Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RT + O Exam 2018 > Endometrial > Flashcards

Endometrial Flashcards

1
Q

NZ Stats 2013 and Epidemiology

A

Most common gynaecological cancer in NZ & the world
5th most commonly registered cancer for NZ woman after breast, colorectal, melanoma and lung
• 500 Reg
• 100 deaths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Is there is disparity between Maori and non-Maori?

A

Māori and Pacific Island women have higher incidence and mortality rates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the risk factors?

A 
Relate to imbalance in hormones
Increasing age: post-menopausal between 55 and 85yrs
Changes of oestrogen and progesterone:
•	Early onset of menstruation
•	Nulliparity – never giving birth
•	Infertility
•	Late menopause
•	HRT – tamoxifen – breast
Past medical history:
•	Obesity
•	Hypertension
•	Diabetes
•	Polycycstic ovaries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the signs and symptoms/clinical presentation?

A 
Abnormal bleeding in 90% of cases
•	Pre/Peri or Post-menopausal - quite an obvious symptom
•	Abnormally heavy 
•	Prolonged
•	Irregular
•	In-between periods
•	Excess blood loss can lead to anaemia
Unusual discharge
Abdo pain or cramping
Changes in bladder & bowel habits 
Significant weight loss or gain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most common pathology of endometrial cancer and cell type?

A

90% adenocarcinoma
• 95% from endometrioid cells
• 5% from serous cells
• 1-2% clear cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is the pathology categorised and which is more common?

A

Categorised as oestrogen dependent (Type 1) and oestrogen-independent (Type 2)
Type 1 is more common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where does it spread to for local invasion?

A

Local Invasion:
• Uterine wall, fallopian tubes & cervix
• Myometrium or perimetrium
• Rectum & bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where does it metastasise to?

A 
Distant Metastasis:
•	Peritoneal seeding - Can spread within the peritoneal fluid in the peritoneal cavity - mix between local invasion and distant spread
•	Lung
•	Liver
•	Bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is its lymphatic spread?

A 
Lymphatic Spread:
•	Internal iliac 
•	Obturator 
•	External iliac 
•	Common iliac 
•	PA nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What investigations are carried out?

A
  • Complete history
  • Internal pelvic examination
  • FBC
  • Tissue samples
  • Trans vaginal ultrasound
  • CT/MRI of pelvis/abdo (contrast)
  • PET-CT
  • Chest x-ray
  • Bone scan for suspicious mets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of tissue samples can be taken?

A

Tissue Samples
• Vacuum aspiration biopsy
• Hysteroscopy +/- pipelle biopsy
• Hysteroscopy +/- dilatation & curettage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the common RT prescription used?

A

45-50.4Gy in 25-28# (1.8Gy/#) EBRT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the prescription for palliative EBRT?

A

20Gy/5# or 30Gy/10# - Palliative EBRT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the brachy prescription for both brachy alone and brachy boost post EBRT?

A

24Gy in 4# twice a week (Brachy alone)

8-10Gy in 2# once a week, 1 week after EBRT (Brachy Boost post EBRT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What chemotherapy regime is used as adjuvant tmt for pts with Stage III and IV disease?

A

Carboplatin and Paclitaxel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the Acute side effects of this chemotherapy regime?

A 
Acute:
•	Nausea and vomiting 
•	Increased risk of infection 
•	Bone marrow suppression 
•	Alopecia
•	Fatigue
•	Weight loss/loss of appetite 
•	Numbness in hands or feet 
•	Aching joints or muscles 
•	Taste changes
17
Q

What are the Late effects of this chemotherapy regime?

A 
Late:
•	Cardiotoxicity
•	Nephrotoxicity
•	Hepatotoxicity
•	Peripheral Neuropathy
•	Tinnitus
•	Infertility
18
Q

What are the characteristics of Type 1?

A
  • Majority of endometrial carcinomas
  • Diagnosed at low histological level
  • Favourable prognosis
19
Q

What are the characteristics of Type 2?

A
  • Less common - serous and clear cell carcinomas
  • Diagnosed at high stage - more aggressive
  • Poorer outcomes
20
Q

What does hormone therapy depend on?

A

Whether the disease is Type 1 or Type 2

21
Q

When is hormone therapy used?

A

For recurrent or advanced endometrioid disease. Last resort to gain some control.

22
Q

What does the response to hormone therapy depend on?

A

Dependent on the expression of oestrogen and progesterone receptors

23
Q

What hormone therapy agents are used?

A

Progesterones are the most common agent:
- MPA or MA
Anti-oestrogens:
- Tamoxifen

24
Q

What are the side effects of hormone therapy?

A
  • Hot flushes
  • Night sweats
  • Weight gain
  • Risk of blood clots
  • Fluid retention

RT + O Exam 2018 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions