations should you not be able to palpate ovaries?

Answer 8

premenarchal and postmenopausal

Question 9

NOT a neoplasm, but arises as a result of normal ovarian physiology

Answer 9

ovarian cyst

Question 10

What are the two types of ovarian cysts?

Answer 10

follicular and corpus luteum

Question 11

Type of cyst that may form if an ovarian follicle fails to rupture during maturation, ovulation does NOT occur

Answer 11

follicular cyst

Question 12

What are the characteristics of a follicular cyst?

Answer 12

mobile, cystic, adnexal mass

Question 13

What is the management for ovarian cysts?

Answer 13

Reevaluation in six to eight weeks to ensure the cyst has resolved. May order transvaginal US as needed

Question 14

Symptom of ruptured follicular cyst and is why pregnancy test is so important

Answer 14

transient acute pelvic pain

Question 15

May occur due to an enarged corpus luteum that continues to produce progesterone longer than 12 days

Answer 15

corpus lutem cyst

Question 16

Presentation of corpus luteum cyst

Answer 16

dull lower quadrant pain along with a missed menstrual period

Question 17

Common stromal cell tumor

Answer 17

Sertoli-Leydig cell tumor

Question 18

Treatment for bening neoplasms

Answer 18

surgical treatment because of their potential for transformation to malignancy

Question 19

Gynecologic cancer with highest mortality rate

Answer 19

ovarian cancer

Question 20

Protective effect that reduces risk of ovarian cancer

Answer 20

suppression of ovulation (OCPs)

Question 21

Top of the differential diagnosis for a postmenopausal patient with a palpable ovary or mass

Answer 21

ovarian cancer

Question 22

Complete or partial rotation of the ovary on its ligamentous supports

Answer 22

ovarian torsion

Question 23

Ligaments that ovary typically rotates around

Answer 23

infundibulopelvic ligament and the utero-ovarian ligament

Question 24

Fallopian tube often twists along with the ovary

Answer 24

adnexal torsion

Question 25

Why is the right ovary more often affected by torsion than the left ovary?

Answer 25

right utero-ovarian ligament is longer than the left

Question 26

Abrupt onset of acute, severe, unilateral, lower abdominal and pelvic pain often associated with nausea and vomiting

Answer 26

ovarian torsion

Question 27

Treatment of choice for ovarian torsion if necrosis develops

Answer 27

unilateral salpingo-oopherectomy