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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
Q

how do you treat the hyperinsulinemia assoc w/ PCOS

A

metformin 500 mg BID

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26
Q

how do you treat the infertility associated with PCOS

A

clomid

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27
Q

what tx of PCOS:

increases SHBG

decreases free testosterone

and restores predictive cycling

A

combo oral contraceptives

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28
Q

what is the main lifestyle change that needs to happen with PCOS

A

weight loss

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29
Q

people w/ PCOS are at increased risk of

A

endometrial hyperplasia/ CA

metabolic syndrome, T2DM

CVD, HTN, hyperlipidemia

infertility

stroke

sleep apnea

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30
Q

adnexal mass on US:

homogenous echos

A

benign:

endometrioma

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31
Q

adnexal mass on US:

thin walled

A

benign

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32
Q

adnexal mass on US:

hyperechoic nodule w/ distal acoustic shadowing

A

benign:

teratoma

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33
Q

network of linear/ curvilinear pattern

A

benign:

hemorrhagic cyst

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34
Q

adnexal mass on US:

under 3 cm in a premenopausal woman

under 1 cm in a post menopausal woman

A

benign:

simple cyst

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35
Q

adnexal mass on US:

thick septations > 2 mm

A

malignant

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36
Q

adnexal mass on US:

solid component appears nodular/ papillary

A

malignant

37
Q

adnexal mass on US:

blood flow to solid component

A

malignant

38
Q

most common benign ovarian cyst

A

follicular

39
Q

these benign cysts are:

caused by a failure of the mature follicle to rupture and release its ovum

A

follicular cysts

(other cause is failure of the non-dominant follicles to undergo atresia in the presence of the mature follicle)

40
Q

these benign cysts are:

caused by a failure of the non-dominant follicles to undergo atresia in the presence of the mature follicle

A

follicular cyst

(other cause is ailure of the mature follicle to rupture and release its ovum)

41
Q

how long will it take follicular cysts to regress

A

1-2 menstrual cycles

42
Q

these benign cysts are:

caused by blood accumulating in the corpus luteum cavity after ovulation

A

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
Q

how long will it take for corpus luteum cysts to resolve

A

1-2 menstural cycles

44
Q

these benign cysts are:

associated with elevated chorionic gonadotropin levels

due to hydatidiform mole, choriocarcinoma, clomid infertility therapy

A

theca lutein cysts

45
Q

how long will it take for theca lutein cysts to resolve

A

spontaneously w/ tx of underlying disorder

46
Q

most common benign cyst in young women of reproductive age

A

mature teratoma

47
Q

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

A

mature teratoma

48
Q

mature teratomas are lined with keratinized squamous epithelium and have abundant

A

glands

sebaceous and apocrine

49
Q

what is the most common germ cell of origin in a mature teratoma

A

ectodermal

hair and teeth

50
Q

mature teratoma tx

A

laparotomy or laparoscopy

ovarian cystectomy or oophorectomy

10% recurrence

51
Q

these benign cysts are:

lined with columnar epithelium

secrete thick, gelatinous mucin

thin walled, uni/multilocular

A

serous/ mucionous cystadenoma

52
Q

which are more common,

serous or mucinous cystadenomas

A

mucinous

53
Q

serous/ mucinous cystadenoma treatment

A

surgical excision

ensure benign pathology

54
Q

what factors increase the risk of ovarian CA

A

obesity

endometriosis

PCOS

BRCA1 or BRCA2 mutations

Lynch Syndrom (hereditary nonpolyposis colorectal CA)

more periods (nulliparity/ early menarche/ late menopause)

55
Q

what factors decrease the risk of ovarian CA

A

decreased ovulation

pregnancy

breast feeding

oral contraceptives

56
Q

abdominal distention

bloating

abdominal/ pelvic pain

ascites

abdominal masses

bowel obstruction

dyspareunia

sister mary joseph nodule

A

sxs of ovarian CA

57
Q

high grade serous carcinoma

endometroids carcinoma

clear cell carcinoma

mucinous carcinoma

A

the subtypes of epithelial ovarian CA

58
Q

dysgerminoma

endodermal sinus

immature teratoma

embryonal carcinoma

choriocarcinoma

A

subtypes of germ cell ovarian CA

59
Q

granulosa cell

sertoli-stromal cell

A

subtypes of sex cord and stromal ovarian CA

60
Q

where do neoplasms that metastasize to the ovary usually originate

A

stomach

colon

breast

61
Q

this epithelial ovarian CA arises from the fallopian tube from the p53 suppressor gene

