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FRCR 2a Flashcards > Reproductive > Flashcards

Reproductive Flashcards

1
Q

Ovarian oestrogen secreting tumours?

A

Ovarian thecoma
Ovarian granulosa cell tumours

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2
Q

What do testicular epidermoid cysts looks like on USS

A

Round hypoechoic mass
Onion skin layering

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3
Q

What is struma ovarii?

A

Mature teratoma containing mostly thyroid tissue

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4
Q

What are the radiological features of molar pregnancy?

A

1st trimester: Intrauterine mass with snowstorm appearance on USS.
2nd trimester: Bunch of grapes on USS.

+/- fetal parts

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5
Q

What is Meigs syndrome?

A

Ovarian fibroma
Ascites
Pleural effusion

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6
Q

What is Ovarian hyperstimulation syndrome?

A

Complication of controlled ovarian stimulation.
Ascites, pleural effusions, and intravascular fluid depletion.
Theca lutein cysts.

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7
Q

What is a Brenner tumour?

A

Benign epithelial tumour of the ovaries.
Appear fibrous and have calcification

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8
Q

Which uterine developmental abnormality has the highest risk of fertility issues?

A

Septate uterus (flat fundus Vs heart shaped fundus of bicornuate/Didelphis)

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9
Q

What is Salpingitis Ithmica Nodosa (SIN)

A

Nodular scarring of the fallopian tube. Basically it’s diverticulosis of the fallopian tubes secondary to inflammation/infection.

High association with infertility and ectopic pregnancy

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10
Q

What is Ashermans syndrome?

A

Intrauterine adhesions. Secondary to prior surgery, infection, or pregnancy.
Clinically can result in infertility.

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11
Q

Classic imaging features of adenomyosis?

A

Thickening of the junctional zone >12mm
Can have high T2 signal in junctional zone or myometrium (cystic change)

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12
Q

What is the main malignant cancer of the uterus?

A

Adenocarcinoma
Rarely leiomyosarcoma (fibroid malignant transformation.)

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13
Q

How does endometrial cancer typically enhance?

A

Typically enhances less than the myometrium

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14
Q

What are the USS imaging appearances of endometrial polyps?

A

Hyperechoic
Single feeding vessel on Doppler

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15
Q

What is the most common type of cervical and vaginal cancer, and what condition increases the risk of developing it?

A

Squamous cell
Related to HPV

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16
Q

Where are Bartholin cysts typically found?

A

BARTHOLIN cysts are cysts of the mucin secreting glands and found BELOW the pubic symphysis.
Can become infected.

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17
Q

Where are Nabothian cysts found?

A

By the cervix

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18
Q

Where are Gartner cysts found?

A

Anterior, lateral, or upper vagina

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19
Q

What are the simple ovarian cyst follow up criteria?

A

Pre menopausal:
<3cm - normal
3-5cm - report presence, no follow up
>5cm - follow up in 3-12 months based on suspicion

Postmenopausal:
<1cm - normal
1-3cm - report presence, no follow up
>3cm - follow up in 3-12 months based on suspicion

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20
Q

What are the USS appearances of haemorrhagic cyst?

A

Lacy fishnet appearance
Absent Doppler flow

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21
Q

What is the most common ovarian neoplasm is patients<20y.

A

Ovarian teratoma

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22
Q

What are the USS features of a dermoid cyst?

A

Fat containing cystic mass with a hyperechoic mural module (Rokitanski nodule)

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23
Q

What cancer can endometriomas turn into?

A

Clear cell and endometroid ovarian cancer.
Will look like a solid nodule with blood flow in a endometrioma.

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24
Q

What cancer can teratomas turn into?

A

Squamous cell cancer

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25
Q

Most common type of ovarian cancer?

A

Serious ovarian cystadenoma/adenocarcinoma

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26
Q

What is an endometroid ovarian cancer?

A

Second most common ovarian cancer.
Associated with endometriosis.
Can grow within endometriomas.
Bilateral in 25-40% of cases.

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27
Q

What is a Krukenberg tumour?

A

GI metastasis to the ovary

28
Q

What is a choriocarcinoma?

A

Highly aggressive, highly vascular malignancy of the testes, uterus or ovary.
Highly elevated bHcg
Haematogenous spread, usually to lungs.

29
Q

Isolated orchitis usually occurs from what infections?

A

Mumps
TB

30
Q

What nodes do testicular cancers metastasize to?

A

Retroperitoneal nodes at level of renal hilum.

31
Q

What are the most common testicular tumors?

A

Germ cell tumour (90%):
- Seminoma (50%)
- Non Seminoma (50%) (Teratoma, yolk sac, mixed germ cell)

(Non germ cell i.e. Sertoli and leydig cell are 10%).

32
Q

Typical USS appearance of Seminoma?

A

Hypoechoic, homogeneous, microcalc
Classically replace the whole testicle.

33
Q

Non Seminoma tumour typical USS appearance?

A

Heterogeneous with cystic spaces and calcifications

34
Q

Most common testicular tumour in >60y?

