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OB review > OB review- ovarian pathology > Flashcards

OB review- ovarian pathology Flashcards

1
Q

indications for ovarian exam? (4)

A
  1. pelvic pain
  2. pelvic fullness
  3. palpable mass
  4. family history of ovarian or brest cancer
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2
Q

what is a functional cyst?,

A

means that the cyst is ovarian in orgin and responds to cyclic hormonal changes

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3
Q

when do functional cysts occur?

A

when a dominent follicle fails either to ovulate or regress

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4
Q

what are hemorrhagic cysts?

A

functional cysts bleeding inside

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5
Q

whats a theca lutein cyst?

A

functional cysts related to human chorionic honadotropin exposure

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6
Q

what are non-functional cysts?

A
  • refer to cysts that do not respond to cyclic hormonal stimulation
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7
Q

examples of nonfunctional cysts? (3)

A
  • endometriomas
  • paraovarian cysts
  • peritoneal inclusion cysts
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8
Q

where do paraovarian cysts originate?

A

from wolffian structures located in the broad ligament

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9
Q

paraovarian cysts usually occur in who? s/s?

A
  • occur in all ages but mostly in mensturating women
  • benign
  • asymptomatic
  • larger cysts may cause symptoms
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10
Q
A

follicular cyst

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11
Q
A

hemorrhagic cyst

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12
Q
A

paraovarian cyst

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13
Q

chocolate cyst refers to?

A

endometrioma

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14
Q

what type of cyst respond to cyclical hormone changes?

A

functional cyst

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15
Q

what cyst is caused by adhesions?

A

peritoneal inclusion

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16
Q

what cyst ruptures about the time of menstruation?

A

corpus luteal

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17
Q

what cyst contains a dominent follicle that fails to regress?

A

follicular

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18
Q

what is ovarian torsion?

A
  • occurs when the ovary twist on its pedicle resulting in impaired blood flow to and from the ovary
  • requires prompt surgical intervention
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19
Q

compromised arterial perfusion in ovarian torsion can cause what?

A

the ovary to infarct and necorse

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20
Q

lack of venous drainage in ovarian can cause the ovary to?

A

enlarge

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21
Q

when does ovarian torsion typicall occur?

A

in childhood or in reproductive years

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22
Q

what is ovarian torsion associated with?

A
  • mobile adnexa or a preexisting ovarian cyst or mass
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23
Q

clinical symptoms- ovarian torsion? (4)

A
  • severe pain
  • nausea
  • vomitting
  • palpable mass
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24
Q

what is CA 125?

A

most widely used serum tumor marker for epithelial ovarian cancer is cancer antigen 125

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25
Q

what % of women with stage 1 epithelian ovarian cancer have elevated serum levels?

A
  • 50-60%
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26
Q

benign conditions can elevate serum concentrations of CA 125 T or F?

A

true

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27
Q

who has the greatest risk of malignant ovarian neoplasm?

A

postmenopausal

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28
Q

ovarian neoplasms are classified by what?

A

type of ovarian tissue from which they arise

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29
Q

what are the 3 types of ovarian neoplasms?

A
  • gem cell
  • epithelial
  • sex cord-stomal tumors
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30
Q

what type of ovarian neoplasm is most common?

A

germ cell tumors

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31
Q

what are the 2 most common types of ovarian neoplasms?

A
  • benign cystic teratoma

- surface epithelial-serous cystadenoma

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32
Q

germ cell tumors are most commonly found in?

A

young women

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33
Q

epithelial tumors are more common in?

A

40-50s

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34
Q

what is a fourth source of ovarian neoplasms?

A

metastatic ovarian disease

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35
Q

benign cystic teratomas are also referred to as (3)?

A
  • cystic teratomas
  • dermoids
  • dermoid cysts
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36
Q

what are benign cystic teratomas composed of? (3)

A
  • ectoderm
  • mesoderm
  • endoderm
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37
Q

what is the most common component of benign cystic teratomas?

A

ectoderm

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38
Q

germ cells form what? (7)

A
  • teeth
  • bone
  • skin
  • fingernails
  • hair
  • fat
  • sebum
39
Q

a cystic teratoma commonly contains?

A

sebum with varying amounts of fat, hair, teeth, and bone fragments

40
Q

benign cystic teratomas s/s?

A
  • commonly asymptomatic
  • abdominal swelling
  • pain
  • can be bilateral
  • slow growth
41
Q

benign cystic teratomas are prone to?

A

torsion or rupture

42
Q

what is tip of the ice burg sign?

A
  • fat/fluid level
  • dermoid plug
  • dermoid mesh
  • obscures entire back wall of the mass because of attenuation
43
Q

what is Rokitansky noduleordermoid plug ?

A
  • solid protuberence projecting from an ovarian cyst, It often contains calcific, dental, adipose, hair and/or sebaceous components
44
Q
A

tip of iceburg sign

45
Q

what is an ovarian dysgerminoma?

A
  • malignant tumor
  • contribute 1%-2% of malignant ovarian tumors
  • occur in 20-30 year old women
46
Q

invasive malignant ovarian tumors discovered during pregnancy are typically what?