A

high grade serous carcinoma

(70-80%)

62
Q

these epithelial ovarian CA are caused by ovarian trauma due to repeated follicular rupture and repair ⇒ malignant transformation

A

endometroid carcinoma

clear cell carcinoma

mucinous carcinoma

63
Q

these ovarian CA tend to

grow rapidly

favor lymphatic spread

contain mixture of tumor types

typically unilateral

A

germ cell ovarian CA

64
Q

a choriocarcinoma is made of

A

placental tissue

(pluripotent germ cell CA)

65
Q

a dysgerminoma is made of

A

oocytes

(a pleuripotent germ cell CA)

66
Q

an endodermal sinus tumor is made of

A

yolk sac

(a pleuripotent germ cell CA)

67
Q

most common germ cell ovarian CA

typically unilateral

typically occur in women under 30

A

dysgerminoma

68
Q

most common germ cell ovarian CA in children

the most rapidly growing germ cell tumor

bilateral

A

endodermal sinus tumor

aka

yolk sac tumor

69
Q

which germ cell ovarian CA’s produce alpha fetoprotein

A

endodermal sinus tumor

immature teratoma

embryonal carcinoma

70
Q

which germ cell ovarian CAs produce HCG

A

embryonal

choriocarcinoma

71
Q

2nd most common type of germ cell ovarian CA

seen mostly in females under 20

A

immature teratoma

72
Q

this uncommon germ cell ovarian CA has rapid growth, extensive spread, and produces alpha fetoprotein and HCG

A

embryonal carcinoma

73
Q

which germ cell ovarian CA are often bilateral

A

endoermal sinus tumor

aka

yolk sac tumor

74
Q

germ cell ovarian CA can be a combination of

A

dysgerminoma

endodermal sinus tumor

immature teratoma

75
Q

which germ cell ovarian CA that is presents most commonly in teenage years and is associated with precocious puberty, uterine bleeding, or amenorrhea

A

choriocarcinoma

76
Q

which sex cord stromal ovarian CA causes hyperandrogenism and is often seen in females in their 20’s or 30s

A

sertoli-stromal cell

77
Q

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

A

granulosa cell

78
Q

call exner bodies

A

granulosa cell

(sex cord stromal ovarian CA)

79
Q

reinke crystals

A

sertoli leydig cell

sex cord stromal ovarian CA

80
Q

schiller duval breasts

(rings of cells around a central blood vessel)

A

endodermal sinus

germ cell ovarian tumor

81
Q

which ovarian CAs have

pleural effusion

bowel obstruction, early satiety, bloating, abdominal distention, dyspepsia, ascites

inguinal lymphadenopathy, pelvic mass, pelvic mass,

A

sex cord stromal ovarian CA

82
Q

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

A

fibroma

83
Q

meigs syndrome

A

seen in fibromas (benign sex cord stromal ovarian CA)

the tumor irritates the peritoneal and pleural surfaces causing ascites and pleural effusion

84
Q

if the CA-125 is elevated, what type of ovarian CA do you suspect

A

epithelial ovarian CA

> 65

85
Q

if the hCG, AFP, or LDH is elevated, what type of ovarian CA do you suspect

A

germ cell ovarian CA

86
Q

epithelial ovarian CA are often associated with ____ age while germ cell ovarian CA are often associated with ___ age

A

epithelial- older

germ cell- younger

87
Q

epithelial ovarian CA are often ____ (side) while germ cell ovarian CA are often ____

A

epithelial- bilateral

germ cell- unilateral (except yolk sac)

88
Q
A

OBGYN rotation review (14 decks)

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