Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB/GYN > Ovarian Pathology > Flashcards

Ovarian Pathology Flashcards

1
Q

What are the sonographic findings of simple ovarian cysts?

A
  • anechoic
  • unilocular
  • thin-walled
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What percentage of ovarian cysts resolve spontaneously?

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sonographic and clinical follow up is recommended when an ovarian cyst exceeds ___ cm.

A

3 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are functional cysts? What do they result from?

A
  • generic hormonally active cysts

- result from stimulation of released pituitary gonadotropins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most common cause of ovarian enlargement in young women?

A

functional cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name 3 types of functional cysts

A
  1. follicular cysts
  2. corpus luteal cysts
  3. theca lutein cysts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are follicular cysts caused by? What happens after this?

A
  • overstimulation of a follicle that fails to rupture or involute
  • serous fluid distends the lumen of the follicle, creating a cyst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most follicular cysts are ______ cm and are ________. What is the maximum measurement of a normal dominant follicle?

A
  • 3-8cm
  • unilocular
  • 3cm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When do corpus luteal cysts occur?

A

following ovulation of the dominant follicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In the absence of pregnancy, what happens to the CL cyst?

A

may continue to grow or hemorrhage into the lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CL cysts rarely exceed ___ cm and may contain ________.

A
  • 4cm

- internal echoes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do CL cysts secrete? When do they resolve by in pregnancy?

A
  • progesterone

- resolve by 16 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name 4 sonographic findings of CL cysts.

A
  1. thick hyperechoic irregular walls
  2. usually echogenic internal content
  3. possible solid appearance
  4. low resistance flow along periphery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which are the largest of the functional cysts?

A

theca lutein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Theca lutein cysts do not secrete ______.

A

hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Theca lutein cysts are ________ and _________. What do they result from?

A
  • multilocular
  • bilateral

result from overstimulation by high levels of hCG associated with gestational trophoblastic disease or hCG administration during infertility treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How long do theca lutein cysts persist? Do they resolve without surgery?

A
  • may persist for days or weeks

- generally involute without surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What do hemorrhagic cysts result from?

A
  • large size of ovarian cyst
  • spontaneous rupture
  • torsion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What do patients with hemorrhagic cysts present with?

A

sudden onset of pelvic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the sonographic findings of a hemorrhagic cyst? (4) Include an acute hemorrhage and subacute hemorrhage.

A
  • typical cystic characteristic
  • acute hemorrhage = hyperechoic (!!!), mimicking a solid mass but with posterior acoustic enhancement
  • subacute hemorrhagic cyst = complex appearance with internal echoes, strands, rarely a fluid-fluid level
  • sonographic appearance of hemorrhagic cyst will vary with time with clot lysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What happens in ovarian torsion?

A
  • there is partial or complete rotation of the ovarian pedicle on its axis
  • lymphatic and venous drainage is compromised
  • this causes congestion and edema of the ovary — leading to loss of arterial perfusion and resultant infarction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the clinical presentation of ovarian torsion?

A

sudden onset pelvic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What can right sided torsion mimic?

A

acute appendicitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the 3 risk factors for ovarian torsion?

A
  • pre-existing ovarian cyst or mass (usually benign)
  • children and young females with mobile adnexa (ovary is usually normal)
  • pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the sonographic findings of ovarian torsion?

A
  • enlarged ovary, often with multiple follicles
  • Doppler findings depend on degree and chronicity of torsion:
  • –absent color and spectral Doppler
  • –possible arterial Doppler flow but absent venous flow
  • –dampened arterial flow (compare flow to both ovaries)
  • “whirlpool” sign - twisted ovarian vessels
  • possible adnexal mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which sonographic finding is more common in peds?

A

abdnormal/midline position of ovary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is another name for PCOS?

A

Stein-Leventhal syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is PCOS?

A

an endocrinology disorder associated with chronic anovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When is PCOS usually diagnosed?

A

late teens, early 20’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is diagnosis based off of for PCOS?

A

clinical and serologic findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the clinical signs of PCOS?

A
  • infertility
  • obesity
  • amenorrhea
  • hirsutism (hairy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the serum laboratory findings for PCOS?

