Brainscape's Knowledge GenomeTM

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


See full index

Foundations 3 > Ovaries Disorders > Flashcards

Ovaries Disorders Flashcards

1
Q

What conditions are Polycystic Ovarian Syndrome associated with?

A 
Hirsutism
Obesity
Glucose intolerance/Diabetes mellitus
Cardiovascular disease
Metabolic syndrome
Dyslipidemia
NAFLD
Obstructive sleep apnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the Pathophysiology or reasoning behind Polysystic Ovarian Syndrome?

A
  1. . Abnormal androgen and estrogen metabolism
  2. Control of androgen production is unregulated
  3. Insulin resistance and hyperinsulinemia
  4. Decreased adiponectin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

look over slide 7

A

slide 7

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

How does Insulin resistance and Hyperinsulinemia cause POS?

A

Increased insulin alters gonadotropin effects on ovarian function

Increased insulin decreases synthesis of sex hormone binding globulin and insulin-like growth factor

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

What role does adiponectin do?

This is decreased in POS

A

Regulates lipid metabolism and glucose levels

Insulin sensitizer

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

slide 10

A

slide 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Clinical Presentation of Polycystic Ovarian Syndrome?

A 
Infertility
PCOS is most common cause
Oligomenorrhea/Amenorrhea
Anovulation
Obesity
Acne
Hirsutism
Upper lip, chin
Male-pattern baldness
Acanthosis nigricans
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Diagnostic Criteria for Polycystic Ovarian Syndrome?

A

Rotterdam Criteria 2003

Two of the three below must be present after the exclusion of related disorders

  • Ovulatory dysfunction (amenorrhea)
  • Clinical or biochemical signs of hyperandrogenism
  • Polycystic ovaries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which imaging would you used to diagnose POS?

What findings do you associate it with?

A

Ultrasound

-Presence of >12 follicles in either ovary measuring 2-9mm in diameter (Rotterdam Criteria)
-“String of pearls” appearance
Ovarian volume >10mL
-No evidence of dominant follicle / corpus luteum

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

To evaluate Hyperandrogenism what value must you first start to measure?

A

Elevated testosterone

If elevated continue to work up

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

What labs do you continue to order is you suspect Hyperandrogenism?

A 
17 – OH progesterone
Measure at 8AM
     > 200 ng/dL suspect CAH
DHEA-S
     > 700mcg/dL suspect adrenal source for hyperandrogenism
Cortisol
     > 10mcg/dL suspect Cushing syndrome
Prolactin
     Normal is PCOS 
     > 25 ng/dL is elevated
TSH
     Hyperthyroidism can cause oligomenorrhea/amenorrhea
β HCG 
     Order if oligomenorrhea/amenorrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What additional tests do you order for POS?

A

Fasting glucose
OGTT or HA1c
Lipid profile

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

Treatments Polycystic Ovarian Syndrome?

A
  1. Weight Loss
  2. Meformin
    Combination oral contraceptives
  3. Fertiliy consultation
  4. Provera
  5. Life-long lifestyle mod.

Fill in the rest slide 20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How would you treat Hisuitism?

A

1st Line: COC’s
-Add on therapy –> spirinolactone

  1. Topical elfonithine (Vaniga)
    • Add on therapy Antiprotozoal
  2. Hair removal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Risks for POS?

A 
Endometrial Hyperplasia/Carcinoma
Type II diabetes
Hypertension
Hyperlipidemia
Cardiovascular disease
Stroke
Infertility
Metabolic syndrome
Sleep apnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are PEARLS Evaluation of Adnexal Masses

A

Pre-menarchal
Ovaries should not be palpable

Reproductive
Palpable about 50% of the time

Peri-menopausal
Increased likelihood of residual functional cysts

Post-menopausal
Non-palpalpable within 3 years of the onset of natural menopause (most)

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

What imaging do you do for scanning adnexal mases?

A

Ultrasound

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

An Adnexal Mass is considered benign if ultrasound shows what?

What about Malignant

A
  1. Thin walled
  2. < 3cm premenopausal or < 1cm postmenopausal
  3. Hyperechoic nodule with distal acoustic shadowing
  4. Network of linear or curvilinear pattern
  5. Homogenous echos

Malignant if:

  1. Solid, nodular or papillary
  2. Blood flow to solid component
  3. Thick septations >2mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 3 types of Functional Ovarian cysts

A
  1. Follicular cysts
  2. Corpus Luteum Cyts
  3. Theca Lutein Cysts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Most common type of Benign ovarian cysts

A

Follicular cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do Follicular cysts occur

A

Failure of the mature follicle to rupture (release the ovum) –> causes pain and pressure

Failure of the non-dominant follicles to undergo atresia in the presence of the mature follicle

22
Q

How do Corpus Luteum cysts appear?

A

Following ovulation, blood accumulates within the cavity of the corpus luteum which stimulates resorption. If resorption doesn’t occur and the corpus luteum is greater than 3cm it is considered a cyst

23
Q

If corpus luteum continues to persist without popping what can happen

A

Prolonged menstrual cycle due to continued progesterone secretions from the CL

24
Q

What is the least common Benign ovarian cysts?

A

Theca Lutein Cysts

25
Q

What is the etiology behind Theca Lutein Cysts?

