OB 1 FINAL EXAM

Why is an ovarian thecoma associated with endometrial thickening?

Thecomas are estrogen-producing

Meigs syndrome

Triad of ascites, pleural effusion, and an ovarian neoplasm.

Postmenopausal risks of HRT

Uterine (endometrial) cancer, breast cancer, heart attack, blood clots

What is the ovarian tumor that originates from germ cells and is associated with high levels of AFP?

Yolk sac tumor

What is the order of development of a fertilized egg?

Zygote (2 cells) Morula (6-18 cells) Blastocyst (32 or more cells)

What is dyspareunia?

painful intercourse

What is dysmenorrhea?

painful menstruation

When do the amnion and chorion fuse?

14-16 weeks

The fundus : cervix ratio in a 2-3 month old is ____

1:1

The fundus : cervix ratio in a newborn is ____

1:2

What is the sonographic appearance of a proliferating endometrium?

3-line sign: hyperechoic endometrial canal, outer basal layer, inner functional layer

The fundus : cervix ratio in an adolescent is ____

3:1

At what MSD measurement should you see a yolk sac?

4.5-5.5 weeks

When should you seen an embryo (think MSD)?

5.5-6.5 weeks MSD greater than 20mm w/o fetal pole is abnormal IUP

What does a subchorionic hemorrhage look like?

A crescent-shaped sonolucent collection of blood between the gestational sac and the uterine wall

What is choriocarcinoma?

A malignant form of trophoblastic disease

Describe adenomyosis

A special form of endometriosis where endometrial tissue occurs within the myometrium. Menometrorrhagia, dysmenorrhea, enlarged tender uterus, can be asymptomatic also. Diffuse- asymmetrically enlarged uterus. Poor visualization of endo/myo junction Localized- hypoechoic, highly attenuating structure on posterior aspect of uterus.

Up to 10 weeks the MSD should grow:

About 1 mm/day

Transitional cell tumor of the ovary

Brenner Tumor. Uncommon;2-3% of ovarian neoplasms... most of those benign. Hypoechoic solid masses w/ possible calcifications in the outer wall.

How do you calculate the due date (EDD or EDC)?

EDD or EDC = LMP + 1 year - 3 months +7 days

What is the most common cause of dysfunctional uterine bleeding?

Endometrial hyperplasia

Risks of HRT

Endometrial hyperplasia - overgrowth of endo due to high E levels Abnormal if greater than 7mm in post menopausal pt on HRT Leiomyoma ( fibroid): benign smooth muscle tumor that is estrogen dependent

What is a pelvic disorder that presents with a history of dysmenorrhea and dyspareunia?

Endometriosis

The inner layer of the uterine wall is?

Endometrium

Which layer of the endometrium is shed during menstruation?

Functional endometrial layer (inner)

What is the double bleb sign?

GS+YS+Amnion =IUP (no fetal pole)

What is the distinction between leiomyoma and leiomyosarcoma?

Leiomyoma- Benign, most common tumor of the female pelvis Leiomyosarcoma- malignant, rare, fast-growing

What are the pelvic floor muscles?

Levator Ani- Coccygeus, Iliococcygeus, Pubococcygeus

Krukenberg tumor

Malignancy in the ovary that metastasized from a primary site ( usually GI tract, colon)

When does a physiologic bowel herniation resolve?

Midgut herniating begins in week 8 and returns to abdominal cavity around week 12

What is a solid ball of about 16 cells?

Morula

Which malignant ovarian tumor is associated with pseudomyxoma peritonei?

Mucinous cystadenocarcinoma are prone to rupture ( large size 20-30 cm) causing the peritoneal cavity to fill with gelatinous material from the cyst

What causes menses to start?

No fertilization or implantation causes a drop in estrogen and progesterone- causes endometrium to slough off

What female pelvic organ has a dual blood supply?

Ovaries- ovarian (AO branch) and uterine (internal iliac branch) arteries

Which pelvic disorder presents with leukocytosis?

PID

What is the name of a broad ligament cyst?

Paraovarian cyst

An ovum fertilized by two sperms results in:

Partial molar pregnancy (2 sperms fertilize 1 normal egg) Complete molar pregnancy (2 sperms fertilize 1 empty egg)

Fitz-Hugh-Curtis syndrome

Perihepatic infection which results in liver capsule inflammation from pelvic infections such as gonorrhea & chlamydia

Sheehan syndrome

Post-partum hypopituitarism caused by necrosis of the pituitary gland.

What makes up the vesicouterine space?

Potential space between the uterus and urinary bladder. AKA Anterior cul-de-sac

What are the normal upper limits for endometrial thickness?

Premenopausal: 14mm Postmenopausal: 8mm Tamoxifen: 10mm

The fundus : cervix ratio in a postmenopausal woman is ____

Small, atrophied uterus

Where is hCG produced?

The cells around a developing zygote- Placental trophoblastic cells

What causes menopause?

The ovaries slowly cease to produce ova, and less estrogen and progesterone are produced.

Most common benign ovarian tumor of germ cell origin

Benign cystic teratoma ( dermoid) is the most common benign GCT Contains teeth, hair, glandular and thyroid tissue

What is the most common molar pregnancy?

Complete molar pregnancy is more common than partial

What is the difference between a complete and partial molar pregnancy?

Complete: 1or 2 sperm fertilize empty egg. NO maternal DNA, only paternal chromosomes (cluster of grapes) Partial: 1 normal egg fertilized by 2 sperm; results in Triploid pregnancy (69 chromosomes) (Swiss cheese)

What is seen on the ovary after ovulation and during pregnancy?

Corpus Luteum- secretes progesterone to prepare/maintain a secretory endometrium until the placenta takes over.

A dominant follicle does what during the luteal phase ( day 15- 28)?

If fertilization does not occur the Corpus luteum regresses and resolves into corpus albicans- estrogen and progesterone levels decrease