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OBGYN rotation review > vulva, vagina, ovaries > Flashcards

vulva, vagina, ovaries Flashcards

1
Q

“cellophane paper” plaques

A

lichen sclerosus

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2
Q

fragility is the hallmark of this vulvar disorder

A

lichen sclerosus

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3
Q

where are you NOT going to see lichen sclerosus

A

keratinized, hair covered labia majora or mucus membranes

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4
Q

this vulvar disease has a higher incidence associated with hypothyroidism

A

lichen sclerosus

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5
Q

where are the bartholin cysts located

A

4 o’clock and 8 o’clock position adjacent to the introitus

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6
Q

word catheter

A

bartholin cyst treatment (plus I and D)

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7
Q

I and D with insertion of a word catheter

A

bartholin cyst

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8
Q

with vulvodynia, pain is limited to the

A

vestibule

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9
Q

which vulvar disorder gets treated with TCAs and gabapentin

A

vulvodynia

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10
Q

HPV types ___ and ___ are associated with VIN and CIN

A

16 and 18

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11
Q

with VINU, what is part of the mandatory treatment

A

colposcopy (because it is often associated with high grade CIN)

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12
Q

which VIN and CIN are related to HPV

A

usual types

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13
Q

which part of the epithelium does VIN-D affect

A

the lower 1/3 of epithelium

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14
Q

what is lichen sclerosus a risk factor for

A

SCC if left untreated

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15
Q

30-50% of women with vulvar cancer are ___ or ___ while 10% are ___

A

30-50% of women with vulvar cancer are OBESE or HYPERTENSIVE while 10% are DIABETIC

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16
Q

vulvar CA: large, exophytic cauliflower like lesion or small ulcerative lesions with surrounding hyperkeratosis

A

SCC

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17
Q

vulvar CA: raised lesions with ulcerated center and rolled borders

A

BCC

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18
Q

vulvar CA: darkly pigmented, raised lesions on the labia minora and clitoris

A

malignant melanoma

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19
Q

Vaginal Intraepithelial Neoplasia (VaIN) is directly caused by

A

HPV

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20
Q

in order to be called vaginal cancer, ____

but the most common cancer in the vaginal area is due to ____

A

in order to be called vaginal cancer, the vagina has to be the primary site of growth

but the most common cancer in the vaginal area is due to metastasis from the endometrium/ ovary/ cervix

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21
Q

infertility/ oligomenorrhea/ amenorrhea

hirsutism

acne

A

PCOS

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22
Q

Rotterdam criteria

A

PCOS

need 2/3 (oligomenorrhea, hirsutism, cystic ovaries)

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23
Q

string of pearls on US

A

PCOS

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24
Q

PCOS:

