Ovarian Disorders Flashcards
What is the most frequent cystic structure in the normal ovary?
Follicular (functional) Cyst
T/F: The majority of follicular cysts are asymptomatic
True
How are Follicular cysts diagnosed?
US
Pelvic Examination
All women are ______ until proven otherwise
Pregnant
What are defining characteristics of a benign ovarian cyst?
Unilateral Adenexa
Mobile
Mild to no pain
What US findings are suggestive of a benign ovarian cyst?
Unilocular
Simple, Fluid Filled
No Septations
When should you preform a follow up US when working up a benign ovarian cyst?
6-12 weeks
When would you use OCPs to manage benign ovarian cysts?
To decrease the risk of recurrence
However, there is no real benefit over observation alone
Why may a corpus luteum cyst result in a delayed onset of menses?
Corpus Luteum Cysts secrete progesterone which would delay menses
When would surgery be indicated for treatment of Corpus Luteum Cyst?
If there was evidence of torsion or symptomatic rupture
***With surgery remember that the goal is ovarian tissue preservation
T/F: A corpus Luteum Cyst is a non-functional cyst
False
It is a functional cyst
Theca Lutein Cysts are almost always ________ (unilateral/bilateral)
Bilateral
What is the most common cause of Theca Lutein Cysts?
Prolonged/Excess stimulation of ovaries by endogenous/exogenous Gn
What is a unique US finding of Theca Lutein Cysts?
Multiple thin-walled cysts blaterally
Is torsion common with Theca Lutein Cysts?
No, its rare
How does a serous cystadenoma differ from a mucinous cystadenoma?
Serous: Filled with pale-yellow serous fluid, unilocular
Mucinous: Filled with sticky mucin, multiloculated
T/F: Mucinous tumors are the largest of all ovarian tumors
True
How are cystadenomas diagnosed?
US
What is the mainstay of cystadenoma management?
Surgical Removal
If a mucinous tumor is removed from an ovary, what additional surgical procedure needs to be preformed?
Appendectomy to r/o coexistent mucinous tumors
What is a tubo-ovarian abscess?
Infectious process of the upper genital tract that creates an inflammatory mass involving the fallopian tube and ovary
Are tubo-ovarian abscesses more likely tobe unilateral or bilateral?
Bilateral
When would a tubo-ovarian abscess become a surgical emergency?
Sepsis
Signs of rupture
What are THREE concerning chronic complications of a tubo-ovarian abscess?
Infertility
Tubal Occlusion
Ectopic Pregnancy
How are tubo-ovarian abscesses managed?
- IV ABx (Cover Gc/CHl)
- Laparoscopy if worsening, not improvening, signs of rupture
- Catheter from drainage
An ___________ is an ovarian cystic mass arising from the growth of ectopic endometrial tissue within the ovary and is typically filled with a thick brown tar-like fluid.
Endometrioma (Chocolate Cyst)
How are endometriomas diagnosed?
H&P consistent with endometriosis
US
How are endometriomas managed?
Observation
Surgery (Pain relief, Malignancy, Infertility)
A ______ is a benign neoplasm that contains tissue from all 3 germ layers
Teratoma
What is the most common benign neoplasm in women < 35 y.o.?
Teratoma
How are teratomas typically diagnosed?
Typically incidentally on pelvic exam, RR, or US
Why is observation not an appropriate management for teratomas?
These will not go away
What do you need to avoid during surgical removal of a teratoma?
Avoid spilling the contents to reduce risk of peritonitis
What is the most common cause of hyperandrogenism and chronic anovulation?
PCOS
What are the symptoms of hyperandrogenism in PCOS?
Acne
Hirsutism
What are the metabolic symptoms of PCOS?
Obesity
Insulin Resistence
Hyperinsulinemia
What are the THREE diagnostic criteria of PCOS?
- Oligoovulation or anovulation
- Hyperandrogenemia
- Polycystic ovaries diagnosed by ultrasound
What is first-line for PCOS management in non-diabetic patients?
OCPs
What can be given to lower insulin levels in non-diabetic women with PCOS?
Metformin
What is the classic US finding in PCOS?
String of Pearls
A ______ ____ is a simple epithelial-lined cyst (rarely complex) or benign fibroid adjacent to the ovary, usually within the broad ligament
Paraovarian cyst/fibroid
Are paraovarian cysts typically symptomatic?
No
How are paraovarian cysts diagnosed?
US
How are paraovarian cysts managed?
Typically observation
***Surgery if symptomatic
Ovarian _____ is described as rotation of the ovary or the ovary and FT to such a degree as to occlude the vascular supply.
Sx include…..
Acute, severe, unilateral pain
N/V
Ovarian Torsion
How is an ovarian torsion diagnosed?
US with Doppler Studies
T/F: Ovarian Torsion is a surgical emergency
True!!!!!
What are TWO serum tumor markers?
CA 125
HE4
______ (ovarian/cervical) cancer is the most lethal form of tumor arising from the female reproductive tract
Ovarian Cancer
90% of ovarian cancers are ______ (Epithelial/Stromal/Germinal)
Epithelial