A

dysgerminoma

47
Q

dysgerminoma s/s?

A
  • abdominal enlargment
  • palpable mass
  • pain
  • mestrual abnormalities
48
Q

prognosis if dysgerminoma is found early?

A
  • 95% 5-year survival
49
Q
A

dysgerminoma

50
Q

most common ovarian tumor among women 50 years or older?

A

Epithelial ovarian neoplasms

51
Q

most common types of spithelial neoplasms?

A
  • serous cystadenoma
  • mucinous cystadenoma
  • cystadenocarcinoma
  • borderline ovarian tumors
  • endometrioid tumors
  • clear cell tumors
  • brenner tumors
  • trasitional cell tumors
52
Q

mose common type of epithelial neoplasm?

A
  • serous tumor

- 50-70% being benign

53
Q

the benign form of serous cystadenoma occur most frequently in?

A

40-50 year old

54
Q

the malignant form of serous cystadenocarcinoma occurs most commonly in?

A
  • perimenopausal or postmenopausal women
55
Q

serous cyctadenocarcinoma accounts for what % of all malignant neoplasms?

A

50%

56
Q
A

serous cystadenoma

57
Q

serous cystadenocarcioma on u/s

A
  • exhibit internal papillary projections with thick septations producing multiple locules
58
Q

what is the most predictable sono feature for malignancy?

A

cystic mass that contains a solid area with detectable flow on doppler

59
Q

mucinous tumors vs. serous tumors?

A
  • less common and are usually benign
60
Q

what is psedomyoxoma peritonei?

A

Rupture of the tumor capsule may cause spillage of the gelatinous contents into the abdomen

61
Q
A

mucinous cystadenoma

62
Q

endometroid tumor occur mostly in who?

A

women in their 50’s-60’s

63
Q

what are endometroid tumors associated with?

A
  • endometrial adenocarcinoma and endometriosis
64
Q

what % of endometroid tumors are malignant?

A

80%

65
Q

what is the seconf most malignant epithelial tumor?

A

endometrioid tumor

66
Q

what has a better prognosis endometroid tumors or serous tumors or mucinous cystadenocarcinomas?

A

endometrioid

67
Q

brenner tumor aka?

A

transitional cell tumor

68
Q

what are brenner tumors?

A
  • benign

- dense fibrous tumors

69
Q

brenners tumour size?

A

<2cm diameter

- rarely exceed 10cm

70
Q

what are brenners tumors associated with?

A
  • ipsilateral cystic neoplasm
  • cystadenoma
  • teratoma
71
Q

brenners tumor s/s?

A
  • asymptomatic

- found incidently

72
Q

Sex cord-stromal tumors arise from?

A
  • sex cords of the embryonic gonad and from the ovarian stroma
73
Q

Sex cord-stromal tumors on u/s?

A

solid masses and are hormonally active

74
Q

most common Sex cord-stromal tumors? (4)

A

Granulosa cell tumor
Sertoli-Leydig cell tumor (androblastoma)
Fibroma
Thecoma

75
Q

Granulosa cell tumor function?

A
  • low-grade malignant tumor

- secrete estrogen- thickened endometrium

76
Q

Granulosa cell tumor occur in?

A

Occur predominantly in postmenopausal women but can occur in patients younger than 30 years and in children

77
Q

what can granulosa cell tumors cause?

A
  • excess estrogen
  • endometrial carcinomama
  • precocious puberty or premature breast development
78
Q

Sertoli-Leydig tumors aka?

A

androblastomas

79
Q

what is a Sertoli-Leydig tumors?

A
  • rare ovarian neoplasm occurring predominantly in menstruating women
80
Q

Sertoli-Leydig tumors may be?

A
  • hormonally active, producing the androgen testosterone, which results in virilization in about 30% of patients
  • occasionally produce estrogen
81
Q

what is virilization?

A

development of male physical characteristics

82
Q

whats a fibroma?

A
  • Fibromas occur most often in perimenopausal and postmenopausal women
  • Fibromas consist of fibrous tissue, are not usually hormonally active, and tend to be asymptomatic
83
Q

what is a thecoma?

A
  • Thecomas contain a variable combination of thecal and fibrous tissue
  • Thecomas may show clinical signs of estrogen production
84
Q

Meig’s syndrome is characterized by?

A

presence of ascites and a pleural effusion

85
Q

what is meigs syndrome?

A

a benign solid ovarian mass, of which fibroma is the most common, causes Meigs’ syndrome

86
Q
A

fibroma

87
Q
A

thecoma

88
Q

the most common tumors to metastisize to the ovary are tumors of the?

A

breast and GI tract

89
Q

metastatic ovarian neoplasms are usuallr uni or bilateral?

A

bilateral

90
Q

metastatic ovarian tumors on u/s?

A
  • complex
  • large
  • predominantly cystic
  • ascites
91
Q

Krukenberg tumor?

A

erroneously used as synonymous with any metastatic tumor to the ovary

92
Q

what is a Krukenberg tumor?

A

best reserved for tumors containing mucin-secreting signet ring cells, which usually arise from the gastrointestinal tract

93
Q
A

metastatic ovarian tumor

OB review (10 decks)

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