Ovarian Cysts: The Daily PANCE Blueprint

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Ovarian Cysts: The Daily PANCE Blueprint

A 22-year-old presents to the clinic for a routine exam. On physical exam, you palpate a smooth, mobile, left adnexal mass. You order a pelvic ultrasound which demonstrates a single, round, 3-cm, anechoic (fluid-filled) cyst in the left ovary. It has a smooth, thin wall, no solid components or septations, and no internal blood flow. What is the next best step?

A. MRI of abdomen/pelvis
B. Initiate IV antibiotics
C. Order birth control pills
D. Exploratory laparotomy
E. Reassurance and follow-up

Answer and topic summary

The answer is E. Reassurance and follow-up

Ovarian cysts are essentially fluid-filled sacs in the ovary. There are 2 types: functional cysts (i.e., cysts that produce hormones like follicular or theca lutein cysts) and non-functional cysts (i.e., cysts that do NOT produce hormones like dermoid or chocolate cysts). Clinical features may include lower abdominal pain and a palpable mass. 1st line diagnostic test is pelvic US. Management includes prn NSAIDs, watchful waiting, and f/u with repeating imaging. Large or persistently painful cysts are appropriate for surgical intervention.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Reproductive System ⇒ Ovarian Disorders ⇒ Ovarian Cysts

Also covered as part of the Women's Health PAEA EOR topic list

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