A
  • FSH: decreased (or normal)
  • LH: increased
  • testosterone: increased
  • AMH (anti-Mullerian Hormone): increased
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Name 4 sonographic findings of PCOS.

A
  • bilateral multiple cysts (< 1 cm) throughout sub capsular and stromal ovarian tissue (greater than or equal to 12-19 follicles per ovary– 19 is preferred now I guess)
  • ovarian volume > 10cm cubed
  • small symmetric cysts in the periphery - “string of pearls”
  • always bilateral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Tumors arising from the surface epithelium account for ______% of all ovarian neoplasms and _____% of all ovarian malignancies.

A
  • 65-75%

- 90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Name the 5 categories of epithelial tumors, based on differentiation.

A
  1. serous
  2. mucinous
  3. endometroid
  4. clear cell
  5. transitional cell (Brenner)
36
Q

What are the three categories of the proliferative changes of epithelial tumors?

A
  1. benign
  2. atypically proliferating (borderline)
  3. malignant
37
Q

Serous tumors are _______, accounting for _____% of all ovarian neoplasms. _____% are benign, but serous cystadenocarcinomas account for 40-50% of all malignant ovarian neoplasms.

A
  • common
  • 25-30%
  • 50-70%
  • 40-50%
38
Q

How often are benign serous tumors bilateral? Who do they most commonly occur in? What is another name for them?

A
  • bilateral 12-20% of the time
  • occur most commonly in women 40-50 years of age
  • serous cystadenoma
39
Q

How often are malignant serous tumors bilateral? Who do they most commonly occur in? What is another name for them?

A
  • bilateral 50% of the time
  • occur most commonly in peri- and postmenopausal women
  • serous cystuadenocarcinoma
40
Q

What is the most common type of ovarian cancer?

A

serous cystadenocarcinoma

41
Q

Typically, serous tumors are _______ in size than mucinous tumors.

A

smaller

42
Q

Name 4 sonographic findings of benign serous cystadenomas.

A
  • sharply marginated
  • anechoic
  • large, but usually unilocular
  • possibly internal thin-walled septations
43
Q

Name 5 sonographic findings of serous cystadenocarcinoma.

A
  • multilocular
  • multiple papillary projections/septations
  • occasional echogenic material within
  • possible multiple echogenic foci
  • ascites
44
Q

Benign mucinous tumors comprise _____% of all benign ovarian neoplasms. What ages are these most common in? Are they commonly bilateral? What is another name for them?

A
  • 20-25%
  • women 30-50 years old
  • very rarely bilateral
  • AKA mucinous cystadenomas
45
Q

Malignant mucinous tumors account for _____% of all malignant primary neoplasms. What ages are these most common in? What percentage are bilateral?

A
  • 5-10%
  • women 40-70 years old
  • 15-20% bilateral
46
Q

How does pseudomyxoma peritonei occur?

A

penetration of the tumor capsule (in mucinous tumors) or rupture may spread mucin-secreting cells into the peritoneal cavity, filling it with gelatinous material.

47
Q

Does pseudomyxoma peritonei occur with benign or malignant tumors? What is it’s sonographic appearance similar to?

A
  • both - benign or malignant

- similar to ascites, possibly with multiple septations

48
Q

Name 3 sonographic findings of benign mucinous cystadenoma.

A
  • multiloculated, with thicker and more numerous septations
  • fine, gravity-dependent echoes
  • up to 50cm in diameter
49
Q

Name 3 sonographic findings of mucinous cystadenocarcinoma.

A
  • multiloculated cystic lesions measuring 15-30cm in diameter
  • contain echogenic material and papillary excrescences
50
Q

What percentage of endometroid tumors are malignant?

A

80%

51
Q

Which have a better prognosis, serous/mucinous carcinomas or endometroid tumors?

A

endometroid tumors

52
Q

Endometroid tumors account for _____% of all ovarian carcinomas.

A

20-25%

53
Q

What are endometroid carcinomas identical to?

A

endometroid adenocarcinoma

54
Q

What are the sonographic findings for endometroid tumors? (3)

A
  • mixed cystic and solid mass
  • in some cases, there may be a predominantly solid mass, possibly with areas of hemorrhage or necrosis
  • may have associated endometrial abnormality
55
Q

What percentage of germ cell tumors account for all ovarian neoplasms?

