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Repro > 02a: Gyn Malignancies > Flashcards

02a: Gyn Malignancies Flashcards

1
Q

Most common gyn cancer:

A

Endometrial cancer

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2
Q

1 “killer” of the gyn cancers

A

Ovarian

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3
Q

Type (X) endometrial cancer is more common (80%), with risk factors reflecting (excess/deficiency) of (Y).

A

X = I (endometrioid)
Excess
Y = estrogen (endometrial hyperplasia)

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4
Q

Post-menopausal woman presenting with bleeding is (X) diagnosis until proven otherwise.

A

X = endometrial cancer

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5
Q

Which two key risk factors/diseases put women at about 3x relative risk of endometrial cancer?

A
  1. PCOS/chronic anovulation

2. Obesity (2-4x)

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6
Q

List 3 risk factors in patient’s Hx that put women at 2x relative risk for endometrial cancer

A
  1. Nullparity
  2. Late menopause
  3. DM (II esp; linked to obesity)
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7
Q

Which drug can be given to decrease risk for endometrial cancer?

A

Progesterone

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8
Q

Type (X) endometrial cancer is less common (20%), with which risk factors?

A

X = II

  1. Multiparity
  2. Advanced age
  3. Black race
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9
Q

T/F: Endometrial cancer is characterized by hyperplasia of endometrium.

A

False - Type I is, but Type II arises from atrophic endometrium

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10
Q

Diagnosis of Type II endometrial cancer by:

A

Tissue pathology (histo)

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11
Q

Endometrial echo for abnormal bleeding: endometrial thickness (greater/less) than (X) mm is reassuring, because it suggests (Y) changes.

A

Less
X = 5
Y = atrophic (lining not thickened)

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12
Q

(X)% of endometrial cancers diagnosed at Stage I

A

X = 70

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13
Q

Women over age (X) with abnormal vaginal bleeding should be evaluated for endometrial hyperplasia/cancer.

A

X = 40

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14
Q

35 year old woman with abnormal uterine bleeding. Which finding(s) in her Hx would prompt you to test for endometrial hyperplasia/cancer?

A
  1. Morbid obesity
  2. Unopposed hormonal estrogen Rx
  3. HNPCC
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15
Q

T/F: Mean age of epithelial ovarian cancer is 70 y.o.

A

False - mid-50s

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16
Q

Most epithelial ovarian cancers present with (X) symptoms in early stages.

A

X = no

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17
Q

RFs for epithelial ovarian cancers:

A
  1. FHx (BRCA1/2)
  2. Nullgravity
  3. Infertility
  4. Early menarche/late menopause
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18
Q

Epithelial Ovarian Cancer has been shown to maybe start in which structure?

A

Fallopian tubes

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19
Q

List the 3 key factors that decrease risk for Epithelial Ovarian Cancer

A
  1. Bilateral Salpingectomy
  2. OCP use
  3. Tubal ligation
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20
Q

Rx for Epithelial Ovarian Cancer

A

Surgery and followup chemo

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21
Q

T/F: High parity is a RF for cervical cancer

A

True

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22
Q

Smoking is RF for (X) type of cervical cancer

A

X = squamous cell

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23
Q

Which part of HPV genome is oncogenic?

A

E6-E7

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24
Q

Non-sexual routes for HPV transmission

A
  1. Mother to newborn (rare)

2. Fomites (exam gloves, undergarments…? Maybe..)

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25
Q

T/F: 80% of HPV infections are transient in young women.

A

True - median duration is 8 months

26
Q

Abnormal pap smear is followed up with:

A

Colposcopy (inspect cervix/vagina)

27
Q

Coposcopy: (X) is applied and abnormal areas turn (Y) color.

A 
X = acetic acid
Y = white
28
Q

Surgical Rx of High Squamous Intraepithelial Lesion (HSIL) of cervix typically involves:

A

Removing entire transition zone

29
Q

9-valent HPV vaccine protects against which strains?

A

6, 11 (warts), 16, 18 (cancer), 31, 33, 45, 52, 58

30
Q

Bivalent HPV vaccine protects against which strains?

