gyn-assignments
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| develop when an ovarian follicle fails to rupture as it normally would at ovulation. usually small and asks, some can be larger and cause tenderness or ovarian torsion. usually regress spontaneously | follicular cyst
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| develop when the corpus luteum persists even when fertilization has not occurred. may cause pain and delay in menstruation. usually regress spontaneously | corpus luteal cyst
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| ovarian cysts that result from over-stiumulation by beta human chorionic gonadotropin. often bilateral and can become large, but diminish when gonadoropin levels fall | theca lutein cyst
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| "chocolate cyst". endometriosis in which endometrial tissue is attached to an ovary. commonly painful, especially with menses. contain glandular-like tissue with thinck blood | endometrioma
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| (dermoid cyst common, persistent, benign ovarian cyst that arises from germ cells. contains various types of tissue, including hair and teeth. | mature teratoma
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| persistent ovarian tumors w/ histologic characteristics similar to those of epithelia in the reproduction tract 2 types (serous: smaller and mutinous: larger) | epithelial tumor
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| if a pelvic mass is palpable on PE, what characteristics of the mass should be evaluated? | smooth vs nodular, mobile vs fixed, size, location, relationship to the uterus, presence or absence of ascites
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| on US report, how might the composition of a mass be described? | unilocular vs multilocular cyst or if its complex vs fully solid, thickness of septations and presence of papillary protection will be determined
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| which composition type is usually considered benign? | simple cysts (unilocular w/ thin, smooth walls) up to 10cm in volume
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| indications for referral of a premenopausal woman w/ a pelvic mass | simple cyst that has persisted for more than 12wks or larger than 10cm. any metastasis or ascites or if hx of breast CA or 1st degree relative had ovarian or breast CA
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| indications for referral of a postmenopausal woman w/ a pelvic mass | complex pelvic mass, CA-125 level of >35, ascites, nodular or fixed mass, metastasis, 1st degree relative w/ breast or ovarian CA
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| what gene-mutation-syndrome is associated w/ an increased risk of ovarian CA? | hereditary nonpolyposis colorectal cancer syndrome (Lynch II syndrome)
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| describe the spread of ovarian CA? | spreads locally to the opposite ovary and the uterus and then intraperitoneally. distant metastases are rare, but may occur in the liver, lungs, pleura, adrenal glands, and spleen
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| 6 sxs to include ovarian CA into ddx? how long should these sxs be occurring? | pelvic pain, abd pain, increased abd size, bloating, difficulty eating, early satiety, occurring more than 12d per month for less than one month
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| when performing a PE on a 57yo pt, would you expect to be able to palpate the ovaries? | no, b/c ovaries normally decrease in size and become non palpable after menopause
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| what else, besides ovarian CA may increase the CA125 results? | PID, endometriosis, functional ovarian cysts, menstruation, and pregnancy
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| what are the referral levels of CA 125 for pre and post-menopausal women? | pre: >200, post: >35
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