Ovaries Flashcards

1
Q

Are ovarian cysts common / rare?

A

V common

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2
Q

Presentations of benign ovarian tumours ?

A

A symptomatic
Chronic pain - dull ache, dyspareunia, cyclical pain
Acute pain - bleeding into cyst, ovarian torsion, rupture
Irregular vaginal bleeding
Abdo swelling/ mass

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3
Q

Vaginal exam of benign ovarian tumour?

A

Discharge
Bleeding
Mass
Tenderness

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4
Q

Abdo exam of benign ovarian tumour ?

A

Mass raising from pelvis
Tenderness
Peritonism
Ascites

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5
Q

If tumour is small, could examination for benign ovarian tumour be normal?

A

Yes

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6
Q

Investigations for benign ovarian tumour?

A

FBC
CA125 if >40 years
AFP, CA19-9, LDH, hCG, CEA if <40 yrs old
TVS
Transabdominal US if cysts extends outside pelvis
MRI if cyst >7cm

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7
Q

Management of benign ovarian tumour if pre -menopausal?

A

Rescan in 6 weeks
If no malignancy and asymptomatic then no surgery needed.
If >5 cm or symptomatic - laparoscopic ovarian cystectomy

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8
Q

Management of a benign ovarian tumour if post menopausal ?

A

Low risk <5cm - repeat TVS and CA125 every 4 months.
Moderate risk - bilateral oophrectomy
High risk - referral for staging laparotomy

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9
Q

What is a functional cyst?

A

Enlarged or persistent follicular/ corpus luteum cyst.
Very common
May cause pain

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10
Q

Treatment for functional cysts?

A

Usually resolve over few months

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11
Q

What are endometriomas?

A

Ovarian cysts filled with old blood.

Chocolate cysts

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12
Q

What is a fibroma?

A

Small, solid, benign, fibrous tissue tumours

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13
Q

What do sex- cord tumours arise from?

A

Cortical mesenchyme

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14
Q

What is a teratoma?

A

Arises from primitive germ cells.

More common in young women

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15
Q

Risk factors for ovarian cancer?

A

Nulliparity
Early menarche/ late menopause
BRCA 1 &2

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16
Q

What are protective for ovarian cancer?

A

Pregnancy
Breast feeding
COCP

17
Q

Presentation of ovarian cancer?

A
Bloating
Weight loss
Loss of appetite
Early satiety 
Fatigue
Urinary symptoms / change in bowel habit 
Abdo/pelvic pain
Vaginal bleeding 
Pelvic mass
18
Q

Potential findings on Examination for ovarian cancer?

A
Fixed abdo/ pelvic mass
Ascites
Omental mass
Pleural effusion
Supraclavicular lymph node enlargement
19
Q

Investigations for ovarian cancer?

A
FBC, U&amp;Es, LFTs
Maybe CA125 increase
TVS
CXR 
CT abdo/pelvis
MRI
If Ascites/ pleural effusion -> cytology
20
Q

Stage I ovarian cancer?

A

Confined to ovary
Ia - one ovary
Ib - both ovaries

21
Q

Stage II ovarian cancer?

A

Limited to pelvis

22
Q

Stage III ovarian cancer?

A

Limited to abdomen - including regional lymph node mets

23
Q

Stage IV ovarian cancer?

A

Metastasis around body

24
Q

Treatment for ovarian cancer ?

A

Full staging laparotomy
If stage III/IV- neoadjuvant chemo
Chemo after surgery on less stage I

25
Q

What chemo is given in ovarian cancer?

A

Carboplatin with paclitaxel

26
Q

Different ovarian cancers?

A

Epithelial ovarian tumours
Germ cell tumours
Stromal /sex cord tumours

27
Q

Types of stromal/ sex cord tumours?

A

Granulosa - theca tumours

Sertoli-leydig cell tumours

28
Q

Types of germ cell tumours?

A
Teratoma
Dermoid cyst
Immature teratoma 
Dysgerminoma
Yolk sac tumour 
Choriocarcinoma
Mixed germ cell tumour
29
Q

Types of epithelial ovarian tumours?

A
Serous
Mucinous
Endometrioid
Clear cell
Brender
30
Q

Classifications of serous ovarian tumours?

A

High grade STIC
Low grade STIC
(STIC - serous tubal intraepithelial carcinoma)