How does it present

A

Seen with elevated chorionic gonadotropin levels

Presents:
Bilaterally
Fluid is clear, straw colored
Cysts regress spontaneously with treatment of underlying disorder

26
Q

Most common nonfunctional epithelial cell ovarian tumor?

Treatment?

A

Serous cystadenoma
Mostly benign

Surgery:
Cystectomy vs oophorectomy

27
Q

2nd most common nonfunctional epithelial cell ovarian tumor?

How does it present?

Treatment

A

Mucinous cystadenoma

Present:
Ultrasound= multilocular septations

Treatment: Surgery

28
Q

Benign cystic teratomas are considered what type of tumors

What are these composed of?

A

Germ cell Ovarian Tumors

Any part of the three germ layers

  1. Ectoderm
  2. Mesoderm
  3. Endoderm
29
Q

What is the histology behind Germ cells ovarian tumors?

Germ cell ovarian tumors originate from which type of tumors?

A

The cyst is lined with keratinized squamous epithelium with abundant sebaceous and apocrine glands

Hair, teeth

30
Q

How do Germ cell teratomas present?

A
  1. Asymptomatic
  2. Pelvic pain
  3. Urinary frequency or urgency
  4. Back pain
31
Q

Physical Exam findings for Germ Cell Ovarian tumors?

Imagine used?

Labs tested?

A

PE: Pelvic mass on bimanual exam

Imagine
Tranvaginal Ultrasound- unilateral, complex cysts

Labs:
CEA, CA-125, AFP, βHCG
-All should be within normal limits

32
Q

Treatment for Germ Cell Ovarian Tumors

A

Surgery
Laprotomy
Ovarian cystectomy

33
Q

What are the two types of Stromal Ovarian Tumors?

Who are they common in?
What do they secrete?

A

Granulose Theca cell tumors

  • Females
  • Produce estrogens

Sertoli-Leydig cell tumors

  • Males
  • Produce androgens
34
Q

How do Ovarian Fibromas occur?

A

Result from spindle cell collagen production

35
Q

Risk factors for Ovarian Cancer

A

Family history of breast, ovarian or colorectal cancer
BRCA1 and BRCA2

  • Nullparity (never pregnant = more ovulations)
  • Early menarche
  • Late menopause
  • Infertility (+/- treatment

Diets high in sat fat or animal fats

36
Q

What are risk reductions for ovarian cancer?

A 
-Multiparty
Breastfeeding
-Long-term oral contraceptive use
     -At least 5yrs of use reduces the relative risk of developing ovarian cancer by 50% compared to non-users
-Bilateral tubal ligation
-Low fat diet
-Bilateral salpingectomy
37
Q

What are the 4 types of Ovarian cancers?

A

Epithelial

Germ Cell

Sex cord and strromal

Neoplasms metastatic to ovary

38
Q

Ovarian Cancer Pathophysiology:

What is the Incessant Ovulation theory

A

Repeated ovarian epithelial trauma by follicular rupture and subsequent epithelial repair results in invagination of surface epithelium into the ovarian cortex creating cortical inclusion cysts

Constant epithelial “repair” leads to malignant transformation

39
Q

Ovarian Cancer Pathophysiology:

What is the Fallopian tube theory

A

p53 is a tumor suppressor gene
Mutant p53 creates a “p53 signature”
Signature is located at the distal fallopian tube
-Location of epithelial stem cells

40
Q

What are the types of Epithelial Neoplasms?

Where do they arise

A
  1. High grade serous carcinomas (70-80%)
    • arise from fallopian tube
  2. Enodmetroid carcinomas
    • arise from the ovary
  3. Clear cell carcinomas
    • arise from ovaries
  4. Mucinous carcinomas
    • arise from ovaries
41
Q

What are the 4 types of Germ Cell ovarian cancers?

A

Dysgerminoma

Endodermal sinus

Immature teratoma

Mixed

Embryonal tumors

42
Q

Etiology behind Germ cell ovarian cancers?

What age group is this most common in?

A

Highest incidence in women 20-30 years old

Etiology unknown

43
Q

Most common type of Germ cell ovarian tumors?

How does it present and What does it secrete

A

Dysgerminomas

Present unilaterally 85-90%

Secrete lactate dehydrogenas, some produce hCG

44
Q

How do Endodermal Sinus Tumors (rare) present?

What do they secrete?

A

Bilateral

Produce alpha fetoprotein

45
Q

Most common symptoms of Ovarian cancers?

A
  1. Abdominal bloating
  2. Abdominal/pelvic pain
  3. Decreased energy or lethargy
  4. Early satiety
  5. Urinary urgency
46
Q

What are some acute symptoms that occur in Ovarian cancers

A

Pleural effusions

Bowel obstructions

47
Q

What are Physical Exam findings ovarian cancers

A

Ascites
Inguinal lymphadenopathy
Pelvic mass

48
Q

What imaging used to detect ovarian cancers

A 
Transabdominal / vaginal ultrasound
Mammogram/Colonoscopy
CT
MRI
CXR
49
Q

What labs are used to detect ovarian cancers

A
  1. CA-125 elevated- Suspected epithelial ovarian cancer

2. Elevated hCG, AFP, LDH- Suspected germ cell tumor

50
Q

Treatment for Epithelial ovarian cancers?

A

Consult gynecologic oncologists

51
Q

Treatment for Germ cell ovarian cancers

A

Consult gynecologic oncologists

Foundations 3 (25 decks)

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