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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?

A
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
Q

cervical cancer symptoms

A

post coital bleeding, painless ulcerative lesions , pain less lymphadenopathy.

26
Q

T/F Endometriosis increases risk for endometrial cancer

A

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
Q

diagnosis?

A

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
Q

endometrial polyp

A

localized hyper plastic growth of endometrial gland

  • intermenstrual bleeding
29
Q

uterine leiomyomata

A

proliferation of myometrial smooth muscle

  • heavy regular menses, large irregular shaped uterus
30
Q

uterine artery embolization, after procedure symptoms

A
  • 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
Q

who do you screen for ovarian cancer and how?

A

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
Q

hydantidiform mole symptoms

A
  • 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
Q

when do you get an endometrial biopsy?

A

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
Q

type II osteogenesis imperfecta

A

autosomal bone disorder due to faulty type 1 collagen sysntehsis causes decreased bone density and fragility

35
Q

in utero DES exposure is a risk factor for

A

clear cell adenocarcinoma (type of vaginal cancer)

36
Q

vaginal cancer risk factors

A
37
Q

Risk factors for endometrial cancer

A

-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
Q

Risk factors for endometrial cancer

A

-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
Q

Risk factors for endometrial cancer

A

-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
Q

risk factor for ovarian cancer

A
  • 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
Q

pruritic, ulcerated lesion on the labia majora with lymphadenopathy is most likely

A

vulvar carcinoma

40
Q

Choriocarcinoma

A

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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