Ovarian disorders

Question 1

3 functional benign ovarian disorders

Answer 1

follicular cyst
corpus lutein cyst
theca lutein cyst

Question 2

most common functional cyst

Answer 2

follicular cyst
unilateral adnexal
fill with fluid
2-8cm

Question 3

theca lutein cyst unique facts 5

Answer 3

1. massive 20-30 cm
2. bilateral / multiple
3. excessive / prolonged GnRH or HCG
4. rarely cause: maternal virilization, morning sickness, preeclampsia, thyroid dysfunction

Question 4

who at risk for corpus leutin cyst

Answer 4

women on anticoagulants

3-10 cm

Question 5

PCOS buzzwords

Answer 5

2/3: hyperaldosteronism, PCOS US, and messed up ovulation

tx: OCP, metformin, clomiphene citrate (if want preggers)

Question 6

string of pearls

Answer 6

PCOS on US

Question 7

paraovarian cyst / fibroid is..

Answer 7

simple epithelial or benign fibroid in broad lig.

tx: conservative, sx or unsure laprascopic

Question 8

ovarian surgical emergency

Answer 8

ovarian adnexal torsion

Question 9

tubo-ovarian abcess caused by

Answer 9

PID

tx: IV abx, low threshold hospitalization

Question 10

CDC TOA recommendations

Answer 10

24 hr observation if PID sx and TOA

worried about rupture –> sepsis

Question 11

2 kinds of cystadenoma

Answer 11

serous and mucinous

Question 12

most common ovarian benign neoplasm

Answer 12

cystadenoma

Question 13

mucinous cystadenoma management

Answer 13

fill with sticky mucin
rupture - pseudomyxoma peritoneii, deposits in cavity
appendectomy as well!!!

Question 14

serous cystadenoma

Answer 14

unilocular thin walled

Question 15

largest of all ovarian tumors

Answer 15

mucinous cystadenoma

Question 16

chocolate cyst

Answer 16

endometrioma ..ectopic endometriosus in ovary

Question 17

with endometrioma when concern malignancy?

Answer 17

over age 40

otherwise.. cystectomy or oophorectomy

Question 18

mature cystic teratoma is tissue from

Answer 18

all 3 germ layers

ectoderm, mesoderm and endoderm

Question 19

most common benign neoplasm for women under 35

Answer 19

mature cystic teratoma

Question 20

tubercle of rokitansky

Answer 20

mature cystic teratoma with nipple in cyst wall

Question 21

stroma ovarii

Answer 21

mature cystic teratoma when thyroid tissue is in cyst can lead to thyrotoxicosis

Question 22

fatty cysts

Answer 22

mature cystic teratoma

higher risk for torsion

Question 23

tx mature cystic teratoma

Answer 23

must do surgery! it wont go away

Question 24

5 US findings that suggest malignant adenexal mass

Answer 24

1. thick septations
2. papillary projection into cyst lumen
3. intramural nodule
4. cystic and solid components
5. increased overall volume of ovary or Doppler measurement of blood flow

Question 25

CA 125 has decreased specificity in __women

Answer 25

premenopausal

Question 26

HE4 has better __ than CA125 for malignant ovarian disorders

Answer 26

specificity

Question 27

if pelvic mass + one of the following refer to gyn oncologist

Answer 27

1. CA 125 over 35 in postmenopausal women 2. CA 125 over 200 in premenopausal women 3. Ascites 4. Nodular or fixed pelvic mass 5. evidence of abdominal or distant metastasis 6. Fhx of 1st degree relative w/ ovarian or breast cancer

Question 28

infertility def

Answer 28

failure preg. after 1 yr unprotected sex (2+ / wk)

Question 29

meds that can cause retrograde ejactulation

Answer 29

sympathomimetics | anticholinergics

Question 30

oligospermia can be associated with..

Answer 30

varicocele

Question 31

ovary probs for __% of infertile women

Answer 31

40%

Question 32

does clomiphene citrate increase risk for ovarian cancer

Answer 32

NO but can lead to cystic ovarian enlargement or increase risk for multifetal pregnancy

Question 33

why does metformin help PCOS women with ovulation?

Answer 33

lowers ovarian androgens increases ovulation frequency decrease other PCOS sx

Question 34

why do aromatase inhibitors help with ovulation

Answer 34

blocks conversion of androgens to estrogen hypothalamus sees low estrogen levels and increase GnRH release = ovulation

Question 35

letrozole is a

Answer 35

aromatase inhibitor | induces ovulation

Question 36

__ is potentially teratogenic

Answer 36

letrozole aromatase inhibitor not FDA approved for ovulation induction but some say with PCOS and over BMI of 30.. its first line

Question 37

when is trasnphenoidal surgery an option for infertility tx

Answer 37

women with giant adenoma over 3 cm who desires pregnancy even if responding to DA agonist

Question 38

diverticulosis of the fallopian tube

Answer 38

SIN: salpingitis isthmica nodosa nodular thicking of isthmus due to inflammation causes obstruction

Question 39

__ is most important factor in tubal occlusive dz/ infertility

Answer 39

PID | increasing risk with each episode probably of tubal infertility

Question 40

standard tx for tubal factor tx

Answer 40

HSG: hysterosalpingography

Question 41

__ is only definitive method to ID peritoneal infertility factors

Answer 41

diagnostic laparoscopy

Question 42

peritoneal factor includes

Answer 42

pelvic or adnexal adhesions and endometriosus

Question 43

__ is most common and initial assisted repro tx

Answer 43

IVF