WH – OVARY 2025 UPDATED
QUESTIONS WITH ANSWERS
VERIFIED BY EXPERTS NEW!!!
Laparoscopic evaluation and treatment may be performed for - CORRECT ANSWER>>>-
Chronic pelvic pain
-Endometriosis
-Infertility
-Pelvic masses
-Ectopic pregnancies
-Congenital abnormalities
-Sterilization (bilateral tubal ligation)
Most common complaints include s/p laparoscopy - CORRECT ANSWER>>>-Incisional pain
and shoulder pain due to referred pain of diaphragmatic irritation from the gas used to provide
visualization
-Rare but serious complications include:
>Damage to major blood vessels
>Bowel damage, and other intra-abdominal or retroperitoneal structures
Adnexal space - CORRECT ANSWER>>>the area between the lateral pelvic wall and the cornu
of the uterus
Adnexal Structures include - CORRECT ANSWER>>>-Ovaries
-Fallopian tubes
-Upper portion of the broad ligament and mesosalpinx
-Remnants of the embryonic Müllerian duct
***Of these, the organs most affected by disease processes are the ovaries and fallopian tubes
Premenarchal ovaries - CORRECT ANSWER>>>-non palpable
-if palpable, presume pathologic condition
Reproductive ovaries - CORRECT ANSWER>>>palpable about 50% of time
>Document � Size, shape, consistency, mobility
*OCP usage may cause smaller, symmetrical, and less palpable ovaries
Perimenopausal ovaries - CORRECT ANSWER>>>residual functional cysts
Postmenopausal ovaries - CORRECT ANSWER>>>majority are not palpable, palpable
enlargement needs evaluation
1
,Palpable ovarian enlargement in PostMenopausal women - CORRECT ANSWER>>>-need to
consider malignancy.
-Significant percent of ovarian masses in PM women are malignant compared to 10% in younger
Functional ovarian cysts - CORRECT ANSWER>>>not neoplasms but, anatomic variations that
arise as a result of normal ovarian function
>May present as an asymptomatic adnexal mass
-Occasionally become symptomatic, requiring evaluation and, possibly, treatment
-Common in reproductive years
-May be asymptomatic until rupture, undergo torsion or become hemorrhagic
three types of functional cysts - CORRECT ANSWER>>>follicular
corpeus luteum cyst, thecal cyst
Most common functional cyst - CORRECT ANSWER>>>follicular
ETIOLOGY/PATHOPHYSIOLOGY of follicular cyst - CORRECT ANSWER>>>-Occurs
when ovarian follicle fails to rupture during follicular maturation
>Causes lengthening of follicular phase of cycle-� Transient secondary amenorrhea
>Follicular cysts lined by granulosa cells � Fluid rich in estrogen
>Granulosa cells persist and enlarge through luteal phase
-Cause is unknown
-A cyst may enlarge beyond 5 cm and continue to fill with follicular fluid from the thickened
granulosa cell layer
SYMPTOMS of folliculat cyst - CORRECT ANSWER>>>-Mild to moderate unilateral lower
abdominal pain
-Alteration of the menstrual interval
>Amenorrhea
-Pelvic examination findings may include:
>unilateral tenderness with a palpable
>mobile
>cystic adnexal mass
2nd Most common functional cyst - CORRECT ANSWER>>>corpus luteum cyst
A corpus luteum cyst - CORRECT ANSWER>>>-Designated a cyst rather than simply a corpus
luteum when diameter exceeds ~ 3 cm
>postovulatory (i.e., progesterone-dominant) phase of the menstrual cycle
Two variations of corpus luteum cysts - CORRECT ANSWER>>>slightly enlarged cyst and
Corpus hemorrhagicum
A slightly enlarged corpus luteum - CORRECT ANSWER>>>-may continue to produce
progesterone for longer than the usual 14 days.
-Menstruation is delayed from a few days
2
, >several weeks,
>usually occurs within 2 weeks of the missed period.
-associated with ipsilateral dull LQpain
-Pelvic examination usually discloses enlarged, tender, cystic, or solid adnexal mass.
Recurrent Persistent corpus luteum cysts may be treated with cyclic oral contraceptives
Triad of missed menstrual period, unilateral LQ pain, and adnexal enlargement - CORRECT
ANSWER>>>Consider ectopic pregnancy as a differential diagnosis
Corpus hemorrhagicum - CORRECT ANSWER>>>-Less common type of corpus luteum cyst is
the rapidly enlarging luteal phase cyst into which there is spontaneous hemorrhage
-a patient presenting with this type would be not
>using oral contraceptives
> regular periods
>presents with acute pain late in the luteal phase
If evidence of hemoperitoneum
>May need to be surgically removed
If the acute pain and blood loss are self limited
>may be managed with mild analgesics and reassurance
Patients at risk for repetitive hemorrhagic corpus luteum cysts include - CORRECT
ANSWER>>>-Use of anticoagulation medication
- those who have a
History of clotting disorder
Theca lutein cyst - CORRECT ANSWER>>>-rare but at risk for torsion or rupture d/t thin
walled and fluid filled
Associated with pregnancy� ELEVATED B-hCG (especially very high levels of B-hCG)
Usually, bilateral
Theca lutein custs are MOST COMMON IN - CORRECT ANSWER>>>-Multiple gestations
-Trophoblastic disease
-Ovulation induction with clomiphene and human menopausal gonadotropin/human chorionic
gonadotropin (hCG)
-May become large and multicystic
>Normally regress spontaneously in most cases without intervention after pregnancy is over
Benign Ovarian Neoplasms: - CORRECT ANSWER>>>Of the ovarian enlargements in women
>25% prove to be nonfunctional ovarian neoplasms
In the reproductive-age group,
>90% of these neoplasms are benign
3
QUESTIONS WITH ANSWERS
VERIFIED BY EXPERTS NEW!!!
