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38 Cards in this Set
- Front
- Back
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Struma ovarii…
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Benign cystic teratoma containing thyroid tissue which can cause hyperthyroidism
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Germ cell tumors: what age group, s/s, and classification…
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¼ of all ovarian tumors usually present in 20-30 yo’s, cause pelvic pain due to rapidly growing size and usually present at stage I. Classification: dysgerminoma, endodermal sinus tumor, embryonal carcinoma, polyembryoma, choriocardinoma, teratoma
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Dermoid cyst (teratoma) description, diagnosis, tx…
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Mature benign can be uni or bilat, contain ectodermal (or all three) layers. US shows hypoechoic area. Torsionis common complication. Tx is cystectomy or oophorectomy. Immature is usually unilat and malignant
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What determines the grade of immature teratomas…
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Quantity of immature neural elements
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Struma ovarii description, diagnosis, tx…
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Teratoma with thyroid tissue causing hyperthyroidism. MRI shows thick septa, multilobulated tumor. Tx is cystecomy or SOP
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Most common ovarian tumors in women under 30 are… over 30…
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Under 30 is dermoid cysts and over 30 are epithelial tumors
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Characteristics of serous epithelial ovarian tumors…
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Ascites, bloating, more often Bilateral.
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Characteristics of mucinous epithelial ovarian tumors…
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Large size, rupture leading to pseudomyxoma peritonei,
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Characteristics of endometroid tumors of ovary…
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May coexist w/ endometrial carcinoma of uterus
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When is CA125 most accurate in detecting ovarian cancer in women and why…
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Postmenopausal because many diseases of repro years can elevate it
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Sonographic features of neoplasms in ovary…
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Sepatations, solid components, excrescences (growths on surface)
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Which ovarian tumors are completely solid…
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Granulose cell and Sertoli-Leydig
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Most important risk factor in development of breast CA… other RFs…
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Age. Family history of mammary Ca is another RF
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Breast CA screening for women 20-39 yrs…
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Monthly self exam plus clinical breast exam q3 yrs
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Breast CA screening guidelines for women >40 yrs…
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Monthly self exam and yearly clinical exam, mammography q 2 yrs if older then 50 yrs and yearly
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False negative rate of mammography… what should be done on palpated mass that has negative mammography findings…
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10%. Always excise or biopsy a palpable mass
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Biopsy types for nonpalpable breast masses detected on mammography…
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Needle localization excisional or stereotactic core needle biopsy
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Risks of breast CA and ovarian CA in BRCA 1 and 2 mutations…
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BRCA 1 has 50-70% risk of breast and 30% of ovarian. BRCA 2 is slightly lower. Ashkenazi Jews are at particularly increased risk
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If mammography is performed and shows cystic mass then needle sucks out straw colored fluid, what is next step… what if the fluid is bloody or another color.
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If straw colored then no more steps necessary. If blood colored or other color then send for cytology
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What is most common type of breast CA… what are the most significant signs impacting prognosis…
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Infiltrating intraductal carcinoma is most common histological subtype of breast CA. Lymph node status is most significant sign followed by size of the tumor
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Most common cause of unilateral serosanguineous nipple discharge from single duct…
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Intraductal papilloma
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Wound/fascial dehiscence… RFs for fascial dehiscence post surgery…
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Separation of part of surgical incision but w/ intact peritoneum, usually has copius serosangineous fluid draining. Obesity, diabetes, cancer, vertical incision, exposure to radiation, corticosteroid use, infxn, coughing, malnutrition
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S/S of separations of subcutaneous tissue post surgery… tx…
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Red, tender, indurated incision and fever 4-10 days post-op. Tx: opening wound and draining purulence. Broad-spec antibios and dressing changes. Wound closure is secondary or primary a few days after drainage
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Which study can help differentiate between lymphatic drainage and urinary tract fistula in case of post-op serous drainage…
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Creatinine level as it would be much higher in urine
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What is the significance of the “frond” pattern on floating endometrial tissue in saline…
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It almost always significies an intrauterine pregnancy
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S/S of hemoperitoneum… causes of hemoperitoneum in pregnancy…
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S/S: hypotension, tachycardia, ab pain abd distension, rebound tenderness and fluid wave. Causes: ectopic prego, ruptured corpus luteum cyst, or splenic injury
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Corpus luteum…
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Physiologic ovarian cyst formed rom mature graafian follicles following ovulation. Secretes progesterone
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When do corpus luteum cysts most often rupture… what are RFs for rupture…
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Days 20-26 of menstrual cycle. RFs include bleeding tendencies (ie. Von Willibrans or Coumadin, as examples)
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How is placental progesterone production maintained in first 10 weeks of pregnancy…
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hCG from syniothotorphoblast causes corpus luteum to make progesterone until placenta takes over in making it around week 10
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What is the first sign of hypovolemia…
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Decreased urine output. A positive tilt test would most likely be the next
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What is the definition of secondary amenorrhea…
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6 mo of no menses in woman with previously normal menses. Ddx: hypothal or hyperprolact, Sheehan, ovarian (premature ovarian failure), or adhesions from d/c, pregnancy, radiation, or infxn
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Difference in layers of adhesions (endo vs myo) in IUA…
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Endometrial adhesion are usually strands of avascular fibrous tissue. Myometrial are usually dense and vascular with poorer prognosis
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Which women with secondary amenorrhea secondary to IUA have the worst prognosis…
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Those with atrophic and sclerotic endometrium w/o adhesions usually post-radiation or tuberculosis endometritis
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Differences in timing of curettage and development of IUD…
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Post-missed abortion curettage has higher incidence of intrauterine synchiae then post-incomplete abortion or molar pregnancy
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Most common method of diagnosing IUD… gold standard…
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Hysterosalpingogram. Hysteroscopy is the gold standard
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S/S of cervical stenosis and what causes it…
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Cramping lower abd pain every month with nml biphasic basal body temp but amenorrhea. Causes often by cervical cone
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Laboratory eval for amenorrhea…
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TSH, prego test, prolactin level, FSH and LH levels
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What willhormone levels (FSH, LH, estrogen) be like in IUA… what is definitive tx of IUA…
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They will be normal but uterus does not respond to them. Definitive tx of IUA is hysteroscopic resection
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