Carcinoma of Uterus and Ovaries - Tieman Flashcards

1
Q

leiomyoma regression

A

stimulated by estrogen

-so post-menopausal women - regresses

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2
Q

ovary gonadostromal tumor

A

produce estrogen

-so get endometrial hyperplasia**

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3
Q

most common female genital tract malignancy

A

uterine carcinoma

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4
Q

abnormal vaginal bleeding in perimenopausal/postmenopausal women

A

uterine carcinoma

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5
Q

risk fx for uterine carcinoma

A
obesity
unopposed estrogen stimulation - permarin
tamixifen
nulliparity
diabetes
late menopause
PCOS
lynch syndrome
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6
Q

ovarian carcinoma

A

most LETHAL

because presents late

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7
Q

obesity

A

increased estrogen - fat cells secrete androstenedione - converted to estrogen

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8
Q

decreased risk of uterine carcinoma

A
ovulation
progestin therapy
combo BCPs**
eraly menopause
multiparity
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9
Q

complex atypical hyperplasia

A

not cancer - but 8x increased risk

recommend TAH-BSO

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10
Q

endometrial carcinoma staging

A

done surgically**

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11
Q

stage 1a endometrial carcinoma

A

confined to endometrium

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12
Q

stage 1b endometrial carcinoma

A

invasion to <1/2 myometrium

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13
Q

stage 1c endometrial carcinoma

A

invasion to >1/2 myometrium

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14
Q

stage 2 endometrial carcinoma

A

invades endocervical canal

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15
Q

stage 3 endometrial carcinoma

A

tumor in peritoneum, vagina, nodes

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16
Q

stage 4 endometrial carcinoma

A

distant mets

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17
Q

evaluation of abnormal vaginal bleeding

A

pelvic exam/pap smear
endometrial sampling
transvaginal U/S
fractional D and C

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18
Q

endometrial stripe

A

should be <5mm

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19
Q

favorable histo of endometrial carcinoma

A

endometroid

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20
Q

grade

A

differentation

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21
Q

lymph drainage of endometrial cancer

A

iliac/para-aortic nodes

22
Q

stage 1, grade 1 and 2 endometrial cancer

A

TAH-BSO
peritoneal washings
removal enlarged nodes

23
Q

stage 1c or 2, grade 3 endometrial cancer

A

TAH-BSO
cytology
iliac/paraaortic node dissection - with radiation

24
Q

stage 3 and 4 endometrial cancer

A

surgical debulking
radiation
chemotherapy

remove everything that looks bad - to make chemo/rad work better

25
Q

fractional D and C

A

to see if cancer to endocervical canal

stage 1 vs. 2

26
Q

increased risk of ovarian carcinoma

A
white
nulliparity/infertile
late childbearing
late menopause
fam hx
BRCA**
27
Q

decresed risk of ovarian carcinoma

A

ovulation interrupted

oral contraceptives
multiparity
breast feeding
tubal ligation
hysterectomy
28
Q

most lethal cancer female genital tract

A

ovarian

due to late stage of disease at diagnosis

increasing girth, pelvic fullness, pelvic discomfort

most patient - stage 3 or 4 age 50-70yo

29
Q

ovarian cancer screening

A

non proven to be effective

30
Q

beta-HCG

A

choriocarcinoma

31
Q

AFP

A

dermoid ovarian cancer

32
Q

CA125 and 19-9

A

epithelial derived

33
Q

most ovarian cancers

A

majority serous epithelium

B9 and low grade - not removed - young women who still want children

34
Q

ovarian cancer spread

A

internal iliac, common iliac, paraaortic nodes

35
Q

germ cell tumors

A

dysgerminomas and teratomas

36
Q

granulosa thecal cell tumor

A

secrete E/PR

37
Q

sertoli-leydig cell tumor

A

secrete androgens

38
Q

ovarian cancer staging

A

done surgically

39
Q

stage 1 ovarian cancer

A

confined to ovary

40
Q

stage 2 ovarian cancer

A

tumor spread confined to pelvis

41
Q

stage 3 ovarian cancer

A

confined to abdominal peritoneal surfaces or retroperitoneal nodes

42
Q

stage 4 ovarian cancer

A

distant mets

43
Q

optimal cytorecuduction

A

get rid of every part of tumor

44
Q

ovarian cancer treatment

A

radiation or platinum based chemotherapy dependent upon stage, histology, and grade of tumor

45
Q

stage 1 low grade ovarian cancer tx

A

no further tx

46
Q

stage 1 high grade ovarian cancer tx

A

platinum based chemo - paclitaxel

47
Q

germ cell tumor of ovary tx

A

platinum based chemo, blemycin, etoposide

48
Q

gonadal-stromal tumors of ovary

A

relatively chemoresistant

49
Q

most important aspect of tx for long term prognosis of ovarian cancer

A

excision of any visible tumor

50
Q

bowel prep

A

mandatory for ovarian ca surgery

bc may be location of spread - and may need to take it