Disorders of Ovary MCQs

HBIG is indicated for newborn infants of HBsAg-positive mothers, with initiation of the vaccine series at the same time, both within 12 hours of birth (administered at different injection sites). Infection at birth is associated with clinically silent acute infection but a 90% chance of chronic infection , whereas infection in young adulthood in immunocompetent persons is typically associated with clinically apparent acute hepatitis but a risk of chronicity of only ~1% Tenofovir is indicated in the management of chronic hepatitis B infection Reference : Harrison's Principles of internal medicine 21st ed chap 341 pg. 2592

Insulin resistance and compensatory hyperinsulinaemia is observed in about 40% of women with normal weight and 80% obese women with PCOS. Hyperinsulinemia results in decreased hepatic synthesis of SHBG and increased ovarian androgen biosynthesis. Metformin reduces weight, BMI fasting insulin levels, blood pressure and LDL cholesterol. Metformin does not cause hypoglycemia neither in normoglycaemic patients nor with diabetic individuals. Reference: Dutta Gynae 6 th /ed p 461-2, 470

There is no doubt that PCOS causes oligomenorrhea/amenorrhea, due to anovulation i.e.option a and b are correct. Pathologically - Ovaries are enlarged (2-5 times the normal size). Tunica albuginea is thickened. There is Theca cell hypertrophy (stromal hyperthecosis) and multiple follicular cysts are localized along the surface of the ovary (i.e.options 'c' is correct). Sonographic findings in case of PCOS include : ROTTERDAM CRITERIA >12 small cysts (2 to 9 mm in diameter) Increased ovarian volume (> 10 ml). Increased amount of stroma relative to the number of follicles. Only one ovary with these findings is sufficient to define PCOS. Other findings like Pearl necklace appear in which follicles are distributed underneath the capsule in a row. Reference: Shaw 15th/ed, pg 369-371

Masculinizing Tumors develop from Sex cord of Embryonic gonad and include Arrhenoblastoma/Androblastoma Hilus cell Tm Adrenal cortical Tm/Lipoid cell Tm of ovary Gynandroblastoma Reference: Shaw 15 th /ed p 380-381

The most frequently used chemotherapeutic regimens for germ cell tumors of the ovary are: BEP (Bleomycin, Etoposide, Cisplatin) EP (Etoposide, Cisplatin) EC (Etoposide, Carboplatin) These combinations are preferred due to their high efficacy and established use in clinical practice. BEP regimen details : Bleomycin : 30,000 IU on days 1, 8, and 15 every 3 weeks Etoposide : 100 mg/m2/day for 5 days every 3 weeks Cisplatin : 20 mg/m2/day for 5 days or 100 mg/m2 on day 1 every 3 weeks Explanation Of Other Options: VBP (Vinblastine, Bleomycin, Cisplatin) (Option B) & VAC (Vincristine, Actinomycin D, Cyclophosphamide) (Option C): While effective, VBP & VAC is less frequently used as first-line therapy compared to BEP and not considered a primary regimen in most guidelines. POMB-ACE (Option D): This is a complex multi-drug regimen used in refractory cases but not the most commonly used.

Answer- D (Most common side effect is diarrhea and hypotension) Celiac Plexus Block: Located retroperitoneally at the level of Ll Usually done bilaterallv Useful for the painful conditions of upper abdomen Most common side effect is diarrhea and hvpotension 89. Ovarian fossa is formed by all except? a) Obliterated umbilical artery b) Internal iliac artery c) Ureter d) Round ligament of ovary Correct Answer - D Each ovary lies in ovarian fossa on lateral pelvic wall which is bounded :?

Krukenberg tumor: Krukenberg tumor by definition represents carcinoma of stomach metastasis to ovary . But the eponym is commonly used to denote any gastric cancer metastatic to ovary Tumor arises by retrograde lymphatic spread e. carcinoma cells pass from the stomach to the superior gastric lymph node which also receives lymphatics from the ovary. Characteristics of Krukenberg Tumour: Always bilateral Have smooth surface No tendency to form adhesions Freely mobile No infiltration through the capsule. Histologically the tumour has signet ring cells in the background of myxomatous stroma. They retain the shape of a normal ovary. Have waxy consistency. Reference : Shaw 15 th /ed pg 425-6; CGDT 10 th /ed pg 877

Stromal invasion is absent. The epithelium shows multilayering, cellular atypia, pleomorphism and mitotic activity. Brenner tumour may present with the features of Meigs' syndrome and treatment prognosis is satisfactory. 20% of ovarian endometrioid carcinoma is associated with endometrial carcinoma. In postmenopausal women with unilocular cyst measuring 8–7 or less with normal several CA125 levels, expectant management is acceptable. Reference : Dutta Gynae 6 th /ed pg 384