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13 Cards in this Set
- Front
- Back
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Describe the pathogensis of ovarian torsion? What does the ovary rotate around?
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Broad ligament
Arterial supply not interupted as much as veins so you get progressive ovarian enlargement |
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What are the RF for ovarian torsion
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Neoplasms and cysts - predispose the ovary to swing on its pedicle more readily
strenuous exercise Increase in abdominal pressure (pregnancy - common - 20-25% of cases) Congenitally long ovarian ligaments |
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What symptoms does someone with ovarian torsion present with?
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Most common symptom = sudden onset abdominal pain associated with N/V
Fever may indicate necrosis Pelvic mass --> dyspareunia and painful defecation |
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What imaging is used in a suspected ovarian torsion?
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Definitive diagnosis is based upon surgical findings
Can order MRI, CT, US, Doppler US but ability to detect torsion is limited |
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Management of ovarian torsion?
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Expedient surgical management is imperative
Laparotomy/laparoscopy |
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What is the aetiology of ovarian cysts?
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Either neoplasm or disrupted ovulation
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How do people with rupture of ovarian cysts present?
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asymptomatic or sudden onset unilateral abdominal pain - pain often begins during strenuous activity or sexual intercouse
May be accompanied by light vaginal bleeding due to drop in secretion of ovarian hormones |
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How do you investigate someone with a suspected ruptured ovarian cyst?
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Main DDx to exclude is ruptured ectopic pregnancy
B-HCG; US (transvaginal or transabdo); FBC (may see mild leukocytosis); AFP or CA125 - tumour markers |
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How do you manage an uncomplicated cyst rupture?
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analgesia
cyst fluid usually reabsorbed within 24 hours and symptoms resolve over a few days usually caused by follicular and corpus luteum cysts |
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How do you managed complicated cyst rupture? i.e. significant haemoperitoneum
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Hospitalisation with fluid resuscitation
Surgery to control haemorrhage if unstable or deteriorating or if dermoid cyst suspected (inflammatory response can cause adhesions with a lot of pain) |
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Is transvaginal or transabdominal US better for visualising ovarian cysts?
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Depends on size of tumour
TV better if confined to pelvis TA - better for larger tumours |
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what are the RF for follicular cysts?
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smoking
progestin only pill tamoxifen |
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what is pathognomic for dermoid cyst on US?
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calcification
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