Ovarian Cysts: The Daily PANCE Blueprint

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Ovarian Cysts: The Daily PANCE Blueprint

A 28-year-old female presents to the ER with intermittent lower abdominal pain. On exam, a mobile, tender adnexal mass is palpated. Pelvic ultrasound reveals a 5 cm simple ovarian cyst. She is stable with no signs of rupture or torsion. Which of the following is the most appropriate next step in management?

A. Monitor with NSAIDs and repeat ultrasound in 6–8 weeks
B. Schedule immediate surgical removal
C. Begin empiric antibiotics
D. Start oral contraceptives
E. Order abdominal CT scan to evaluate further

Answer and topic summary

The answer is A. Monitor with NSAIDs and repeat ultrasound in 6–8 weeks

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 a pelvic ultrasound. Management includes PRN NSAIDs, watchful waiting, and follow-up with repeated 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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