A

20%

56
Q

In adults, most germ cell tumors are ______, with 95% being __________.

A
  • benign

- cystic teratomas

57
Q

In children and adolescents, more than ____% of ovarian neoplasms are of germ cell origin and _____ of them are malignant.

A
  • 60%

- 1/3

58
Q

What are the three types of germ cell tumors?

A
  • benign cystic teratoma
  • dysgerminoma
  • endodermal sinus tumor
59
Q

What is the most common germ cell tumor of the ovary?

A

benign cystic teratoma

60
Q

Benign cystic teratoma’s (BCT) account for ______% of ovarian neoplasms.

A

15-25%

61
Q

BCTs are usually found in women of _______________.

A

active reproductive years

62
Q

What are the layers of BCT’s?

A
  • endoderm
  • mesoderm
  • ectoderm
63
Q

What is another name for benign cystic teratoma’s? Which layer does this contain?

A
  • dermoid cyst

- ectoderm

64
Q

What percentage of of BCTs are bilateral?

A

up to 15%

65
Q

What are the symptoms of benign cystic teratomas?

A
  • usually asymptomatic
    symptoms may include:
  • abdominal pain (especially with torsion)
  • abdominal mass or swelling
66
Q

What is the most common complication of benign cystic teratomas? What about less commonly?

A

most common: ovarian torsion

less commonly: rupture

67
Q

What are immature teratomas called?

A

teratocarcinoma

68
Q

What are immature teratomas? When do they most commonly occur?

A

very rare, rapidly growing solid malignant tumors

most commonly occur in first 2 decades of life

69
Q

What is a dermoid plug?

A

predominantly cystic mass with an echogenic mural nodule

typically casts acoustic shadow

70
Q

What is a dermoid mesh?

A

multiple echogenic linear interfaces floating within a cystic mass (hair fibers)

71
Q

Describe the sonographic features of a teratoma.

A
  • predominantly cystic adnexal mass
  • complex mass with calcifications
  • fat-fluid level (changes with patient position)
  • diffusely echogenic
72
Q

What are homologous to testicular seminomas?

A

dysgerminoma

73
Q

What is a dysgerminoma? Who do they occur in?

A

malignant germ cell tumor

women under 30 years of age

74
Q

Sonographic findings of dysgerminomas

A
  • multilobulated solid mass, size variable

- may be bilateral

75
Q

What is the second most common germ cell tumor? What is the most common germ cell tumor?

A

second most - endodermal sinus (YS) tumor

most common - dysgerminoma?

76
Q

What ages get YS tumors?

A

ages 20-30 years old

77
Q

Are YS tumors unilateral or bilateral? What lab values are increased with these? What are the sonographic findings?

A
  • unilateral
  • increased AFP/LDH/hCG
  • predominantly solid mass with necrosis
78
Q

What percentage of ovarian tumors are sex cord stromal?

A

8%

79
Q

Half of sex cord stromal tumors are what?

A

fibromas

80
Q

What percentage of fibromas account for all ovarian pathology?

A

4%

81
Q

Fibromas are benign or malignant? Occur at what age? Unilateral or bilateral?

A
  • benign
  • all ages, frequently 40s-50s
  • unilateral
82
Q

What is Meig’s syndrome associated with?

A
  • ascites
  • pleural effusions
  • fibromas
83
Q

What are the sonographic findings of a fibroma?

A
  • similar to pedunculated fibroid or Brenner tumor
  • homogeneous, hypoechoic mass with posterior acoustic shadowing (highly attenuating mass)
  • rarely focal or diffuse calcifications
84
Q

What percentage of ovarian tumors do thecomas account for?

A

1%

85
Q

Thecomas are _______ producing. Who do they most commonly occur in?

A

estrogen

postmenopausal women

86
Q

Sonographic findings of thecomas

A
  • solid hypoechoic
  • posterior shadowing
  • possibly abnormally thick endometrium due to hormonal stimulation
  • similar to fibromas

OB/GYN (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions