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womens health > Ovarian > Flashcards

Ovarian Flashcards

1
Q

3 layers of ovarian tissue

A

epithelian
stromal
germ

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2
Q

each layer of ovarian tissue can produce what kinds of tumor

A

cysts
benign
malignant
solid

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3
Q

what are risk factor for ovarian cyst

A 
Infertility Tx
Tamoxifen
Pregnancy in 2nd trimester when hCG peaks
Hypothyroidism
Cigarette smoking
Tubal ligation
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4
Q

what is the most common type of functional cyst

A

follicular

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5
Q

characteristics of endometriomas

A

blood filled cysts from ectopic edometrium
called chocolate cysts
Triad: Dysmenorrhea, dysparenuia, menorrhagia

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6
Q

malignant cells most oftenly arise from what tissue layer?

A

epithelium (mesothelium)

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7
Q

what will the history of a person with ovarian cysts be like

A

torsion or rupture that causes severe pain: sudden sharp unilateral pain. This may be brought on by exercise, trauma, coitis
May have difficult bowel movements, frequent urination, irrgeular menses, dysparenuia
Can cause puberty to happen early in girls
Abdominal bloating or fullness

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8
Q

what will the history of a woman with polycystic ovary syndrome be like

A

hirsutism, infertility, oligomenorrhea, obesity, acne tenesmus

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9
Q

what will exam be like for ovarian cysts

A

may be tender to palpation

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10
Q

what is the cancer antigen for ovaries

A

CA125

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11
Q

what is ovarian torsion

A

occurs when the ovary flips over

cuts off blood supply to ovary

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12
Q

what is the median age for ovarian torsion

A

28 years old

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13
Q

what is presentation like for ovarian torsion

A

2/3 on the right side

acute unilateral sharp pain, vomiting with onset of pain, pelvic mass, leukocytosis and fever

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14
Q

what type of test would you want to do for ovarian torsion

A

U/S with color doppler

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15
Q

what is the Tx for ovarian torsion

A

removal of ovary

can untwist if done immediately

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16
Q

women with PCOS have abnormalities with what?

A

metabolism of androgen and estrogen

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17
Q

what will PCOS look like on the ovaries

A

bilaterally enlarged
spherical rather than ovoid
multiple 1cm follicles
string of pearls appearance

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18
Q

How is PCOS dx made

A

2 of the following:
Polycystic ovaries
signs of androgen excess: acne, hirsutism, temporal balding, male pattern hair loss
menstrual irregulatieis: oligomenorrhea or polymenorrhea

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19
Q

what will PE be like for a pt with PCOS

A 
excess body hair, acne, alopecia, increased muscle mass, deepening voice
Obesity
Acanthosis nigricans,
HTN
Enlarged ovaries
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20
Q

what is the Tx for PCOS

A 
diet and exercise
Meds for anovulation
hirsutism
Acne
Endocine consult
surgery
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21
Q

what is the meigs syndrome triad

A

ascities
pleural effusion
benign ovarian fibroma

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22
Q

what guides the diagnosis and tx of patient

A

type of mass and age of the patient

23
Q

why is it hard to diagnose ovarian cancer

A

presentation is vague

24
Q

RF for ovarian cancer

A

older age
early menarch 50
Caucasian>Hispan>African Americans
Infertility

25
Q

what factors are protective for ovarian cancer

A

OCP

breast feeding

26
Q

how is ovarian cancer dx’d

A

U/s
elevated CA-124
elevated Inhibin B

27
Q

which causes increased risk for familial ovarian cyst?

A 
Fm Hx
BRCA 1
BRCA 2
Ashkenazi Jews, French Canadians
Icelandic descent
28
Q

what is the Tx of ovarian cancer

A

Surgery
Chemo
Marker Ca-125

29
Q

uterine prolapse stage 0

A

no prolapse

30
Q

uterine prolapse stage 1

A

cervix is in the upper 1/2 of vagina

31
Q

uterine prolapse stage 2

A

cervix is 1cm above or below hymen remnants

32
Q

uterine prolapse stage 3

A

cervix is >1cm below hymen remnants but the uterus is still at least 2cm in the vagina canal

33
Q

uterine prolapse stage 4

A

uterus is outside the vaginal canal

34
Q

what are RF for uterine prolapse

A

more than 2 vaginal deliveries

age, obesity, chronic cough, repetitive heavy lifting

35
Q

what are the symptoms of uterine prolapse

A

vaginal fullness, pressure, heaviness, presence of soft reducible mass in vagina, urinary complaints

36
Q

Leiomyoma

A

commmon in women over 40, african american

menorrhagia is usually due to submucosal firboids

37
Q

Leiomyoma pathology

A

arise from smooth muscle
usually benign tumors
tissue exam need for dx

38
Q

Leiomyoma presentation

A 
menorrhagia
fullness in pelvic area
increased abdominal girth
Freq. urination
low back pain
39
Q

how are leiomyoma dx’d

A 
U/S
MRI
CT
hyterosalpingogram
Sonohyterogram
40
Q

what is the Tx for leiomyoma

A

watchful waiting
operative hysterectomy
Embolization
monitor 3mth, 6mths, yearly

41
Q

How is embolization used to tx fibroids

A

using arterial catherization, synthetic emboli are introduced to the artery feeding the fibroid

42
Q

What uterine cancer has what

A

precursor lesion

endometrial hyperplasia that thickens endometrium and causes heavier period

43
Q

how does uterine cancer present

A

menorrhagia
metrorrhagia
post menopausal bleeding

44
Q

risk factors for endometrial hyperplasia

A 
obesity
Anovulation
DM
HTN
Age
Nulliparity
45
Q

What affects endometrial hyperplasia

A

unopposed estrogen w/o estrogen which can progress to cancer

46
Q

how is endometrial hyperplasia tx’ed

A

add extra progesterone during luteal phase

(methoxyprogesterone) during days 16-25 for 3 months

47
Q

what is the MC endometrial cancer

A

uterine cancer

has good prognosis d/t being found in early stages

48
Q

what are the 2 types od uterine cancer pathology

A

80% are type 1 d/t unopposed estrogen stimulation, endometrial hyperplasia
type II estrogen independent

49
Q

what are the RF for uterine cancer

A 
age, obesity, DM, HTN, Nulliparity, Late menopause, Early menarch
Hx of Breast CA
Tamoxifen
Estrongen alone
PCOS
50
Q

what are the Sx of uterine cancer

A

abnormal menses 80%
postmenopausal bleeding
classic presentation: obese, nuliparous, infertile, HTN, DM, white

51
Q

how is uterine cancer dx’d

A

U/S
endometrial biopsy
D&C-definitive procedure

52
Q

what is the treatment for uterine cancer

A 
surgery:
Hysterectomy
B/L salpingoopherectomy
Radiation
progesterone therapy
53
Q

how often should a patient with uterine cancer follow up

A

every 3-4 mths for first 2yrs

then 6mths for next 3yrs then annually

54
Q

what should each post cancer tx include

A

pelvic exam
pap smear
lymph node survery
Cxry annually

womens health (6 decks)

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