follicles: how many and what size

ovarian volume: how much

A
  • follicles
    • more than 12 per ovary
    • 2 to 9 mm
  • ovarian volume
    • more than 10 mL
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25
how do you treat the hyperinsulinemia assoc w/ PCOS
metformin 500 mg BID
26
how do you treat the infertility associated with PCOS
clomid
27
**what tx of PCOS:** increases SHBG decreases free testosterone and restores predictive cycling
combo oral contraceptives
28
what is the main lifestyle change that needs to happen with PCOS
weight loss
29
people w/ PCOS are at increased risk of
endometrial hyperplasia/ CA metabolic syndrome, T2DM CVD, HTN, hyperlipidemia infertility stroke sleep apnea
30
adnexal mass on US: homogenous echos
**benign:** endometrioma
31
adnexal mass on US: thin walled
benign
32
adnexal mass on US: hyperechoic nodule w/ distal acoustic shadowing
**benign:** teratoma
33
network of linear/ curvilinear pattern
**benign:** hemorrhagic cyst
34
adnexal mass on US: under 3 cm in a premenopausal woman under 1 cm in a post menopausal woman
**benign:** simple cyst
35
adnexal mass on US: thick septations \> 2 mm
malignant
36
adnexal mass on US: solid component appears nodular/ papillary
malignant
37
adnexal mass on US: blood flow to solid component
malignant
38
most common benign ovarian cyst
follicular
39
these benign cysts are: caused by a failure of the mature follicle to rupture and release its ovum
**follicular cysts** ## Footnote (other cause is failure of the non-dominant follicles to undergo atresia in the presence of the mature follicle)
40
these benign cysts are: caused by a failure of the non-dominant follicles to undergo atresia in the presence of the mature follicle
**follicular cyst** ## Footnote (other cause is ailure of the mature follicle to rupture and release its ovum)
41
how long will it take follicular cysts to regress
1-2 menstrual cycles
42
these benign cysts are: caused by blood accumulating in the corpus luteum cavity after ovulation
corpus luteum cysts (normally this would be absorbed but if it does not and it is greater than 3 cm then it's a cyst)
43
how long will it take for corpus luteum cysts to resolve
1-2 menstural cycles
44
these benign cysts are: associated with elevated chorionic gonadotropin levels due to hydatidiform mole, choriocarcinoma, clomid infertility therapy
theca lutein cysts
45
how long will it take for theca lutein cysts to resolve
spontaneously w/ tx of underlying disorder
46
most common benign cyst in young women of reproductive age
mature teratoma
47
these benign cysts are caused by: originate from primordial germ cells often found along the germ cell migration pathway from the yolk sac to the gonads composed of tissue from any of the 3 germ layers
mature teratoma
48
mature teratomas are lined with keratinized squamous epithelium and have abundant
**glands** sebaceous and apocrine
49
what is the most common germ cell of origin in a mature teratoma
**ectodermal** ## Footnote hair and teeth
50
mature teratoma tx
**laparotomy or laparoscopy** **ovarian cystectomy or oophorectomy** 10% recurrence
51
these benign cysts are: lined with columnar epithelium secrete thick, gelatinous mucin thin walled, uni/multilocular
serous/ mucionous cystadenoma
52
which are more common, serous or mucinous cystadenomas
mucinous
53
serous/ mucinous cystadenoma treatment
surgical excision ensure benign pathology
54
what factors increase the risk of ovarian CA
**obesity** **endometriosis** **PCOS** **BRCA1 or BRCA2 mutations** **Lynch Syndrom** (hereditary nonpolyposis colorectal CA) **more periods** (nulliparity/ early menarche/ late menopause)
55
what factors decrease the risk of ovarian CA
decreased ovulation pregnancy breast feeding oral contraceptives
56
abdominal distention bloating abdominal/ pelvic pain ascites abdominal masses bowel obstruction dyspareunia sister mary joseph nodule
sxs of ovarian CA
57
high grade serous carcinoma endometroids carcinoma clear cell carcinoma mucinous carcinoma
the subtypes of epithelial ovarian CA
58
dysgerminoma endodermal sinus immature teratoma embryonal carcinoma choriocarcinoma
subtypes of germ cell ovarian CA
59
granulosa cell sertoli-stromal cell
subtypes of sex cord and stromal ovarian CA
60
where do neoplasms that metastasize to the ovary usually originate
stomach colon breast
61
this epithelial ovarian CA arises from the fallopian tube from the p53 suppressor gene
high grade serous carcinoma | (70-80%)
62
these epithelial ovarian CA are caused by ovarian trauma due to repeated follicular rupture and repair ⇒ malignant transformation
endometroid carcinoma clear cell carcinoma mucinous carcinoma
63
these ovarian CA tend to grow rapidly favor lymphatic spread contain mixture of tumor types typically unilateral
germ cell ovarian CA
64
a choriocarcinoma is made of
placental tissue | (pluripotent germ cell CA)
65
a dysgerminoma is made of
oocytes | (a pleuripotent germ cell CA)
66
an endodermal sinus tumor is made of
yolk sac | (a pleuripotent germ cell CA)
67
most common germ cell ovarian CA typically unilateral typically occur in women under 30
dysgerminoma
68
most common germ cell ovarian CA in **children** the **most rapidly growing** germ cell tumor bilateral
endodermal sinus tumor aka yolk sac tumor
69
which germ cell ovarian CA's produce alpha fetoprotein
endodermal sinus tumor immature teratoma embryonal carcinoma
70
which germ cell ovarian CAs produce HCG
embryonal choriocarcinoma
71
2nd most common type of germ cell ovarian CA seen mostly in females under 20
immature teratoma
72
this uncommon germ cell ovarian CA has rapid growth, extensive spread, and produces alpha fetoprotein and HCG
embryonal carcinoma
73
which germ cell ovarian CA are often bilateral
endoermal sinus tumor aka yolk sac tumor
74
germ cell ovarian CA can be a combination of
dysgerminoma endodermal sinus tumor immature teratoma
75
which germ cell ovarian CA that is presents most commonly in teenage years and is associated with precocious puberty, uterine bleeding, or amenorrhea
choriocarcinoma
76
which sex cord stromal ovarian CA causes hyperandrogenism and is often seen in females in their 20's or 30s
sertoli-stromal cell
77
which sex cord stromal ovarian CA causes hyperestrogenism, is often seen in females in their 40s, and is associated with precocious puberty, breast tenderness, and post-menopausal bleeding
granulosa cell
78
call exner bodies
granulosa cell | (sex cord stromal ovarian CA)
79
reinke crystals
sertoli leydig cell sex cord stromal ovarian CA
80
schiller duval breasts (rings of cells around a central blood vessel)
endodermal sinus germ cell ovarian tumor
81
which ovarian CAs have pleural effusion bowel obstruction, early satiety, bloating, abdominal distention, dyspepsia, ascites inguinal lymphadenopathy, pelvic mass, pelvic mass,
sex cord stromal ovarian CA
82
this type of ovarian CA is benign and made of fibroblast cells that can grow to be large presents with ascites and pleural effusion caused by Meigs syndrome pulling sensation in the groin caused by compressed round ligament
fibroma
83
meigs syndrome
seen in fibromas (benign sex cord stromal ovarian CA) the tumor irritates the peritoneal and pleural surfaces causing ascites and pleural effusion
84
if the CA-125 is elevated, what type of ovarian CA do you suspect
epithelial ovarian CA \> 65
85
if the hCG, AFP, or LDH is elevated, what type of ovarian CA do you suspect
germ cell ovarian CA
86
epithelial ovarian CA are often associated with ____ age while germ cell ovarian CA are often associated with ___ age
epithelial- older germ cell- younger
87
epithelial ovarian CA are often ____ (side) while germ cell ovarian CA are often \_\_\_\_
epithelial- bilateral germ cell- unilateral (except yolk sac)
88

OBGYN rotation review (14 decks)

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