Laparoscopic evaluation and treatment may be performed for - CORRECT ANSWER>>>-
Chronic pelvic pain
-Endometriosis
-Infertility
-Pelvic masses
-Ectopic pregnancies
-Congenital abnormalities
-Sterilization (bilateral tubal ligation)
Most common complaints include s/p laparoscopy - CORRECT ANSWER>>>-Incisional pain
and shoulder pain due to referred pain of diaphragmatic irritation from the gas used to provide
visualization
-Rare but serious complications include:
>Damage to major blood vessels
>Bowel damage, and other intra-abdominal or retroperitoneal structures
Adnexal space - CORRECT ANSWER>>>the area between the lateral pelvic wall and the cornu
of the uterus
Adnexal Structures include - CORRECT ANSWER>>>-Ovaries
-Fallopian tubes
-Upper portion of the broad ligament and mesosalpinx
-Remnants of the embryonic Müllerian duct
***Of these, the organs most affected by disease processes are the ovaries and fallopian tubes
Premenarchal ovaries - CORRECT ANSWER>>>-non palpable
-if palpable, presume pathologic condition
Reproductive ovaries - CORRECT ANSWER>>>palpable about 50% of time
>Document � Size, shape, consistency, mobility
*OCP usage may cause smaller, symmetrical, and less palpable ovaries
Perimenopausal ovaries - CORRECT ANSWER>>>residual functional cysts
Postmenopausal ovaries - CORRECT ANSWER>>>majority are not palpable, palpable
enlargement needs evaluation
1
,Palpable ovarian enlargement in PostMenopausal women - CORRECT ANSWER>>>-need to
consider malignancy.
-Significant percent of ovarian masses in PM women are malignant compared to 10% in younger
Functional ovarian cysts - CORRECT ANSWER>>>not neoplasms but, anatomic variations that
arise as a result of normal ovarian function
>May present as an asymptomatic adnexal mass
-Occasionally become symptomatic, requiring evaluation and, possibly, treatment
-Common in reproductive years
-May be asymptomatic until rupture, undergo torsion or become hemorrhagic
three types of functional cysts - CORRECT ANSWER>>>follicular
corpeus luteum cyst, thecal cyst
Most common functional cyst - CORRECT ANSWER>>>follicular
ETIOLOGY/PATHOPHYSIOLOGY of follicular cyst - CORRECT ANSWER>>>-Occurs
when ovarian follicle fails to rupture during follicular maturation
>Causes lengthening of follicular phase of cycle-� Transient secondary amenorrhea
>Follicular cysts lined by granulosa cells � Fluid rich in estrogen
>Granulosa cells persist and enlarge through luteal phase
-Cause is unknown
-A cyst may enlarge beyond 5 cm and continue to fill with follicular fluid from the thickened
granulosa cell layer
SYMPTOMS of folliculat cyst - CORRECT ANSWER>>>-Mild to moderate unilateral lower
abdominal pain
-Alteration of the menstrual interval
>Amenorrhea
-Pelvic examination findings may include:
>unilateral tenderness with a palpable
>mobile
>cystic adnexal mass
2nd Most common functional cyst - CORRECT ANSWER>>>corpus luteum cyst
A corpus luteum cyst - CORRECT ANSWER>>>-Designated a cyst rather than simply a corpus
luteum when diameter exceeds ~ 3 cm
>postovulatory (i.e., progesterone-dominant) phase of the menstrual cycle
Two variations of corpus luteum cysts - CORRECT ANSWER>>>slightly enlarged cyst and
Corpus hemorrhagicum
A slightly enlarged corpus luteum - CORRECT ANSWER>>>-may continue to produce
progesterone for longer than the usual 14 days.
-Menstruation is delayed from a few days
2
, >several weeks,
>usually occurs within 2 weeks of the missed period.
-associated with ipsilateral dull LQpain
-Pelvic examination usually discloses enlarged, tender, cystic, or solid adnexal mass.
Recurrent Persistent corpus luteum cysts may be treated with cyclic oral contraceptives
Triad of missed menstrual period, unilateral LQ pain, and adnexal enlargement - CORRECT
ANSWER>>>Consider ectopic pregnancy as a differential diagnosis
Corpus hemorrhagicum - CORRECT ANSWER>>>-Less common type of corpus luteum cyst is
the rapidly enlarging luteal phase cyst into which there is spontaneous hemorrhage
-a patient presenting with this type would be not
>using oral contraceptives
> regular periods
>presents with acute pain late in the luteal phase
If evidence of hemoperitoneum
>May need to be surgically removed
If the acute pain and blood loss are self limited
>may be managed with mild analgesics and reassurance
Patients at risk for repetitive hemorrhagic corpus luteum cysts include - CORRECT
ANSWER>>>-Use of anticoagulation medication
- those who have a
History of clotting disorder
Theca lutein cyst - CORRECT ANSWER>>>-rare but at risk for torsion or rupture d/t thin
walled and fluid filled
Associated with pregnancy� ELEVATED B-hCG (especially very high levels of B-hCG)
Usually, bilateral
Theca lutein custs are MOST COMMON IN - CORRECT ANSWER>>>-Multiple gestations
-Trophoblastic disease
-Ovulation induction with clomiphene and human menopausal gonadotropin/human chorionic
gonadotropin (hCG)
-May become large and multicystic
>Normally regress spontaneously in most cases without intervention after pregnancy is over
Benign Ovarian Neoplasms: - CORRECT ANSWER>>>Of the ovarian enlargements in women
>25% prove to be nonfunctional ovarian neoplasms
In the reproductive-age group,
>90% of these neoplasms are benign
3
