Obgyn Ch 42

Front 1

Name 3 functions of the ovary

Back 1

1. mature oocytes for ovulation

2. synthesize androgens and convert them to estrogens

3. produce progesterone after ovulation to sustain early pregnancy.

Front 2

Name 4 functional cyst

Back 2

1. Follicular

2. Corpus Luteum

3. Hemorrhagic

4. Theca-Lutein Cysts

Front 3

What is the formula for calculating ovarian volume?

Back 3

Length x Width x Height x 0.523

Front 4

Would an ovarian volume of 10cc be considered abnormal for a postmenopausal patient?

Back 4

Yes, above 8cc is considered abnormal

Front 5

While performing an exam on a 28 year old patient, you note the ovarian volume of the right ovary is 11cc and the volume of the left ovary is 18cc.

Is this considered abnormal?

Back 5

No, the volume of more than TWICE that of opposite side is considered abnormal.

Front 6

Which of the functional cysts appears simple?

Back 6

Follicular

Front 7

Which of the functional cysts are most likely to be unilateral? Bilateral?

Back 7

Unilateral: Follicular, corpus luteal, hemorrhagic

Bilateral: Theca-lutein

Front 8

Which of the functional cysts is most likely to mimic a solid lesion?

Back 8

Hemorrhagic

Front 9

What hormone is secreted by theca-lutein cysts?

Back 9

None

Front 10

Sonographic and clinical follow up is recommended for cysts measuring greater than _______.

Back 10

3 cm

Front 11

What syndrome is the result of an iatrogenic complication?

Back 11

Ovarian Hyperstimulation Syndrome

Front 12

What 2 hormones are imbalanced in PCOS?

Back 12

LH and FSH

Front 13

T or F: Diffuse endometriosis is easily detected on ultrasound?

Back 13

False

Front 14

What measurements are used a guidelines for mild vs. severe ovarian stimulation?

Back 14

Mild: < 5 cm

Severe: > 10 cm

Front 15

What is PCOS?

Back 15

- Chronic an ovulation

- Several follicles begin development but do not ovulate due to hormone imbalance. `

Front 16

What is your conclusion of this image?

Back 16

Severe form of Ovarian Hyperstimulation Syndrome

Front 17

What clinical findings is this patient likely to have?

Back 17

1. Amenorrhea

2. Obesity

3. Infertility

4. Hirsutism

Front 18

Differentiate endometriosis from adenomyosis:

Back 18

Endometriosis: Ectopic tissue can be found almost anywhere in the pelvis, including ovary, fallopian tube, broad ligament, external surface of uterus, scattered over peritoneum, cul-de-sac, and bladder.

Adenomyosis: endometrial tissue invades and implants within myometrium.

Front 19

What is an ovarian torsion?

Back 19

A partial or complete rotation of ovarian pedicle on its axis, compromising lymphatic and venous drainage.

Front 20

What are characteristics of a complex mass?

Back 20

- Any simple cyst that hemorrhages as it involutes may appear as a complex mass.

Front 21

What are characteristics of a solid mass?

Back 21

- More monographically complex

- The tumor is more likely to be malignant (especially if associated with ascites)

Front 22

What type of patients are affected by complex masses?

Back 22

Patients of reproductive age

Front 23

What type of patients are typically affected by solid masses?

Back 23

1. Patients during peak fertile years (Only 1 in 15 are malignant)

- The ratio becomes 1 in 3 after age 40.

Front 24

Considerations for complex masses:

Back 24

1. ectopic pregnancy

2. Endometriosis

3. Pelvic Inflammatory Disease

4. Dermoids/Benign tumors

Front 25

Considerations for solid masses:

Back 25

1. connection with uterus to differentiate ovarian lesion from pedunculated fibroid.

2. color doppler can determine between mass and uterus

Front 26

More likely to be benign or malignant?

Unilocular vs. Multilocular

Back 26

unilocular = Benign

Multilocular = Malignant

Front 27

Benign or Malignant? Thick or Thin septations

Back 27

Thin = Benign

Thick = Malignant

Front 28

Benign or Malignant? Enlarged Echogenic Ovaries

Back 28

Malignant

Front 29

Benign or Malignant? Well defined anechoic lesions

Back 29

Benign

Front 30

Benign or Malignant? Any change in ovarian echogenicity or volume of more than 20 ml.

Back 30

Malignant

Front 31

Benign or Malignant? Masses > 10 cm

Back 31

Malignant

Front 32

Benign or Malignant? Extension beyond ovary into omentum or peritoneum and liver metastases

Back 32

Malignant

Front 33

Benign or Malignant? Lesions with irregular walls

Back 33

Malignant

Front 34

Benign or Malignant? Wall or septal thickness > 3 mm

Back 34

Malignant

Front 35

Benign or Malignant? Masses < 5 cm

Back 35

Benign

Front 36

What type of cyst is this an image of?