A

16, 18

31
Q

Most commonly reported STD in US

A

Chlamydia

32
Q

Condyloma lata are indicative of:

A

Secondary syphilis

33
Q

List the two types of Condyloma

A
  1. Condyloma lata

2. Condyloma accuminata

34
Q

Condyloma accuminata indicative of:

A

HPV infection

35
Q

Condyloma (lata/accuminata) are wart-like and (X) colored.

A

Accuminata

X = skin

36
Q

Condyloma (lata/accuminata) are flat-topped (macules/papules/patches). They’re “velvety” and (X) colored

A

Lata
Papules
X = white-ish

37
Q

(X) imaging modality is good for intramural uterine and ovarian lesions

A

X = US

38
Q

Sonohysterogram is imaging modality similar to (X) but using (Y) injection

A 
X = US
Y = saline (to distend uterus)
39
Q

(X) imaging modality is best for tubal patency

A

X = hysterosalpingogram (X-ray with intrauterine contrast injection)

40
Q

(MRI/CT) is more commonly used/preferred for gyn purposes.

A

MRI

41
Q

Perihepatic adhesions after pelvic inflammatory disease:

A

Fitz-Hugh-Curtis Syndrome

42
Q

Endometriosis refers to:

A

Presence of endometrial glands/stroma outside endometrial cavity

43
Q

List some postulated theories of endometriosis pathogenesis

A
  1. Retrograde menstruation
  2. Coelomic metaplasia
  3. Dissemination (via vessels/lymph)
  4. Altered immunity
  5. Over-expression of ER-beta (suppressing progesterone R levels)
44
Q

Endometriosis is associated with (continuous/an-) ovulation

A

Continuous (incessant; like ovarian, not endometrial, cancer)

45
Q

Endometriosis: (increased/decreased) risk with multiparity.

A

Decreased

46
Q

Endometriosis: RF for (X) cancer

A

X = ovarian

47
Q

T/F: Fibroids, like endometriosis, are estrogen-dependent

A

True - shrink at menopause

48
Q

T/F: Fibroids have no familial predisposition.

A

False

49
Q

Clinical findings of uterine fibroids

A

Menorrhagia, pelvic pressure/pain, reproductive dysfunction

50
Q

Submucosal fibroids are best diagnosed by which exam/modality?

A

Hysterosalpingogram or sonoysterogram (dye/saline injected into uterus, so helps see submucosal fibroid projecting into cavity)

51
Q

Uterine fibroid Rx:

A
  1. Surg (myomectomy or hysterectomy)

2. Uterine a embolization (causing fibroid infarction/size reduction)

52
Q

Pt with uterine fibroids is getting prepped for surgery, but is experiencing heavy bleeding. How can you control the bleeding temporarily prior to procedure?

A

GnRH analogs (limited long-term efficacy though; rebound fibroids)

53
Q

List some scenarios in which uterine fibroid embolization should be avoided

A
  1. Pedunculated/submucosal or very large fibroids
  2. Extensive adenomyosis
  3. Patients that want future pregnancy
54
Q

Adenomyosis is:

A

Endometrial glands/stroma present within uterine muscle

55
Q

Best imaging modality to inspect adenomyosis:

A

MRI

56
Q

Adenomyosis is more common in (multi/nulli)-parous women.

A

Multiparous (and those with prior uterine surgery)

57
Q

Adenomyosis Rx of choice:

A

Hysterectomy

58
Q

Surg for adenomyosis can be delayed with which meds?

A
  1. Progestins (Mirena, IUD)
  2. GnRH analogs
  3. Aromatase inhibitors
59
Q

Uterine Synechiae, aka (X) syndrome, arise as a result of:

A

X = Asherman

Uterine surg or curettage removes deep endometrial layers and destroys basal crypts/glands required for endometrial regeneration

60
Q

Asherman syndrome clinical findings:

A
  1. Amenorrhea or hypomenorrhea
  2. Infertility/recurrent fetal loss
  3. Cyclic pelvic pain
61
Q

Asherman syndrome best diagnosed by:

A

Hysterosalpingography, sonohysterography, hysteroscopy

62
Q

Rx for Asherman syndrome:

A

Hysteroscopic resection

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