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OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is dermoid ovarian cyst (mature cystic teratoma). While this may seem a odd practice, it is useful to see multiple examples of how dermoid ovarian cyst (mature cystic teratoma) will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)
When it comes to standardized exams, each topic has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for teratoma.
- Ultrasound findings:
- Ovarian cystic structure
- Histological findings:
- Teeth
- Hair
QUESTION EXAMPLES
Question # 1
A 18 year old nulliparous girl comes to the clinic with complaints of right adnexal fullness. her last menstrual period was 3 weeks ago. Menses occur every 32 days, and last about 5 days with 2 days of moderate flow. She is sexually active with a new partner, and they use condoms for contraception. She used to take oral contraceptives, but stopped 4 months ago because they gave her severe headaches. She has no remarkable past medical history, and has had no surgeries in the past. She does not use tobacco products, alcohol, or any illicit drugs. She receives an ultrasound that shows a 8-cm left ovarian cyst that has calcifications and hyperechoic nodules.
Explanation # 1
Ovarian cystic structure + areas of calcifications/hyperechoic nodules = teratoma
Question # 2
A 25 year old woman, G1P1, comes to the clinic with complaints of right lower quadrant pain. She has been experiencing the pain for the past few months, and taking ibuprofen has not helped. She comments that the pain is worsened with physical activity. Her menses are regular (occur every 28 days, last for 5 days). She has a history of gonorrhea cervicitis that occurred when she was an adolescent. Two years ago she was treated for an ectopic pregnancy. She has a family history notable for a maternal grandmother who died of ovarian cancer at the age of 69. A pelvic ultrasound is conducted, and shows a 4-cm ovarian mass. During laparoscopic cystectomy the cyst is ruptured, and a dense yellow fluid is noted. There is also the presence of hair, as well as a solid, calcified, and irregularly shaped object. What is the likely diagnosis?
Explanation # 2
Ovarian cystic structure + presence of hair and calcified materials in the cyst = teratoma
Question # 3
A 26 year old woman comes to the clinic because she has been experiencing right sided pelvic pain for the last month. She has been monogamous with 1 partner for the past 3 years, and they use condoms for contraception. Her last menstrual period was 2 weeks ago. Her vital signs are within normal limits. A physical examination reveals the presence of a 11 cm, mobile right adnexal mass. Her serum CA-125 concentration is 30 U/mL (normal is < 35 U/mL). Serum beta-hCG test is negative. An abdominal X-ray shows calcium deposits in the mass. What is the most likely diagnosis?
Explanation # 3
Question # 4
Explanation # 4
TESTABLE FACTS ABOUT THIS TOPIC (BEYOND ITS IDENTIFICATION)
Many questions on standardized exams go beyond simply recognizing the underlying topic. Often there are specific testable facts regarding some aspect of the topic’s pathophysiology/management/clinical implications that are commonly asked. Some of these are listed below:
Page Updated: 10.15.2016