To diagnose ovarian disorders, which of the following diagnostic ...

[erika]

To diagnose ovarian disorders, which of the following diagnostic studies is most helpful?
 
  A. Transvaginal ultrasound
  B. Pelvic CT scan
  C. Pelvic MRI scan
  D. Pap smear

Question 2

Your patient is a 63-year-old postmenopausal female with complaints of bloating, left lower quadrant abdominal pain, and feeling of abdominal fullness.
 
  On physical examination, the abdomen is non-tender with shifting dullness and there are enlarged left sided inguinal lymph nodes. Pelvic examination reveals slight adnexal tenderness. The clinician should have a high index of suspicion of:
  A. Endometriosis
  B. Ovarian cancer
  C. Uterine cancer
  D. Ovarian cyst

[Zebsrer]

Answer to Question 1

ANS: A
Pelvic examination has been shown to have a low sensitivity and specificity for ovarian cancer, with many tumors smaller than 10 cm being missed. Several diagnostic studies are useful for detecting ovarian cancer. The CA-125 blood test by immunoassay is used as a tumor marker for treatment decisions but can also be used as a diagnostic tool. False-positive elevations in CA-125 do occur with endometriosis and pelvic surgeries; therefore, tests should be interpreted with caution and followed up with transvaginal ultrasound. Transvaginal ultrasound will show a solid, irregular mass that may be adhered to adjoining structures. A Pap smear may contain malignant cells. X-rays may show metastatic lung or bone lesions. Transvaginal ultrasound will give the best information for differentiating a blood- or fluid-filled ovarian cyst from a solid mass.

Answer to Question 2

ANS: B
In the postmenopausal female, early symptoms of ovarian cancer are vague and include mild lower abdominal discomfort, feelings of fullness, bloating, distension, nausea, dyspepsia, constipation, and urinary frequency if the tumor is large. The CA-125 blood test by immunoassay can be used as a diagnostic tool. The characteristics typical of a malignant ovarian mass include solid, fixed, nodular, non-tender, and bilateral. The abdominal examination is essential looking for distension, changes in percussion, or ascites. As the cancer metastasizes, lymphadenopathy occurs, especially in the inguinal and supraclavicular areas.

[erika]

Gracias!

[xiazhe]

Excellent