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Women's Health exam 2 > Cervical & Uterine Disease > Flashcards

Cervical & Uterine Disease Flashcards

1
Q

screening for cervical disease age 21-29

A

cytology alone q 3 years

no HPV testing

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2
Q

screening for cervical disease age 30-65

A

HPV & cytology q 5 years

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3
Q

indications for yearly screening for cervical disease (4)

A

immunocompromised
CIN 2/3
hx cervical CA
HIV +

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4
Q

HIV+ cervical disease screenings

A

cytology 2x in the year after diagnosis

annually thereafter

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5
Q

what cytology finding is consistent w/ CIN 1

A

low-grade squamous intraepithelial lesion (LSIL)

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6
Q

LSIL + HPV –>

LSIL w/o HPV –>

A

colposcopy

repeat cotesting at 1 year

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7
Q

cytology finding consistent w/ CIN 2/3

A

high-grade squamous intraepithelial lesion (HSIL)

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8
Q

CIN 1

A

lower 1/3 of epithelium

lesions typically regress in 12 mo

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9
Q

CIN 2

A

lower 2/3 of epithelium
about 50% regress
22% progress to CIN 3
few increase to invasive cancer

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10
Q

CIN 3

A

involves > 2/3 of the epithelial thickness

up to 40% progress to invasive cancer

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11
Q

goal of colposcopy

& if not achieved?

A

complete visualization of the transformation zone

incomplete visualization –> endocervical curettage

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12
Q

high risk & low risk HPV

A

high: 16,18
low: 6, 11

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13
Q

ablative method goal & indications (3)

A

destroys TZ, no specimen collection

persistent CIN > 2 years
CIN 2,3 w/ adequate colposcopy
no suspicion for invasive or endocervical disease

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14
Q

ablative methods (2) and healing time

A

cryothrapy
laser

4-8 weeks

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15
Q

excision treatment goals & indications

A

removes entire TZ, provides a diagnostic specimen

inadequate colposcopy
high grade lesions/atypical glandular cells
CIN 2+ or recurrent CIN 2,3

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16
Q

excision methods (2) and healing time

A

cold knife conization
loop (LEEP)- more common

1-2 weeks

17
Q

which cervical disease treatment method has higher risk of adverse obstetric outcomes

A

excision

18
Q

precursor to cervical adenocarcinoma

A

adenocarcinoma in situ

19
Q

adenocarcinoma in situ presentation

A

lesions may be high in endocervical canal, “skip lesions”

may be asymptomatic & not visible on gross exam

20
Q

adenocarcinoma in situ diagnostics & treatment

A

cervical biopsy

cold knife conization

21
Q

cervical cancer types (2) most common

A

squamous cell

adenocarcinoma

22
Q

cervical cancer follow up? (4)

A

q 4 mo. x 2 years
q 6 mo. until year 5
annual PAP
annual CXR until year 5

23
Q

uterine fibroids characteristics (4)

A

most common pelvic tumor
most common indication for hysterectomy
reproductive age pts
estrogen responsive

24
Q

pelvic pressure/pain, increased/irregular menses, infertility, spontaneous abortion

A

uterine fibroids

25
Q

which uterine fibroids are assoc. w/ increased menstrual bleeding

A

submucosal

26
Q

postmenopausal pts w/ enlarging uterine masses, PMB, pelvic pain, unusual discharge

A

uterine sarcoma

27
Q

chronic estrogen dependent disorders during reproductive years (2)

A

uterine fibroids

endometriosis

28
Q

most commonly affected site of endometriosis

A

ovaries

29
Q

dysmenorrhea (1-2 days before menses, starting several years after menarche), abd/pelvic pain, dyspareunia, menorrhagia, bowel/bladder sx, LBP, fatigue

A

endometriosis

30
Q

endometriosis PE findings (3)

A

tender posterior vaginal fornix
localized tenderness & nodules in posterior cul-de-sac (pouch of Douglas)
adenexal masses or tenderness (chocolate cysts)

31
Q

definitive endometriosis diagnostic

A

laparoscopy & biopsy

32
Q

1st line tx endometriosis

A

NSAIDs

33
Q

type 1 endometrial CA (4)

A

estrogen dependent
majority
caused by excess estrogen unopposed by progesterone
better prognosis

34
Q

type 2 endometrial cancer (3)

A

estrogen independent
seen with endometrial atrophy
poor prognosis

35
Q

most common site & type of uterine CA

A

endometrial adenocarcinoma

36
Q

abn bleeding, pelvic discomfort/pressure, back pain, wt loss, dyspareunia

A

endometrial cancer

Women's Health exam 2 (3 decks)

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