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Repro HK > ovary pathology > Flashcards

ovary pathology Flashcards

1
Q

ovarian symptoms

A

pain
swelling
endocrine effects

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2
Q

types of ovarian cysts

A 
follicular 
luteal
endometric
epithelial 
mesothelial
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3
Q

why might follicular cysts form

A

when ovulation doesn’t occur - follicle doesn’t rupture but becomes a cyst

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4
Q

pathology of follicular cyst

A

thin wall

lined by granulosa cells

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5
Q

many follicular cysts in

A

PCOS

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6
Q

clinical triad of PCOS

A

hyperandrogenism
oligomenorrhoea
polycystic ovaries on USS

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7
Q

associations with PCOS

A 
obesity 
metabolic syndrome (hypertension, dyslipidaemia, insulin resistance)
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8
Q

other presentations of PCOS

A

acne
subfertility
hirsutism
acanthosis nigrans (darkened skin on neck and flexures - hyperinsulinaemia)

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9
Q

criteria for PCOS diagnosis

A

Rotterdam criteria: 2/3 must be present
polycystic ovaries (12+follicles or ovarian volume >10cm3)
oligo/anovulation
clinical/biochemical signs of hyper androgenism

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10
Q

what should be excluded before diagnosis of PCOS is made

A 
thyroid disease
hyperprolactinaemia 
adrenal hyperplasia
androgen secreting tumours
cushing's
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11
Q

management of PCOS

A

weight loss
smoking cessation
treat metabolic diseases

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12
Q

what is endometriosis

A

endometrial glands and stroma outside the uterine body

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13
Q

common sites of pathological endometrial tissue

A 
ovary
pouch of douglas 
peritoneum
cervix/vulva/vagina
bladder and bowel
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14
Q

clinical manifestation of PCOS

A

pelvic inflammation
infertility
pain (including dysuria, dyspareunia, pain on defaecation)

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15
Q

what are endometrial cysts in ovary called

A

chocolate cysts

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16
Q

why does endometriosis affect women of reproductive age

A

oestrogen driven

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17
Q

what is adenomyosis

A

endometrial tissue in myometrium

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18
Q

why might pain be cyclical in endometriosis

A

response of endometrial tissue to menstrual cycle (oestrogen)

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19
Q

why might pain be constant in endometriosis

A

formation of adhesions

chronic inflammation

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20
Q

signs of endometriosis on speculum exam

A

visible lesions

fixed retroverted uterus

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21
Q

complications of endometriosis

A

cysts/adhesions
infertility
ectopic pregnancy
malignancy

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22
Q

investigations for endometriosis

A 
transvaginal ultrasound (ovarian disease)
laparoscopy with biopsy is gold standard
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23
Q

treatment for endometriosis

A

COCP/progesterone empirically without definitive treatment if fertility not an issue
NSAIDs for pain
surgery if medical treatment fails

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24
Q

types of ovarian cancers

A 
epithelial
germ cell (teratoma)
sex-cord/stromal
metastatic 
miscellaneous
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25
Q

most common ovarian cancer

A

epithelial

26
Q

cell of origin in epithelial tumours

A 
unknown, can be from:
serous
mucinous
endometrioid
clear cell
brenner
27
Q

classification of epithelial tumours

A

benign
borderline
malignant

28
Q

benign epithelial tumour pathology

A

no cytological abnormalities
proliferative activity absent/scant
no stromal invasion

29
Q

borderline epithelial tumour pathology

A

cytological abnormalities
proliferative
no stromal invasion

30
Q

difference between borderline and malignant epithelial tissue

A

borderline - no invasion

malignant - stromal invasion

31
Q

where do high grade serous epithelial tumours come from

A

tubal disease

32
Q

what epithelial cancer is associated with endometriosis

A

clear cell

33
Q

what are brenner tumours

A

epithelial

transition areas

34
Q

brenner tumours are usually malignant/benign

A

benign

35
Q

most common type of germ cell tumour

A

dermoid cyst - benign

36
Q

what does dermoid cyst contain

A

tissue from endoderm, mesoderm and ectoderm
usually contain fat
may contain sebum and hair
thyroid tissue - thyrotoxicosis

37
Q

other types of germ cell tumour

A 
immature teratoma 
dysgerminoma 
yolk sac tumour 
choriocarcinoma 
mixed
38
Q

germ cell tumour found in children and young women

A

dysgerminoma

39
Q

types of sex cord/stromal tumours

A

fibroma/thecoma (benign)
granulosa cell tumour (malignant) - precocious puberty
sertoli-leydig cell tumour

40
Q

what might sex cord tumours produce

A

oestrogen

androgens

41
Q

commonest places for tumours to metastasise from

A

stomach
colon
breast
pancreas

42
Q

stage 1A ovarian cancer

A

cancer in one ovary

43
Q

stage 1B in ovarian cancer

A

cancer in both ovaries

44
Q

stage 1C ovarian cancer

A

involves ovarian surface/rupture

45
Q

stage 2A ovarian cancer

A

involves uterus/tubes

46
Q

stage 2B ovarian cancer

A

spread to other pelvic intra-peritoneal organs (eg bladder, bowel)

47
Q

stage 3a ovarian cancer

A

retroperitoneal lymph node involvement

48
Q

stage 3B ovarian cancers

A

macroscopic peritoneal mass <2cm

49
Q

stage 3C

A

macroscopic peritoneal mass >2cm

50
Q

stage 4

A

distant metastases

51
Q

what is salpingitis

A

infection of fallopian tubes

52
Q

presentation of ovarian cancer

A 
bloating 
pelvic mass 
vaginal bleeding 
abdo pain 
weight loss
bowel/bladder symptoms
53
Q

what tumour marker is raised in ovarian epithelial cancers

A

Ca125

54
Q

what age group are mostly affected by ovarian cancers

A

older women - 75-84

55
Q

risk factors for ovarian cancer

A

nulliparity
early menarche/late menopause
BRCA 1 and 2
lynch syndrome

56
Q

what is protective of ovarian cancer

A

pregnancy
breastfeeding
COCP
tubal litigation

57
Q

investigations for ovarian mass

A

TVS
CXR - for staging
CT abdo/pelvis

58
Q

management for benign tumours

A

pre-menopausal - rescan in 6 weeks, if <5cm or asymptomatic then leave. if >5cm/symptomatic/dermoid/endometriosis then remove

post-menopausal - manage risks. may need to remove

59
Q

what are the 2 types of functional cysts

A

follicular

luteal

60
Q

management of functional cysts

A

resolve spontaneously

61
Q

what is meig’s syndrome

A

benign fibroma

pleural effusion

Repro HK (37 decks)

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