Back 36

A simple cyst

Front 37

What are the arrows pointing to?

Back 37

Papillary projections

Front 38

What is this an image of?

Back 38

An endometrioma

Front 39

What is this an image of?

Back 39

Dermoid Plug

Front 40

Is this unilocular or multilocular?

Thick or thin septations?

Back 40

Multilocular with thick septations

Front 41

A patient in her 15th week of pregnancycame to the clinician with size larger than dates. The ultrasound examinationshowed an enlarged uteruscompletely filled with grapelike clusters.What finding may the sonographer notice whenscanning the ovaries?

Back 41

1. Enlargeduterus with grapelike clusters (Gestational Trophic Disease Ovaries)

2. Theca-lutein cysts

Front 42

Where are paraovarian cysts located?

Back 42

In the broad ligament

Front 43

What is "Meigs Syndrome"

Back 43

theassociation of ascites and pleural effusion with a fibrous ovarian tumor (mostcommonly a fibroma) that disappears after excision of the tumor.

Front 44

What hormone is elevated in this condition?

Back 44

hCG

Front 45

What are the arrows pointing to?

Back 45

Gestational Trophoblastic Disease

Front 46

What is this?

Back 46

Theca Lutein Cysts

Front 47

Does the following image appear more cystic or solid?

Back 47

Cystic because of posterior enhancement

Front 48

What is this an image of?

Back 48

Ovarian Torsion

Front 49

Which type of teratomais malignant?

mature or immature?

Back 49

Immature

Front 50

What is this person suffering from?

Back 50

PCOS

Front 51

Aside from PCOS, what is this disease known as?

Back 51

The String of Pearls

Front 52

A thecoma,fibroma, and granulosa are what type of tumor?

Back 52

Sex cord stromal tumors

Front 53

What areas should be evaluated in thecase of a suspicious ovarian mass?

Back 53

1. Peritoneum(for ascites and mets)

2. Lymphnodes

3. Liver

4. Pleuralspace

Front 54

What procedure is being performed in this image?

Back 54

Ultrasound guided needle aspiration

Front 55

What type of cyst is in this image?

Back 55

Hemorrhagic Cyst

Front 56

What type of cyst is in this image?

Back 56

Theca Lutein Cyst

Front 57

Theca Lutein cyst have high levels of _____, which result from overstimulation during infertility treatment.

Back 57

hCG

Front 58

What is this an image of?

Back 58

Ovarian Hyperstimulation Syndrome

Front 59

This is a sideffect of which disease?

Back 59

Polycystic Ovarian Syndrome

Front 60

Endometriosis can implant where?

Back 60

Almostanywhere in pelvis; including ovary, fallopian tube, broad ligament, externalsurface of uterus, scattered over peritoneum, cul-de-sac & bladder

Front 61

Which cystic mass is this?

- Containing diffuse homogeneous, low-levelinternal echoes

- Predominantly cystic mass

Back 61

Endometrioma

Front 62

What is this known as?

What is the clinical term?

Back 62

"Chocolate Cyst"

The clinical terms is Endometrioma.

Front 63

What is this diagram demonstrating?

Back 63

Ovarian Torsion

Front 64

What tool is this demonstrating?

What is this known as?

Back 64

> Color doppler

> Whirlpool sign to help identify ovarian torsion

Front 65

What is the name of this tumor and what organ is it associated with?

Back 65

> Krukenberg Tumor

> Pancreatic Carcinoma

Front 66

Is this an image of bilateral or unilateral ovarian carcinoma?

Back 66

Bilateral Metastasis

Front 67

What carcinoma is known as looking "sausage shaped"?

Back 67

Fallopian Tube Carcinoma

Front 68

This is an image of Serous Cystadenoma, is it typically unilateral or bilateral?

Unilocular or Mulilocular?

Back 68

> Unilateral

> Multilocular

Front 69

Is this an image of Serous Cystadenoma or Serous Cystadenocarcinoma?

Back 69

Serous Cystadenocarcinoma

Front 70

______ cyst can contain hair, cartilage, bone & teeth

Back 70

Dermoid

Front 71

What is this image known as?

Back 71

"Tip of the iceberg"

Front 72

This is known as a dermoid ______.

Back 72

mesh

Front 73

Numerous IntracysticFloating Balls as a Sonographic Feature of Benign Cystic Teratoma called _________.

Back 73

A dermoid tumor

Front 74

This mass is rare, malignant, occurs in women <30 yrs old & commonly seen in pregnancy is known as _______.

Back 74

Dysgerminoma

Front 75

A 46-year-old woman was found to have agrapefruit-sized mass on pelvic examination. Sonography showed a well-defined,homogenous mass in the right ovary, which was surgically removed. This mass is known as ________

Back 75

Granulosa

Front 76

This is known as ______

Back 76

Pelvic Kidney