A

Testicular lymphoma

35
Q

What condition is Sertoli tumours associated with?

A

Peutz-Jeghers Syndrome

36
Q

What testicular tumors elevate BhCG?

A

Seminoma
Choriocarcinoma

37
Q

What testicular tumors elevate AFP?

A

Mixed germ cell
Yolk sac

38
Q

What is Zinner syndrome?

A

Wolffian duct anomalies:
- unilateral renal agenesis
- ipsilateral seminal vesicle cyst
- ejaculatory duct obstruction

39
Q

Classical presentation of adrenal rests?

A

Bilateral solid testicular masses and congenital adrenal hyperplasia.

40
Q

How does testicular sarcoidosis classically present?

A

Bilateral multiple testicular AND epididymal masses.

41
Q

Where are seminal vesicle cysts typically and what are they associated with?

A

Lateral to bladder

Aquired - Polycystic kidney disease
Congenital - Renal agenesis + ejaculatory duct obstruction = Zinner syndrome

42
Q

What does Uterine AVM look like on USS?

A

Tubular anechoic structures in myometrium.
High velocity colour on Doppler flow.

43
Q

How do you define a cystocele?

A

Bladder prolapse into the vagina.
Bladder decent >1cm below pubococcygeal line.

44
Q

What are the 4 types of fibroid degeneration?

A

Hyaline - fibroid outstrips blood supply
Red - venous thrombosis ( in pregnancy)
Myxoid
Cystic

45
Q

What are the MRI appearances of uterine fibroids?

A

Classic fibroid
T1 Dark
T2 Dark
C Homogeneous

46
Q

What are MRI appearance of hyper cellular fibroid?

A

T1 Dark
T2 Bright
C Homogeneous

Respond well to embolisation

47
Q

How do fibroids undergo malignant transformation?

A

Leiomyosarcoma
Look like a fibroid but rapidly enlarge with areas of necrosis

48
Q

What is the upper limit for endometrial thickness in postmenopausal women?

A

4-5mm
>5mm should get a biopsy

49
Q

What is the upper limit of normal for endometrial thickness in women on Tamoxifen?

A

12mm

50
Q

How does Tamoxifen affect the endometrium?

A

Sub endometrial cysts
Endometrial polyps

51
Q

What is the difference between cervical cancer stage 2a and 2b?

A

2a spread beyond the cervix, NO parametrial invasion - Surgery

2b spread beyond the cervix, WITH parametrial involvement - Chemo radiotherapy

52
Q

What tumours metastasise to the anterior upper wall of the vagina?

A

Upper genital tract tumours (90%)

(Posterior wall is GI tract tumours)

53
Q

What tumours metastasise to the posterior lower wall of the vagina?

A

GI tract tumours (90%)

(Anterior wall is upper genital tract tumours)

54
Q

Where are Skene gland cysts found?

A

Paraurethral
Can cause recurrent UTI and urethral obstruction.

55
Q

What are theca lutein cysts?

A

Multilocular cyst related to ovarian hyper stimulation.
Typical spoke wheel appearance.

Seen in molar and multiple pregnancies

56
Q

How can you differentiate corpus luteum cyst from ectopic pregnancy?

A

Ectopic - thick echogenic rim, ring of fire, separate from ovary

Corpus luteum - thin echogenic rim, ring of fire, moves with ovary

57
Q

How can you differentiate Brenner tumour from fibroma?

A

Both are fibrous
Brenner tumours have calc in 80%
Fibromas no calc

58
Q

What are the causes of hydrosalpinx?

A

PID

Tubal cancer
Torsion
Endometriosis
Hysterectomy

59
Q

What is a peritoneal inclusion cyst?

A

Occurs when adhesions envelope an ovary.
Adhesions cannot absorb the normal secretions of the ovary and so they collect and form a cyst.

Risk factors include:
PID
Endometriosis
Surgery

60
Q

What is the Gleason grade Vs Gleason score?

A

Gleason grade is the histological pattern, 1-5. Higher grade is worst.

Gleason score is the total of the two most common histological patterns. 3+4, or 4+3. The first number is the most common pattern in the sample

61
Q

What does J shaped/hockey stick ureter signify in regards to the prostate?

A

Enlarged prostate - BPH

62
Q

Most common bilateral testicular malignancy?

A

Testicular lymphoma

63
Q

How is the UK breast screening programme work?

A

All women aged 50 up to 71 are invited for breast screening every 3 years.

64
Q

What day of the hormone cycle is MRI and Mammography best performed?

A

Follicular phase - day 7-14

65
Q

What does involution of fibroadenomas look like on mammography?

A

Course “pop corn” like calcification.

66
Q

How can you differentiate Phyllodes tumour from fibroadenomas?

A

Age, growth, mets.

Middle age to older women (fibroadenoma in young women).

Rapid growth.

Haematogenous mets (lung/bone).

67
Q

Most common metastases to the breasts?

A

Lymphoma

FRCR 2a Flashcards (11 decks)

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