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OB Gyn Shelf > Cancers > Flashcards

Cancers Flashcards

1
Q

Cervical Cancer Stage 3

3a, 3b,
3c1, 3c2

A

Extended to the pelvic sidewall, involves lower 1/3 of vagina, hydronephrosis or nonfunctioning kidney

3a: extends to lower 1/3 of vagina

3b extends to side wall or hydronephrosis/nonfunctioning kidney

3c: involves lymph nodes
C1: pelvic lymph nodes
c2 para-aortic lymph nodes

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2
Q

Cervical Cancer stage 1

1a1, 1a2
1B1, b2, b3

A

confined to the cervix
1a can only see lesions with microscope
1a1 stroma < 3mm in depth
1a2 stroma 3-5 mm in depth

1b: visible
1b1<2cm
1b2: 2-4cm
1b3: > 4cm

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3
Q

Cervical Cancer Stage 2 is located

2a1, 2a2, 2b

A

extends beyond uterus to upper 2/3 of vagina, but not to the pelvic sidewall

2a: no parametrium involvement
A1 </= 4cm
a2 >4cm

2b involves the parametrium

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4
Q

Cervical Cancer Stage 4

4a, 4b

A

4a: spread to pelvic organs ( bladder, rectum)

4b: distant organs, outside pelvis

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5
Q

Atypical squamous cells of undetermined significance

A
  1. HPV testing
    -positive: 25 yo or older colposcopy; 21-24 Pap test
    -negative: routine screening
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6
Q

CIN2 that is
p16 positive is LSIL or HSIL?

A

HSIL high grade squamous intraepithelial lesion
16 year olds like to get high - so p16- high grade

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7
Q

CIN2 that is
p16 positive is LSIL or HSIL?

A

HSIL high grade squamous intraepithelial lesion
16 year olds like to get high - so p16- high grade

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8
Q

Pap with high grade squamous intraepithelial lesion (HSIL) next step

A

Colposcopy and biopsy

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9
Q

ovarian cyst with calcifications and hyper echoic nodules is most likely? Treatment ?

A

ovarian cystectomy( remove cyst), oophorectomy ( remove ovary)

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10
Q

TVU with endometrial stripe > 5mm suggests

A

endometrial cancer ( think stripe no cancer)

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11
Q

risk factors for cervical cancer

A

SITO + 4 Sex RF
low Socioeconomic status
Immunosuppression
Tobacco Use
OCP

  • Sex: infxn with HPV, STD history, early onset of sex, multiple or high0risk partners
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12
Q

PT who is experiences bloating, pain with the following US findings most likely has?
- thick separations, solid components, and moderate amount of peritoneal fluid

A
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13
Q

What do you do after D&C of hydatidiform mole?

A

-monitor Hcg and place on contraceptions during the monitoring period

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14
Q

Endometrial cancer symptoms

A

abnormal bleeding in the setting of risk factors like obesity

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15
Q

Treatment of hydatiform mole pregnancy

A
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16
Q

PAP smear requirement

A

> 21 yo, every 3 years
30 yo or older PAP + HPV cotest every 5 years or pap eery 3 years

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17
Q

Adenomyosis symptoms and cause

A

Ectopic endometrial tissue grows into the myometrium

  • symmetrically enlarged, globular, boggy uterus dues to hypertrophy of myometrium
  • can cause abnormal uterine bleeding, dysmenorrhea
18
Q

Endometriosis vs adenomyosis

A

Adenomyosis ( A for aged)
- older, multiparous women ( but not post-menopausal)
- tissue is not as responsive to hormonal stimulation ,noncyclic pain ( old people stuck in their ways noncyclic)

Endometriosis (E for estrogen)
- young nulliparous women
-tissue responds to hormonal stimulation
-cyclic pain ( young like change so cyclic)

19
Q

chocolate cyst in the ovary is

A

ovarian endometrioma
endometrial tissue in ovary

tender, palpable, freely mobile adnexal mass
on US appears as homogenous ovarian cyst with ground glass appearance

20
Q

Endometriosis
Symptoms

A

Tissue grows outside uterus

Can be symptomatic 3D’s
Dysmenorrhea ( pain with menses), dyspareunia ( pain with sex), dyschezia ( pain with shitting)

  • infertility, ovarian mass, cyclic bowel or bladder symptoms
  • classic exam findings, immobile uterus, uterosacral ligament thickening, posterior fornix tenderness
21
Q

