Ovary and Thyroid Pathology! - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 01-21-2012
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 333
Threads: 162
Thanked 282 Times in 146 Posts
Reputation: 292
Thyroid Ovary and Thyroid Pathology!

A 48-year-old woman was seen by her gynecologist for mild pelvic pain of insidious onset. Her medical history revealed that she was diagnosed with thyromegaly after the birth of her first child approximately 18 years before. She had been on thyroid hormone therapy for two years until the birth of her second child. Physical examination her thyroid revealed that the gland was minimally enlarged, firm, and had a bosselated texture consistent with Hashimoto’s thyroiditis. Preoperative laboratory testing revealed that her serum thyroid stimulating hormone level was 5.73 uIU/mL (0.35-to-5.5 uIU/mL) with referance-range T4 and T3 levels. Pelvic ultrasound showed a complex right ovarian mass. She subsequently underwent a laparoscopic right salpingo-ophorectomy. Immediately after the surgery, the patient’s serum TSH was 3.33 uIU/mL Histological examination of the ovary mass is shown below. What is the most likely diagnosis?
A) Dermoid cyst
B) Struma ovarii
C) Immature teratoma
D) Endodermal sinus tumor
E) Clear cell carcinoma
F) Primary hyperparathyroidism
G) Endometrioid tumor

Ovary and Thyroid Pathology!-struma-ovary.jpg
click image to enlarge

Reply With Quote Quick reply to this message
The above post was thanked by:
Abdulaziz (01-22-2012), CraCIT (01-21-2012), Doctor Ali (02-14-2013), neha_subh (02-14-2013)



  #2  
Old 01-21-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 646
Threads: 52
Thanked 761 Times in 256 Posts
Reputation: 772
Default

this is a TERATOMA>..
you can clearly make out the different cell types under the microscopic picture


so the answer is DERMOID CYST/ Immature teratoma..

Dermoid cyst is more common in females... but it is a benign condition and requires only oophorectomy..

but to hv the fallopian tubes and the ovaries all removed.. must be a malignant condition.. so i wud think IMMATURE TERATOMA


struma ovarii ( i found this answer confusing me at first) causes HYPERTHYROIDISM... in which case the T3 and T4 levels wud be raised. and it wud not present as a Hypothyroidism case.. with raised TSH

http://faculty.cs.tamu.edu/chen/papers/jing2.pdf
http://www.thyroidmanager.org/Chapter13/chapter13.htm

Last edited by mbbs2010; 01-21-2012 at 05:16 PM.
Reply With Quote Quick reply to this message
The above post was thanked by:
Evergreen (01-21-2012)
  #3  
Old 01-21-2012
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 333
Threads: 162
Thanked 282 Times in 146 Posts
Reputation: 292
Default

Quote:
Originally Posted by mbbs2010 View Post
this is a TERATOMA>..
you can clearly make out the different cell types under the microscopic picture


so the answer is DERMOID CYST/ Immature teratoma..

Dermoid cyst is more common in females... but it is a benign condition and requires only oophorectomy..

but to hv the fallopian tubes and the ovaries all removed.. must be a malignant condition.. so i wud think IMMATURE TERATOMA


struma ovarii ( i found this answer confusing me at first) causes HYPERTHYROIDISM... in which case the T3 and T4 levels wud be raised. and it wud not present as a Hypothyroidism case.. with raised TSH

http://faculty.cs.tamu.edu/chen/papers/jing2.pdf
http://www.thyroidmanager.org/Chapter13/chapter13.htm
Your discussion is good but your answer is wrong. This case has evidence of autoimmune thyroiditis. However, please not the pathological findings in ovary especially at the left side of the slide.
http://www.thyroidscience.com/cases/...am.10.6.10.htm
Reply With Quote Quick reply to this message
 
  #4  
Old 01-21-2012
Hitman's Avatar
USMLE Forums Master
 
Steps History: Not yet
Posts: 928
Threads: 17
Thanked 539 Times in 375 Posts
Reputation: 549
Default

Ans ..B it is still Struma ovarii becoz it is related to Hashimoto’s thyroiditis and can cause Hypothroidism by secreting Thyroxine .......

