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Gynae > The ovary and its disorders > Flashcards

The ovary and its disorders Flashcards

1
Q

What is Meig’s syndrome?

A

Benign ovarian tumour, usually a fibroma associated with ascites and pleural effusion

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2
Q

What are the symptoms of PCOS?

A

Amenorrhoea, hirsutism, infertility, acne, increased BMI.

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3
Q

In terms of hormone levels, what happens in PCOS?

A

Typically there will be in inverse FSH/LH ratio (LH 3x the FSH level), low SHBG and raised free androgen index (the measure of testosterone unbound by SHBG). SO LOOK AT FSH/ LH ratio.

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4
Q

Which type of ovarian cyst is most common?

A

Follicular cyst

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5
Q

What are follicular cysts usually due to?

A

Due to non-rupture of the dominant follicle or failure of atresia in a non-dominant follicle, commonly regress after several menstrual cycles

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6
Q

What are the two physiological/functional cysts?

A

Follicular cysts, corpus luteal cysts (corpus luteum cysts are more likely to present with intraperitoneal bleeding than follicular cysts.

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7
Q

What is a benign germ cell tumour in the ovary?

A

Cystic teratomas

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8
Q

What is the most common benign tumour in a woman under 30?

A

Dermoid/teratoma

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9
Q

What percentage of teratomas are bilateral?

A

10-20%

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10
Q

Which tumour is torsion likely with?

A

Teratoma

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11
Q

What is the most common form of benign epithelial tumour?

A

Serous cystadenoma (cyst with the most resemblance to serous carcinoma. Also bilateral in 20%

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12
Q

What is the second most common benign epithelial tumour of the ovary?

A

Mucinous cystadenoma second most common benign epithelial tumour.
They are typically large and may become massive
if ruptures may cause pseudomyxoma peritonei

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13
Q

What is a pseudomyxoma?

A

Pseudomyxoma peritonei (PMP) is a clinical condition caused by cancerous cells (mucinous adenocarcinoma) that produce abundant mucin or gelatinous ascites. The tumors cause fibrosis of tissues and impede digestion or organ function, and if left untreated, the tumors and mucin they produce will fill the abdominal cavity.

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14
Q

What is a positive rosvings sign?

A

More pain in RIF than LIF when palpating LIF

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15
Q

What is the whirl pool sign?

A

This is when there is ovary torsion or volvulus, seen on an ultrasound scan

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16
Q

When does ovarian torsion usually happen?

A

Commonly coincides with exercise.

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17
Q

What is the link between the COCP and ovarian cancer?

A

The combined oral contraceptive pill reduces the risk (fewer ovulations) as does having many pregnancies.

18
Q

At what length are ovarian cysts considered large?

A

5cm- GIANT- 15cm

19
Q

What are the benign epithelial tumours?

A

Serous Cystadenoma, mucinous cystadenoma

20
Q

What is the most common type of cyst?

A

Follicular cyst

21
Q

Which hormone causes follicles to regress?

A

inhibin- allows maturation of all follicles except for one.

22
Q

What is seen on USS of a follicular cyst?

A

Thin walled fluid filled sac

23
Q

What is the technical name for the dominant follicle?

A

Graafian

24
Q

What reduces likelihood of developing a follicular cysts?

A

COCP, menopause

25
Q

What is the corpus luteum?

A

the space left behind after the graafian ruptures

26
Q

If a woman does not become pregnant, how long does it take for the CL to regress?

A

5-9 days

27
Q

Which cyst is most likely to cause bleeding and pain?

A

CL cyst, common <5cm

May rupture and cause intra-peritoneal bleeding and pain.

28
Q

Which cyst is most likely to cause ovarian torsion?

A

CL cyst

29
Q

What is the most common benign epithelial tumour?

A

Serous cystadenoma (20% bilateral)

30
Q

Which tumour is most associated with pseudomyxoma peritonea?

A

Mucinous cystadenoma

31
Q

What is a complication of PID, (cyst)?

A

Tubo-ovarian abscess- pus between ovary and fallopian tubes.

32
Q

What is an endometrioma?

A

Chocolate cysts- when burst blood fluid come out of them- chocolate signifying old blood.

33
Q

Which cyst is most likely to cause ovarian torsion?

A

Dermoid cyst

34
Q

Which part of the fallopian tube is most prone to rupture?

A

Isthmus

35
Q

What is the most common site of ectopic pregnancies?

A

Ampulla

36
Q

Which location of the ovary is ectopic commonly missed?

A

Cornu

37
Q

What is a heterotropic pregnancy?

A

One IU pregnancy plus one ectopic

38
Q

Which age group are most at risk of ectopic pregnancies?

A

35-40

39
Q

When would symptoms of an ectopic most commonly occur?

A

4-12 weeks

40
Q

What quick blood test can you do if you suspect ectopic?

A

CRP, raised inflammatory markers

41
Q

When can you only do conservative management in an ectopic?

A

<1500 HCG

42
Q

When do you have to treat an ectopic surgically?

A

if >35mm, HCG>3000 (5000)

Gynae (15 decks)

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