Endometriosis Treatment

A

Treatment: GNC AD

-GnRh agonist
-NSAID
-Contraceptive : combined, progestin

-aromatase inhibitor ie Letrozole (used in combo with progestin x refractory pain)
-Danazol (androgen derivative that suppresses FSH/LH, not commonly used due to androgenic ADR)

Surgery
-Conservative/ preserve reproductive potential: laparascopic lysis, ablation, excision of adhesions and endometriosis implants
-Definitive: hysterectomy +/- bilateral sapling-oophorectomy ( refractory cases when child bearing is complete)

22
Q

adenomyosis treatment

A

Treatment: (GNC)
-GnRh agonist
- NSAIDS
-contraceptives: combined or progestin

Surgery : hysterectomy or excision of adenomyoma

23
Q

unifocal, erythematous, highly friable plaque on labium majus
is most likely? risk factors?

24
Q

purple-hued plaques that are sometimes associated with thin, white striae around the labia and vulva

A

vulvar lichen planus

6 P’s of planus include: pruritic, purple papules , polygonal, planar, plaques

25
cervical cancer symptoms
post coital bleeding, painless ulcerative lesions , pain less lymphadenopathy.
26
T/F Endometriosis increases risk for endometrial cancer
False since endometriosis is gland proliferation outside the uterus - instead increases risk for infertility due to intraperitoneal inflammation and fibrosis, increasing risk for ovarian cancer
27
diagnosis?
5 alpha reductase dificiency, due to inability to create DHT, external male genitalia is not formed, so internally male, externally female, no breasts diagnosis: elevated testosterone/DHT ratio
28
endometrial polyp
localized hyper plastic growth of endometrial gland - intermenstrual bleeding
29
uterine leiomyomata
proliferation of myometrial smooth muscle - heavy regular menses, large irregular shaped uterus
30
uterine artery embolization, after procedure symptoms
- pain in first 24 hours: fever, nausea, malaise - weeks to months following embolization, patients experience watery, blood-tinged vaginal discharge due to on-going tissue sloughing - wet mount positive for leukocyctes = normal finding
31
who do you screen for ovarian cancer and how?
Genetic screening in those with FH ( 2 or more 1rst degree relatives with breast or ovarian cancer, 3 or more relatives with lynch syndrome-associated cancer) Breast Cancer, Ashkenazi Jew ancestry
32
hydantidiform mole symptoms
- first trimester bleeding, abdominal pain, uterine size greater than expected, hyperemesis gravidarum, no fetal heart tones - inc b Hcg an also stimulate thyroid to secrete thyroid hormone, causing palpitations and jittery feeling
33
when do you get an endometrial biopsy?
45yo and older: AUB, postmenopausal bleeding younger then 45: AUB + 1 of following unopposed estrogen / resistant to medications ( COC) / lynch syndrome 35 and older, atypical glandular cells on pap
34
type II osteogenesis imperfecta
autosomal bone disorder due to faulty type 1 collagen sysntehsis causes decreased bone density and fragility
35
in utero DES exposure is a risk factor for
clear cell adenocarcinoma (type of vaginal cancer)
36
vaginal cancer risk factors
37
Risk factors for endometrial cancer
-chronic state of unopposed exposure to estrogen that can result from anovulation - ie PCOS, nulliparity, unopposed estrogen therapy, history of breast cancer, tamoxifen treatment, lynch syndrome protective effect: high progestin, lowe estrogen
37
Risk factors for endometrial cancer
-chronic state of unopposed exposure to estrogen that can result from anovulation - ie PCOS, nulliparity, unopposed estrogen therapy, history of breast cancer, tamoxifen treatment, lynch syndrome protective effect: high progestin, lowe estrogen
37
Risk factors for endometrial cancer
-chronic state of unopposed exposure to estrogen that can result from anovulation - ie PCOS, nulliparity, unopposed estrogen txm tamoxifen - history of breast cancer, lynch syndrome protective effect: high progestin, low estrogen state - ie multiparity, COC, soy, exercise
38
risk factor for ovarian cancer
- BRCA 1/BRCA 2 mutation -HNPCC sundrome -Peutx Jegher syndrome - elevated number of ovulations: infertility/low number of pregnancies, early menses/ late menopause, endometriosis
39
pruritic, ulcerated lesion on the labia majora with lymphadenopathy is most likely
vulvar carcinoma
40
Choriocarcinoma
malignant neoplasm of trophoblastic tissue that can develop after pregnancy that can metastasize to the lung, vagina, brain, and liver --markedly increased B-HcG concentration, potential neurological symptoms, dyspnea

OB Gyn Shelf (15 decks)

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