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Special Pops - Women's Health > Ovarian and Uterine Disease > Flashcards

Ovarian and Uterine Disease Flashcards

1
Q

When can ovarian cysts form?

A

Any stage of life - infancy to menopause

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2
Q

Types of functional ovarian cysts

A

Follicular

Corpus luteal

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3
Q

MC type of functional ovarian cyst?

A

Follicular

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4
Q

Describe follicular ovarian cysts

A
  • MC
  • Asymptomatic
  • 3 to 15 cm
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5
Q

How is a follicular ovarian cyst formed?

A

Follicle fails to rupture

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6
Q

How is a corpus luteum ovarian cyst formed?

A

Failure of corpus luteum to regress in 14 days

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7
Q

Which type of ovarian cyst is typically smaller in size?

A

Corpus luteal

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8
Q

Which type of ovarian cyst is more likely to rupture?

A

Follicular

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9
Q

Which type of ovarian cyst is firm or solid?

A

Corpus luteal

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10
Q

Name the layers of ovarian tissue

A
  1. Epithelium
  2. Stroma
  3. Germ cells
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11
Q

What is a luteoma of pregnancy?

A

Proliferation of luteinized stromal cells

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12
Q

Describe features of luteoma of pregnancy

A
  • Multifocal and bilateral
  • Hormonally active w/androgens
  • Typically resolves after delivery
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13
Q

What do cystic teratomas contain?

A

All 3 embryonic germ layers

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14
Q

What are endometriomas?

A

Blood filled cysts from ectopic endometrium

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15
Q

What are “chocolate cysts”?

A

Endometriomas

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16
Q

What are endometriomas a/w?

A

Endometriosis

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17
Q

Describe polycystic ovarian syndrome

A

Multiple cystic follicles 2-5 mm

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18
Q

When in pregnancy increases risk of ovarian cyst development?

A

2nd trimester when hCG peaks

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19
Q

When are ovaries typically palpable?

A

Thin premenopausal patient

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20
Q

Pathophys of ovarian torsion

A
  • Ovary flips over
  • Cuts off blood supply
  • Ovarian tumors are involved in 50-60% cases (whether benign of malignant)
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21
Q

Presentation of ovarian torsion

A
  • 2/3 are on the RIGHT
  • Acute unilateral sharp pain
  • Vomiting w/onset of pain
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22
Q

Diagnosis of ovarian torsion

A

U/S with color doppler

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23
Q

Treatment of ovarian torsion

A

Surgical (oophorectomy)

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24
Q

Describe cancer antigen 125 (CA125)

A
  • Mostly used to monitor ovarian cancer progression
  • Most useful in combo with U/S
  • Can be positive in 6% healthy pts
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25
Q

When should CA125 NOT be drawn?

A
  • Acute care settings

- Elevated in cyst rupture, infections, hemorrhage, endometriosis

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26
Q

What is the primary tool for ovarian cyst evaluation?

A

Ultrasonography

  • Endovaginal
  • Transabdominal (for large masses)
27
Q

Prognosis of ovarian cysts

A

Most with simple ovarian cysts require NO treatment (resolve within 60 days)

28
Q

Treatment of fetal and neonatal ovarian cysts

A

Most are small and resolve within first few months of life

29
Q

Treatment of ovarian cysts in pregnancy

A
  • Most resolve by gestational 14-16 weeks

- Surgery if symptomatic or rapid growth

30
Q

Etiology of PCOS

A
  • Unclear

- May be abnormal function of hypothalamic-pituitary-ovary axis

31
Q

How do ovaries present in PCOS?

A
  • Bilaterally enlarged
  • Spherical (rather than ovoid)
  • String of pearls configuration
32
Q

Diagnosis of PCOS

A

2 of the following:

  • Polycystic ovaries
  • Signs of androgen excess (acne, hirsutism, male pattern hair loss)
  • Menstrual irregularities
33
Q

Treatment of PCOS

A

Lifestyle changes!

