USMLE Step 2 CK Lecture Notes 2019: Obstetrics/Gynecology (Kaplan Test Prep)

GYN TRIAD

Functional  Ovarian Cyst

In  the reproductive    age years,  the most    common cause    of  a   simple  cystic

mass    is  a   physiologic cyst    (luteal or  follicular  cyst).  During  those   years   the

ovaries are functionally    active, producing   a   dominant    follicle    (in the first

half    of  the cycle)  and a   corpus  luteum  after   ovulation   (in the second  half    of

the menstrual   cycle). Either  of  these   structures  can become  fluid-filled    and

enlarged,   producing   a   functional  cyst.

Differential Diagnosis.

Diagnosis.

Pelvic  mass    in  reproductive    years

β-hCG   (–)

Sonogram:   fluid-filled    ovarian simple  cyst

Pregnancy:  most    common cause    of  a   pelvic  mass    in  the reproductive    years

Complex mass:   most    common  complex adnexal mass    in  young   women   is  a

dermoid cyst    or  benign  cystic  teratoma;   other   diagnoses   include

endometrioma,   tubo-ovarian    abscess,    and ovarian cancer

Qualitative β-human chorionic   gonadotropin    (β-hCG) test.   If  negative,

this    will    rule    out pregnancy.

Sonogram.   A   complex mass    on  ultrasound  appearance  is  incompatible    with    a

functional  cyst.