Ovarian Disorder Flashcards
Give three protective factors for ovarian cancer
Multiparty
COCP
Breast feeding
Which genes are implicated in ovarian cancers?
BRCA1&2
What is lynch syndrome?
Hereditary syndrome associated with increased risk of colorectal and endometrial cancers (TCCs)
Where is the BRCA1 gene found?
Chromosome 17
Where is the BRCA2 gene found?
Chromosome 13
Describe a simple ovarian cyst
Regular, smooth
Contains only fluid
What is a complex ovarian cyst?
Irregular
Solid material and blood may be found in
What is the typical size of a follicular cyst?
<3cm
What is the typical size of a corpus luteal cyst?
<5cm
What is a “chocolate cyst”?
Endometrioma
What is a theca luetin cyst a consequence of?
Raised hCG
What is the most common type of ovarian tumour?
Serous cystadenoma
In which groups to mature cystic teratomas present?
Young women
Pregnancy
Which tissues may cystic teratomas contain?
Teeth, hair, skin, bone
What is a mature cystic teratoma otherwise known as?
Dermoid cyst
Which type of tumour is a cystic teratoma?
Germ cell
Which type of tumour is a fibroma?
Sex-cord stromal
What is Meig’s syndrome?
Fibroma
Ascites
Pleural effusion
What causes Lynch syndrome?
Mismatch in repair of the genome due to microsatellite instabilities
Why is CA125 not measured in premenopausal women?
Several benign triggers for increase
What should be measured in cysts/tumours in women under 40?
LDH
AFP
hCG
What are the most common hormonal abnormalities found in PCOS?
Excess LH
Insulin resistance
Where is LH produced?
Ant pituitary
What is LH produced in response to?
GnRH
How does insulin resistance contribute to PCOS?
High insulin levels suppress sex hormone binding globulin so higher levels of circulating androgens
What are the main clinical features of PCOS?
Oligo/amenorrhoea Hirsutism Acne Obesity Chronic Pain Depression Infertility
What is acanthosis nigrans?
Darkened skin which occurs secondary to insulin resistance
How is PCOS investigated?
Test/SHBG/LH/FSH/progesterone levels
USS
What do investigations show in PCOS?
High testosterone Low SHBG Raised LH Normal FSH Low progesterone USS shows polycystic ovaries
How is infertility in PCOS treated?
Clomifene and metformin
How can hirsutism in PCOS be treated?
Anti-androgen
Give examples of anti-androgen
Cyproterone
Spironolactone
Finasteride
Which topical treatment can be used to treat hirsutism?
Eflornithine
How can menstrual abnormalities be treated in PCOS?
COCP
Dydrogesterone
