Ovarian Cyst

Question 1

What are ovarian cyst ?

Answer 1

Fluid filled sacs within the ovary

Question 2

What are the 2 type of cysts ?

Answer 2

Functional ovarian cysts
Non functional ovarian cyst

Question 3

What are the types of the functional ovary cysts ?

Answer 3

Follicular cyst of the ovary
Corpus luteam cyst
Theca lutien cyst

Question 4

What are the types of nonfunctional ovarian cyst ?

Answer 4

• chocolate cyst
• dermoid cyst
• cytoadenoma
• malignant cells

Question 5

What is the main feature of functional ovarian cysts ?

Answer 5

It often resolves on their own

Question 6

What are the features of follicular cyst of the ovary ?

Answer 6

1) develops when the follicle don’t rupture and continue to grow
2) 7cm cyst lined with granulosa cells
3) associated with hyperestrogenosim and endometrial hyperplasia

Question 7

What are the features of corpus luteum cyst ?

Answer 7

1) enlargement and buildup of fluid after failed regrussion after release of ovum
2) produce progestin leads to delayed menses
3) associated with progestin only contraceptive pills

Question 8

What are the features of theca lutien cyst ?

Answer 8

1) develops bilaterally
2) due to increase theca cells due to increase B-HCG
3) associated with molar
4) resolve with B-HCG normalize

Question 9

Clinical features of nonfunctional ovarian cyst

Answer 9

Lower abdominal pain
Palpable adnexal mass
Menorrhagia
Acne, hirsutism

Question 10

Single cyst

Answer 10

Corpus luteum, follicular

Question 11

Multiple cysts

Answer 11

Theca lutien, PCOS

Question 12

Ruptured ovarian cyst is a complication caused by what ?

Answer 12

Increase in Intracystic pressure
Corpus luteum is the most common

Question 13

Risk factors for ruptured ovarian cyst

Answer 13

Strong , exercise
Vaginal intercourse
Large cyst

Question 14

Clinical features of ruptured ovarian cyst

Answer 14

1) sudden onset unilateral lower abdominal pain
2) nausea , vomiting
3) vaginal bleeding
4) hemorrhage that leads to hypovolimic shock 

Question 15

How to diagnose ruptured ovarian cyst ?

Answer 15

CBC for anemia
Transabdominal / transvaginal pelvic ultrasound for free fluid in pouch of doglus and for adnexal mass

Question 16

What is the treatment for ruptured ovarian cyst ?

Answer 16

Unstable
- emergency explatory laproscopy
- cystectomy
- oophrectomy if massive hemorrhage

Stable
- conservative management
- analgesics and observation

Question 17

What is ovarian torsion?

Answer 17

Twist of the ovary around the adnexal ligament

Question 18

What are the risk factors for ovarian torsion ?

Answer 18

1) cyst more than 5cm
2) dermoid cyst
3) ovarian tumors
4) pregnancy
5) long ovarian ligament
6) strong exercise
7) history of PID
8) previous pelvic surgery ( tubal ligation or hysterectomy)

Question 19

What are the clinical features of ovarian torsion ?

Answer 19

1) sudden onset unilateral lower abdominal pain
2) nausea, vomiting
3) adnexal mass may be palpable
4) adnexal tenderness

Question 20

How to diagnose ovarian torsion ?

Answer 20

1) B-HCG to rule out pregnancy
2) pelvic US with Doppler
- to check for enlarged , edematous ovary IgG decrease blood low
- thickened Fallopian tube
- twist vascular Peclicles ( whirl pool )

Question 21

What is the treatment of ovarian torsion in premenopausal patients?

Answer 21

• laparoscopy
• adnexal distortion ( un twist )
• preservation of ovarian function
  If ovary got necrossised do oophorectomy

Question 22

What is the treatment of ovarian torsion in postmenopausal women ?

Answer 22

Laproscopy + salengio oophorectomy