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What are the possible lesions that may result in a mass in the right fornix? Name 3 categories and 2 examples each.
- Infected organ (abscess) - PID, ovarian abscess, puerperal pelvic cellulitis
- Neoplasms - ovarian cancer, cervical ncacer, pelvic mets, uterus adenocarcinoma
- Other - ectopic pregnancy, ovarian cyst, pelvic hematoma
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Name 3 things that cause a cystic ovarian mass appearance on U/S.
- Ovarian cyst
- Ovarian cancer
- Leiomyoma (normal on other side)
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Name 5 further Ix for such mass.
- CA 125 (not so useful, only when combined with U/S)
- CT
- IVP
- Laparoscopy + biopsy
- PET scans
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Name 3 causes for fleshy nodules over peritoneum.
- Ovarian cancer
- Peritoneal cancer
- Endometriosis
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Name 4 main categories of ovarian cancers.
- Common epithelial (90%) - serous, endometriod, mucinous, clear cell
- Germ cell (3%) - occur in young women, very curable, raised beta-HCG & AFP
- Sex cord (5%)
- Rare types e.g. Brenners
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Name 5 predisposing factors for ovarian cancer.
- White women & industrialised countries
- Women w/o kids
- Early menarche, late menopause
- Breast cancer
- Fx & genetic mutation BRCA 1/2
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Name 2 chemotherapy agents and their mechanism.
Carboplatin - binding to DNA and interfering with cell's repair mechanism ---- cell death
Paclitaxel - interferes with microtubules breakdown (for cellular transport)
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Name 4 complications of ovarian cancer.
- Metastases
- Loss of organ functions
- Ascites
- Intestines blockage
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Name 5 causes for post-menopausal PV bleeding.
- Hormone replacements
- Endometrial cancer/polyps
- Cervical cancer/lesions
- Uterine tumors
- Estrogen-secreting tumors in other parts
- of the body
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Name 8 risk factors for endometrial cancer (altogether 10).
- Age: 50-59 (peak)
- HRT(unopposed oestrogen)
- Obesity/Diabetes
- Nulliparity
- Late menopause/early menarche
- Tamoxifen
- COCP
- Cigarette smoking
- Breast, colon, ovarian cancers
- Family history
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Name 5 Ix for suspected endometrial cancer.
- Vaginal ultrasonography
- Endometrial biopsy
- Hysteroscopically directed biopsy
- Dilatation and curettage
- Examination under anesthesia
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