reference :

http://www.ncbi.nlm.nih.gov/pubmed/21780949

http://www.thyroidscience.com/cases/...m.10.13.10.pdf


Reply With Quote Quick reply to this message
The above post was thanked by:
CraCIT (01-21-2012)
  #5  
Old 01-21-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 646
Threads: 52
Thanked 761 Times in 256 Posts
Reputation: 772
Default

doesnt struma ovarii cause HYPERTHYROIDISM?? in this patient TSH levels are increased.. if the ovary is secreting T3 and T4 shudnt TSH be LOW??/
Reply With Quote Quick reply to this message
The above post was thanked by:
CraCIT (01-21-2012)
  #6  
Old 01-21-2012
Hitman's Avatar
USMLE Forums Master
 
Steps History: Not yet
Posts: 928
Threads: 17
Thanked 539 Times in 375 Posts
Reputation: 549
Default

yes it does , but in this case i feel its trying to teach us that struma ovarii related to hashimoto leads to hypothroidism which gets corrected after Sx ...

i think usmle keeps it pretty simple , it just wants us to know that and ovarian problem related to thyriod dysfunction is struma ovarii ... there is no hard and fast rule in medicine , rare and unpredictable symptoms can occur but if you answer from basics it will most often be correct ...
Reply With Quote Quick reply to this message
The above post was thanked by:
Abdulaziz (01-22-2012), CraCIT (01-21-2012), hassansiraj (01-21-2012)
  #7  
Old 01-22-2012
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 646
Threads: 52
Thanked 761 Times in 256 Posts
Reputation: 772
Default

Quote:
Originally Posted by Hitman View Post
yes it does , but in this case i feel its trying to teach us that struma ovarii related to hashimoto leads to hypothroidism which gets corrected after Sx ...

i think usmle keeps it pretty simple , it just wants us to know that and ovarian problem related to thyriod dysfunction is struma ovarii ... there is no hard and fast rule in medicine , rare and unpredictable symptoms can occur but if you answer from basics it will most often be correct ...


yup ur right

check this out
http://www.thyroidscience.com/
Reply With Quote Quick reply to this message
The above post was thanked by:
Hitman (01-22-2012)
  #8  
Old 02-14-2013
USMLE Forums Addict
 
Steps History: 1+CK+CS+3
Posts: 109
Threads: 29
Thanked 20 Times in 13 Posts
Reputation: 30
Default answer

u can find the answer of this qtn in the slide b/c its already written in slide...sturma ovarii...
Reply With Quote Quick reply to this message
  #9  
Old 02-14-2013
neha_subh's Avatar
USMLE Forums Veteran
 
Steps History: 1 + CS
Posts: 209
Threads: 18
Thanked 112 Times in 75 Posts
Reputation: 122
Default

A 48-year-old woman was seen by her gynecologist for mild pelvic pain of insidious onset. Her medical history revealed that she was diagnosed with thyromegaly after the birth of her first child approximately 18 years before. She had been on thyroid hormone therapy for two years until the birth of her second child. Physical examination her thyroid revealed that the gland was minimally enlarged, firm, and had a bosselated texture consistent with Hashimoto’s thyroiditis. Preoperative laboratory testing revealed that her serum TSH level was 5.73 uIU/mL (0.35-to-5.5 uIU/mL) with referance-range T4 and T3 levels. Pelvic ultrasound showed a complex right ovarian mass. She subsequently underwent a laparoscopic right salpingo-ophorectomy. Immediately after the surgery, the patient’s serum TSH was 3.33 uIU/mL Histological examination of the ovary mass is shown below. What is the most likely diagnosis?

B) Struma ovarii


[/FONT]Attachment 2286
click image to enlarge

__________________
lets kick some doors open and help each other to reach our destinies
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
The above post was thanked by:
Doctor Ali (02-14-2013)
  #10  
Old 02-14-2013
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 283
Threads: 35
Thanked 206 Times in 115 Posts
Reputation: 216
Default

When ever you enconter thyroid problem and see answer choices relating to reproductive ovaries, just pick Stroma Ovarii as an answer. What else is related to thyroid problems in reproductive ovaries besides stroma ovarii? None. That's the only one.
Reply With Quote Quick reply to this message



Reply

Tags
Endocrine-, Pathology-, Reproductive-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Polycystic Ovary Syndrome Endocrinology! USMLE123 USMLE Step 1 Forum 11 06-17-2016 09:28 AM
Ovary with mucinous signet cells! Evergreen USMLE Step 1 Forum 15 11-09-2011 05:01 AM
resistant ovary syndrome aghammoud85 USMLE Step 2 CK Forum 1 08-11-2011 01:02 PM
Non-palpable ovary healer2b USMLE Step 2 CK Forum 1 03-23-2011 05:21 AM
Non-palpable ovary healer2b USMLE Step 2 CK Forum 4 03-19-2011 10:19 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)