34
Q

MC type of ovarian tumor

A

Epithelial (60-80%)

35
Q

Most ovarian neoplasms are ___ (malignant/benign)?

A

Benign

36
Q

When are ovarian neoplasms more likely to be malignant?

A

Postmenopausal women

37
Q

Types of stromal ovarian tumor

A
  • Thecoma (postmenopausal, produces estrogen)

- Fibroma (perimenopausal)

38
Q

What is Meig’s syndrome?

A
  • A/w ovarian fibroma

- Triad = ascites, R pleural effusion, ovarian fibroma

39
Q

What is a hilus cell tumor?

A
  • Stromal ovarian tumor

- Androgen secreting

40
Q

What are dermoid cysts?

A
  • Mature cystic teratomas
  • Germ cell tumors
  • 40-50% of all benign ovarian neoplasms
  • Teeth can be present
41
Q

Why is ovarian cancer called “the silent killer”?

A

Presentation is vague

42
Q

Risk factors for ovarian cancer

A
  • Older age
  • Early menarche (under 12)
  • Late menopause (over 50)
  • Caucasians
  • Infertility
43
Q

Protective factors against ovarian cancer

A
  • Use of OCPs (50% reduction w/in 15 yrs of use)

- Breastfeeding

44
Q

Diagnosis of ovarian cancer

A
  • U/S
  • Elevated CA125
  • Elevated Inhibin B
45
Q

Familial ovarian cancer risk factors

A
  • BRCA 1
  • BRCA 2
  • Ashkenazi Jewish, French Canadians, Icelandic descent
46
Q

What increases risk for uterine prolapse?

A
  • More than 2 vaginal deliveries

- Age, obesity, chronic cough, repetitive heavy lifting

47
Q

Stages of uterine prolapse

A

0: no prolapse
1: cervix in upper 1/2 of vagina
2: cervix is 1 cm above or below hymen remnants
3: cervix is greater 1 cm below hymen remnants but uterus is still at least 2 cm in vaginal canal
4: uterus is outside vaginal canal

48
Q

Who is affected by uterine leiomyoma (fibroids)?

A

Women over 40

AAs

49
Q

Pathology of uterine leiomyoma

A
  • Arise from smooth muscle

- Usually benign

50
Q

Treatment of uterine fibroids

A
  • Watchful waiting
  • Operative hysteroscopy (electrocautery wire)
  • Embolization
  • Hysterectomy
  • Myomectomy
  • Morcellation
51
Q

What is the precursor lesion of endometrial cancer?

A

Unopposed (w/o progesterone) estrogen

52
Q

Treatment of endometrial hyperplasia?

A

Add extra progesterone during luteal phase

53
Q

What is the MC gynecological malignancy?

A

Endometrial (uterine)

54
Q

Prognosis of endometrial cancer

A

Good - many found in stage 1

55
Q

Prognosis of ovarian cancer

A

Poor - often found late stage

56
Q

Categories of endometrial cancer

A
  • Type I: 80%, unopposed estrogen stimulation, endometrial hyperplasia
  • Type II: estrogen independent, older women
57
Q

MC histologic subtype of uterine cancer?

A

Endometrioid adenocarcinoma

58
Q

Presentation of uterine cancer

A

Abnormal menses (80%)
Postmenopausal bleeding
Obese, infertile, HTN, DM

59
Q

When is radiation indicated in uterine cancer?

A

If invasion of the myometrium is present

60
Q

Treatment of uterine cancer

A
  • Surgery
  • Radiation
  • Hormone therapy (progesterone)
61
Q

Describe sarcoma of uterus

A
  • Avg age at dx is 50
  • Aggressive
  • MC in AAs
62
Q

Presentation of sarcoma of uterus

A
  • Abnormal uterine bleeding (60%)

- Pelvic pain (50%)

63
Q

2 primary factors for assessing and diagnosing a pelvic mass of gyn origin?

A
  1. Patient age

2. Menopause status

Special Pops - Women's Health (11 decks)

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