Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
25 Cards in this Set
- Front
- Back
|
PID Casues
|
– most polymicrobial
– N. gonorrhea most common single, upward migration from mucinous glands gets tubo-ovarian region – also E. coli, Staph, Strep, Clostridium via lymph or vascular after surgery – Also Chlamydia, Mycoplasma, Actinomyces (IUDs) |
|
|
Adenomatoid tumor
|
benign fallopian tumor of mesothelial origin
|
|
|
Surface epi inclusion cysts of ovaries
|
small cysts from involution of surface epi, benign
|
|
|
Functional ovarian cysts
|
follicular and corpus luteal cysts, benign
|
|
|
PCO path
|
– Increased ovarian production of androgens that act locally to cause premature follicular atresia, multiple follicular cysts, persistent anovulatory state and decreased P
– Excess androgens converted to E in peripheral adipose tissue |
|
|
Sporadic ovarian cancer
|
– activation of oncogenes (c-myc, K-ras, HER2/neu)
– Inactivation of tumor suppressor genes (p53, p16) – Aneuploidy |
|
|
Hereditary ovarian cancer
|
– 5-10% in women w/ familial susceptibility to ovarian and/or breast cancer
– Germline mutations in DNA repair genes – BRCA-1 (chromo 17), BRCA-2 (chromo 13) |
|
|
Most common germ cell tumor in adults
|
95% are benign mature cystic teratomas (dermoid cyst)
|
|
|
Ovarian mets
|
– stomach (Krukenberg tumor) colon, pancreas and appendix
– also breast, endometrium |
|
|
Ovarian tumor cell markers
|
– Serous/endometrioid is CA125
– Mucinous is CEA – Yolk sac tumor is AFP – Choriocarcinoma is hCG |
|
|
Imperforate hymen
|
– no obvious vaginal orifice
– thin, bulging, blue perineal membrane – fluctuant pelvic |
|
|
Mullerian agenesis
|
– Absent vagina, absent/ rudimentary uterus
– 46,XX, – Normal ovaries – Normal 2o sexual development – ASx |
|
|
Transverse vaginal septum/cervical atresia
|
– Blind vaginal pouch, 46,XX
– Normal ovaries – Normal 2o sexual development – Cryptomenorrhea |
|
|
Asherman Syndrome
|
– Synechiae
– Dx w/ strong suspicion – based on hx uterine curettage (retained POC, endometritis) – hx of IUD infection or PID – hx of genital TB, schistosomiasis – Hysterosalpingogram (HSG) |
|
|
Drugs that could cause amenorrhea
|
Phenothiazines
Reserpine Amphetamines Opiates Benzos Butyrophenones TCA’s Metaclopramide |
|
|
Enzyme deficiencies that can cause ammenorhea w/ high FSH
|
P450c17, aromatase
|
|
|
Evaluation for PCOD
|
– 1) T (producing neoplasm) > 200 – Transvaginal U/S – Adrenal CT/MRI
– 2) 17-hydroxyP (nonclassical CAH) > 2 – ACTH stim test – 3) 24 hr cortisol if cushing signs and Sx |
|
|
Abnormal Uterine bleeding Evlauation
|
– 1) Exclude pregnancy
– 2) Identify anemia, thrombocyto – 3) Assess ovulatory function – Menstrual hx, Timed serum P, Endometrial bx (Age > 40 yr – Hx of chronic anovulation – Confusing/suspicious hx) |
|
|
Hypoestrogenism
|
– Thin, inactive endometrium
– don’t tx w/ P, b/c it organizes and attenuates bleeding – Dx if Biopsy yields minimal tissue and there is Attenuated endometrium (Stripe < 4 mm) – Tx must begin w/ estrogen to build a foundation, then do progestin |
|
|
Why is nulliparity an RF for endometrial cancer
|
– Infertility common link
– Anovulation – high serum levels of androstenedione – lack of monthly menses more common in this population |
|
|
Endometrial cancer and ultrasound
|
– Normal has a very thin lining
– if lining less than 5 mm, possibility of having endometrial cancer is very small – if asian, less than 3 means you are ok |
|
|
Endometrial Cancer Staging
|
– Stage I is Uterus only
– Stage II is Cervical involvement – Stage III is Ab involvement (tubes/ovaries/washings/nodes) or vaginal involvement – Stage IV is Bowel, bladder, or mets |
|
|
First line Tx for ovarian cancer
|
– Debulking Surgery/Staging
– then Chemotherapy (Platinum + Taxol) every 3 weeks for 6 cycles – then second look surgery |
|
|
2nd line Tx for ovarian cancer
|
– Ovarian cancer recurrence
– then Other chemo? Hormonal treatment? Interval debulking surgery? Radiation |
|
|
Ovarian Cancer Staging
|
– Stage I is Ovaries only
– Stage II is Pelvic extension – Stage III is Abdominal implants or lymph node spread – Stage IV is Distant METs |
