ovaries Flashcards
4 kinds of ovarian cysts
start with most common
- functional
- follicular
- corpus luteum
- theca lutein
ovarian cysts dx test
pelvic ultrasonography: they will be mobile, simple, fluid filled
ovarian cyst sx
asymptomatic; or pain and menstrual delay; or w/ hemmorhage due to rupture
ovarian cyst in postmenopausal women
may be malignant
ovarian cyst treatment
watch if smaller than 8cm.
ovarian cysts in normal menstrual cycle
follicular and corpus luteum cysts
serous adenomas, mucinous adenomas, teratomas, dermoid cysts
common types of benign ovarian cysts
PCOS is the most common cause of what 2 things
hirsutism and androgen excess
underlying abnormality with PCOS
we think hypothalmic pituitary dysfunction and insulin resistance
PCOS pts at increased risk for what
endometrial hyperplasia and carcinoma because of unopposed estrogen stimulation
menses with PCOS
nml puberty and adolescence; followed by progressively longer episodes of amenorrhea.
PCOS symptoms
50% have what
30% have what
8% have what
50% are hirsute
30% have impaired glucose tolerance
8% have frank diabetes type 2
PCOS tests
- ultrasonography show “string of pearls” or “oyster ovaries”
- mild elevation of serum androgen levels
- increased LH/FSH ratio
- lipid abnormalities
- insulin resistance
ultrasonography show “string of pearls” or “oyster ovaries”
PCOS; also to look for androgen secreting ovarian tumor
what does weight loss do in PCOS
improve hirsutism, lipid, and glucose paramenters, and fertility
how to treat hirsutism
androgen lowering agents, include oral contraceptives, finasteride, flutamide, spironolactone
how to treat infertility
clomiphene citrate stimulates ovulation, add dexmethasone at bedtime
why get thyroid levels
it can cause menstrual irregularities
why get FSH and LH
to check for premature ovarian failure and hypogonadotrophic hypogonadism
why get a DHEAS
to test for adrenal neoplasm
how to test for adrenal neoplasm
DHEAS
medroxyprogesterone acetate
for PCOS pt that does not desire pregnancy; it causes the regular shedding of endometrial lining
common cause of infertility in women
PCOS
acanthosis nigricans
DM in PCOS
acne, androgenic alopecia, obesity, menstrual cycle disturbances, hirsutism
PCOS
moon facies, buffalo hump, abdominal striae
cushings sydrome (think hyperandrogenism)
how to evaluate for metabolic abnormalities in PCOS
- 2 hr oral glucose tolerance test
- fasting lipid and cholesterol levels
what decreases the risk of endometrial hyperplasia/carcinoma among women with PCOS
combined hormonal contraception or progestin
4 risk factors for ovarian cancer
age 60, nulliparous, white, + FH of ovarian or endometrial cancer
what is protective for ovarian cancer
long term oral contraceptive due to the suppression of ovulation
5th most common cancer in american women and 2nd most common gynecologic malignancy; mortality rate
ovarian cancer
60% pts die within 5 years
ovarian cancer
genetic?
10% genetic
90% sporatic
breast and ovarian cancer syndrome and
hereditary nonpolyposis colorectal cancer syndrome
2 forms of hereditary ovarian cancer
sister mary joseph nodule
metastatic implant in the umbilicus; ovarian cancer
ascites, abdominal distention, early satiety, change in bowel habits, fixed mass
ovarian cancer
tx of ovarian cancer
- chemo and radiotherapy
- ultrasound both transvaginal and abdominal
CA 125 with ovarian cancer
CA 125 to monitor tx; not for screening;
for postmenopausal women;
normally elevated in premenopausal women
