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Clin Med Repro > Ovarian DO > Flashcards

Ovarian DO Flashcards

1
Q

What is the most common type of ovarian cyst? How does it present? How do you treat it?

A

Follicular cyst
Usually asymptomatic
Will usually resolve spontaneously!

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2
Q

What causes a follicular cyst?

A

Failure of ovulation

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3
Q

What type of cyst occurs after ovulation?

A

Corpus luteum cyst

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4
Q

What type of cyst is a bilateral functional cyst that is greater than 3cm and usually occurs in pregnancy?

A

Theca-lutein cyst

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5
Q

What level is high with a theca-lutein cyst? What does this put a patient at risk for?

A

B HCG

Risk multifetal gestations or molar pregnancy

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6
Q

What is a molar pregnancy?

A

Non-viable fertilized egg implants into uterus

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7
Q

What type of cyst will sometimes occur with endometriosis?

A

Hemorrhagic cyst

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8
Q

What can occur if a patient has an ovarian cyst that is greater than 6cm?

A

Torsion of the cyst or ovary

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9
Q

How do you manage a fluid-filled cyst?

A

Periodic US

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10
Q

What is the most common method of removing a cyst?

A

Laparascopy

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11
Q

How do you prevent ovarian cysts?

A

OCPs!

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12
Q

How do you treat the pain of ovarian cysts?

A

NSAIDs

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13
Q

When can you diagnose PCOS clinically?

A

2 out of 3 of the following

Oligo or amenorrhea and anovulation
Hyperandrogenism
Ultrasound: Evidence of polycystic ovaries

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14
Q

What is the most common cause of infertility in women?

A

PCOS

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15
Q

What are two things that can cause PCOS?

A

Insulin resistance

Unopposed estrogen

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16
Q

How do you diagnose PCOS?

A

Diagnosis of exclusion!

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17
Q

What do you want to exclude before you diagnose PCOS?

A

Nonclassic congenital adrenal hyperplasia
Cushing’s sydnrome
Ovarian and adrenal androgen-secreting tumors and ovarian hyperthecosis

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18
Q

Who do you treat PCOS?

A 
Treat unopposed estrogen and insulin resistance
OCPs
Cycle w/ progesterone
Metformin for insulin resistance
Clomiphene citrate for infertility
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19
Q

What is an additional benefit of using metformin to treat insulin resistance?

A

May also improve fertility :)

20
Q

What should you do if you find an enlarging ovarian mass with a solid component or change in character?

A

REMOVE IT! Esp. in a postmenopausal woman

21
Q

Does screening for ovarian CA reduce mortality?

A

No! It is not recommended

22
Q

85-90% of ovarian cancer originates in the _____

A

Epithelium of the ovary

23
Q

What percentage of ovarian cancer is a germ cell tumor?

A

5-10%

24
Q

Where do germ cell tumors occur? Who is typically affected by these?

A

Cells that produce eggs

Typically women in their 20s

25
Q

What percentage of ovarian cancer is from stroma carcinoma tumors?

A

about 5%

26
Q

Clear cell ovarian carcinomas are _____ benign

A

Rarely

27
Q

What make up 40-50% of all benign ovarian neoplasms from totipotential germ cells?

A

Teratomas or dermoid cysts

28
Q

Who is more likely to have a malignant germ cell tumor?

A

Teenage girls :(

29
Q

Stromal tumors produce?

A

Hormones!

30
Q

What age puts a patient at an increased risk for ovarian cancer?

A

Over 65

31
Q

What is the most lethal gynecologic malignancy, often referred to as the “silent killer”?

A

Ovarian cancer

32
Q

When does the risk of ovarian cancer peak?

A

65-75

33
Q

What are the common symptoms of ovarian cancer? (8 total, shoot for 4!)

A 
Pelvic pain
Abdominal pain/fullness
Indigestion
Heartburn
Back pain
Feeling rapidly full post eating
Urinary frequency
Changes in bowel habits
34
Q

What are some symptoms associated with LATE STAGE ovarian cancer?

A

Abdominal pain/bloating
Early satiety
Urinary urgency/frequency

35
Q

What do you do if you find a palpable ovary in a postmenopausal woman?

A

Evaluate ASAP!

36
Q

Is an US a screening test for ovarian cancer?

A

NO

37
Q

Who should manage treatment of ovarian cancer?

A

Gynecologic oncologist

38
Q

Does a family history of ovarian cancer increase a woman’s lifetime risk?

A

Only 2-6%

39
Q

What raises a woman lifetime risk of ovarian cancer to 25-50%?

A

Familial ovarian cancer syndrome (BRCA gene)

40
Q

If a patient has the BRCA gene, what should you do?

A

Prophylactic bilateral salpingo-oophorectomy by age 35 or as soon as childbearing is complete

41
Q

One last time, is screening recommended for ovarian cancer?

A

No! Screening has shown that the risks outweigh the benefits. Also, 98% of women screened as positive WILL NOT have ovarian cancer!

42
Q

How do you diagnose ovarian cancer?

A

Transvaginal US or laparoscopic evaluation

43
Q

How do you treat ovarian cancer?

A

Remove tumor with surgery - maybe a total hysterectomy
Bilteral oophorectomy
Chemotherapy
Radiation - Not highly regarded in the treatment of ovarian cancer

44
Q

What is the 5 year survival rate of ovarian cancer?

A

45% - survival dependent on stage at diagnosis

45
Q

What increases the survival rate of ovarian cancer?

A

Detecting prior to spreading outside of the ovary

Clin Med Repro (7 decks)

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