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Post Info TOPIC: Medscape Quiz - Ovarian Cysts
Have you had or do you know someone who had this? [5 vote(s)]

yes
80.0%
no
0.0%
don't know
0.0%
other
20.0%
ed11563


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Medscape Quiz - Ovarian Cysts
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Quiz: Are You Prepared to Confront Ovarian Cysts?

Michael E. Rivlin, MD

|October 12, 2015

An ovarian cyst is a sac filled with liquid or semiliquid material that arises in an ovary. The vast majority of these lesions are benign. However, a ruptured ovarian cyst is a common phenomenon, with presentation ranging from no symptoms to symptoms mimicking an acute abdomen. Rarely, the rupture can be associated with significant pain. In even rarer circumstances, intraperitoneal hemorrhage and death may occur. Do you know best practices associated with this potentially serious condition? Test yourself with our quick quiz.

Which of the following types of cysts most commonly ruptures?
Endometriomas
Corpus luteum cysts
Dermoid cysts
Cystadenomas
852361-Figure1a.jpg

Corpus luteum cysts tend to be larger and more symptomatic than follicular cysts and are more prone to hemorrhage and rupture. Follicular cysts are usually smaller, with internal hemorrhage being relatively uncommon.

For more on ovarian cysts, read here.

Which of the following is not associated with symptoms of ovarian cyst rupture?
Abdominal distention
Unilateral pelvic pain
Amenorrhea
Peritoneal signs
852361-Figure2a.jpg

Cyst rupture is characterized by sudden, unilateral, sharp pelvic pain. This can be associated with trauma, exercise, or coitus. In addition, cyst rupture can lead to peritoneal signs, abdominal distention, and bleeding that is usually self-limited.

For more on the presentation of ovarian cyst rupture, read here.

Which of the following is the preferred imaging modality for assessing ovarian cysts with or without rupture?
CT
MRI
Ultrasonography
Radiography
852361-Figure3a.jpg

Ultrasonography is the preferred imaging modality for assessing gynecologic structures, given its low cost, availability, and sensitivity in recognizing adnexal cysts and hemoperitoneum. Despite this, ultrasound findings are nonspecific in some instances, particularly after rupture and decompression of a cyst in the setting of apparent physiologic levels of fluid in the pelvis. If ultrasound yields ambiguous results in a patient with significant pain, CT of the pelvis with contrast should be performed.

For more on the workup of patients with suspected ovarian cyst rupture, read here.

Cancer is always a concern with ovarian cysts, and cancer antigen 125 (CA-125) testing is often used to investigate for ovarian cancer. Which of the following is a contraindication to CA-125 testing?
Age 20-30 years
Anemia
Pregnancy
Postmenopause
852361-Figure4a.jpg

CA-125 testing should not be done in pregnant patients with ovarian cysts because levels are significantly higher, especially during the first trimester. CA-125 testing should also not be done in the acute setting of ovarian cyst accidents, as this marker is raised in peritonitis, hemorrhage, cyst rupture, and infection, as well as in menstruation, fibroids, and endometriosis.

For more on CA-125 testing in patients with ovarian cysts, read here.

Although most patients with unruptured ovarian cysts do not require treatment, which of the following is an indication that treatment is necessary?
Premenopausal women with cysts < 7 cm and a CA-125 level ≤ 20 U/mL
Premenopausal women with cysts < 8 cm and a CA-125 level of 25-30 U/mL
Postmenopausal women with cysts 3-5 cm and a CA-125 level of 30 U/mL
Postmenopausal women with cysts < 5 cm and a CA-125 level ≥ 35 U/mL
852361-Figure5a.jpg

In a postmenopausal patient, a persistent simple cyst < 5 cm in the presence of a normal CA-125 value (< 35 U/mL) may be monitored with serial ultrasound. Some evidence suggests that cysts ≤ 10 cm can be safely followed in this way. Premenopausal women with asymptomatic simple cysts < 8 cm on sonograms in whom the CA-125 value is within the reference range may be monitored with a repeat ultrasound in 8-12 weeks.

For more on the workup of ovarian cysts, read here.

Editor's Recommendations
 

Medscape © 2015  WebMD, LLC

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this article: Michael E. Rivlin. Quiz: Are You Prepared to Confront Ovarian Cysts? Medscape. Oct 12, 2015.



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lilyofcourse


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Yep. I was 18 or 19.

The pain woke me up around 3ish in the morning. I just about crawled to my parents room, got out "I need help" and pretty much passed out.

Mom and dad took me to the ER.

I was given some pretty strong IV pain meds.

I had to fill my bladder for an ultra sound. I drank 32 ounces of water and couldn't pee until after the ultrasound.

Thing is, they didn't get to me till after 9.

I was hurting so bad.



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ed11563


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I watched as one was removed once.

It was the size of a volleyball.

 

She was 14 years old.

 



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Fort Worth Mom


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ed11563 wrote:

I watched as one was removed once.

It was the size of a volleyball.

 

She was 14 years old.

 

Seriously?

Just anyone, who isn't a doctor, can watch a surgery?confuse

No wonder I won't go to the doctor, unless bones are poking through my skin.no 

I'm sorry, ed.

Posts like these, freak me out.cry



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Nobody Just Nobody


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Fort Worth Mom wrote:
ed11563 wrote:

I watched as one was removed once.

It was the size of a volleyball.

 

She was 14 years old.

 

Seriously?

Just anyone, who isn't a doctor, can watch a surgery?confuse

No wonder I won't go to the doctor, unless bones are poking through my skin.no 

I'm sorry, ed.

Posts like these, freak me out.cry

 They're not supposed to do it FWM.  You, as the patient, have a right to know who every single person in the room is.  And that includes salesmen pushing a product and also medical and nursing students.  You are supposed to sign a waiver to allow them to watch.



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Mellow Momma


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If it's a teaching hospital, often there is no waiver, it's just the way things are done.

My PC doc was a prof of family medicine at the local college and she occasionally had a student with her, but she always had the nurse ask first before she came in with the student so it wouldn't be awkward.

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Tinydancer


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ed I'm going to say this for you because no one else will. It creeps me out to no end that you post these threads about womens' ovaries, or vaginas, or abortions for 8 year olds. I know flan will jump in and say it's because of blah blah blah but really it's just creepy. Carry on if you'd rather believe this is normal.

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Nobody Just Nobody


Rib-it! Rrrib-it!

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Mellow Momma wrote:

If it's a teaching hospital, often there is no waiver, it's just the way things are done.

My PC doc was a prof of family medicine at the local college and she occasionally had a student with her, but she always had the nurse ask first before she came in with the student so it wouldn't be awkward.

 Yes, at a teaching hospital you risk getting a resident or something.  But they are supposed to ask or at least inform you that they are a student.  When I was nursing we never did anything without asking if a student could be in there.  And I did work at one teaching hospital.  We still asked.



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