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
