Brainscape's Knowledge GenomeTM

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


See full index

Gynecologic Oncology > Endometrial Intraepithelial Neoplasia > Flashcards

Endometrial Intraepithelial Neoplasia Flashcards

1
Q

What is the risk of progression to endometrial cancer with SIMPLE HYPERPLASIA?

A

1%

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

What is the risk of progression to endometrial cancer with COMPLEX HYPERPLASIA?

A

3%

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

What is the risk of progression to endometrial cancer with SIMPLE ATYPICAL HYPERPLASIA?

A

8%

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

What is the risk of progression to endometrial cancer with COMPLEX ATYPICAL HYPERPLASIA?

A

29%

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

What is the average time to endometrial cancer in a patient with persistent hyperplasia?

A

6 years

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

Endometrial Intraepithelial neoplasia (EIN) is also known as?

A

Atypical hyperplasia

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

Risk of coexisting cancer in a patient with EIN ?

A

40%

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

Risk of progression to endometrial cancer with EIN?

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the best procedure to confirm endometrial malignancy or exclude cancer?

A

Hysteroscopy and D&C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What percentage of the endometrium does an EMB sample?

A

15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

At what endometrial thickness should an EMB or sampling be done in a postmenopausal patient with PMB?

A

> 4mm

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

At what endometrial thickness should an EMB or sampling be done in a postmenopausal patient without PMB?

A

> 11mm

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

an EMS > 11 mm correlates with what percent risk of endometrial cancer?

A

6%

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

What is the dose and regimen for Megace (Megesterol) therapy for endometrial hyperplasia?

A

40 - 200 mg/day

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

What is the dose and regimen for Provera (Medroxyprogesterone acetate)

A

10 - 20 mg/day 12-14 day OR cyclic 12-14 days per month

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

What is the best form of progesterone to give a patient with endometrial hyperplasia?

A

Mirena IUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the general frequency of EMB follow up for a patient with hyperplasia without atypia?

A

EMB q 3-6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Management of patient with regression of hyperplasia following hormonal therapy?

A

re-biopsy if repeat bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Management of patient with persistence of hyperplasia following IUD placement?

A

add on oral progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Management of patient with progression to atypia (EIN) following hormonal management?

A

Hysterectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Rate of regression in patient with hyperlasia w/o atypia following hormonal management?

A

86%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Rate of relapse following regression in a patient with hyperlasia w/o atypia following hormonal management?

A

26%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the most common GYN cancer in the US?

A

Endometrial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Greatest risk factor for type 1 endometrial cancer?

A

unopposed estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the risk of developing endometrial cancer for a patient with LYNCH syndrome?

A

increased up to 60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What type of genetic mutation is associated with LYNCH syndrome?

A

Missmatch repair genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What genes are involved with LYNCH syndrome?

A

MLH1, MSH2, PMS2, MSH6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What gene mutations are associated with Cowden disease?

A

PTEN mutations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

BRCA1 increases the risk of which type of endometrial cancer?

A

Type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

When should a CT scan be used in the evaluation of a patient with endometrial cancer?

A

To evaluate for advanced/Metastatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

When should a MRI be used in the evaluation of a patient with endometrial cancer?

A

used in the pretreatment evaluation to determine myometrial invasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Following which pap smear results should an EMB be preformed?

A
  1. IF AGS/ AGUS do EMB in a patient > 35yrs or with significant risk factors for endometrial hyperplasia
  2. IF atypical endometrial cells seen on pap smear
  3. If endometrial cells seen on pap in post menopausal woman
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When should an EMB be performed in a patient < 45 yrs old?

A

Persistent abnormal bleeding with risk factors including obesity, anovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

When should an EMB be performed in a patient 45 yrs - Menopause?

A

If cycles are < 21 days, intermestrual bleeding, heavy or prolonged bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

When should an EMB be performed in a patient who is postmenopausal?

A

any spotting or vaginal bleeding with EMS > 4 mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

True or false: Routine imaging to evaluate for metastases in a patient with endometrial cancer is not recommended

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What type of uterine cancer is associated with type 1?

A

Endometriod

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What mutation is associated with type 1 uterine cancer?

A

PTEN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

True or false: Most Type 1 uterine cancers are diagnosed at late stage?

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the survival rate in type 1 uterine cancer?

A

85%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

True or false: Type 1 uterine cancer is not associated with unnoposed estrogen?

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What type of uterine cancer is associated with type 2?

A

Clear cell, pap serous

43
Q

What mutation is associated with type 2 uterine cancer?

A

TP53, BRCA1

44
Q

True or false: Most Type 2 uterine cancers are diagnosed at late stage?

A

True

45
Q

What is the survival rate in type 2 uterine cancer?

A

50%

46
Q

True or false: Type 2 uterine cancer is not associated with unnoposed estrogen?

A

True

47
Q

Serous uterine cancer accounts for what percentage of uterine cancer?

A

10%

48
Q

Clear cell uterine cancer accounts for what percentage of uterine cancer?

A

3%

49
Q

Which types of uterine cancer account for the highest proportion of uterine cancer related deaths?

A

Serous

50
Q

Definition of grade 1 uterine cancer?

A

< 5% non morular/solid growth pattern

51
Q

Definition of grade 2 uterine cancer?

A

6 - 50% non morular/solid growth pattern

52
Q

Definition of grade 3 uterine cancer?

A

> 50% non morular/solid growth pattern

53
Q

Definition of stage IA uterine cancer?

A

< 50% myometrial invasion

54
Q

Definition of stage IB uterine cancer?

A

> 50% myometrial invasion

55
Q

Definition of stage II uterine cancer?

A

Tumor invades cervical stroma

56
Q

Definition of stage IIIA uterine cancer?

A

Tumor invades UP. Uterine serosa or adnexa

57
Q

Definition of stage IIIB uterine cancer?

A

Tumor invades DOWN. Vaginal or parametrial involvement

58
Q

Definition of stage IIIC uterine cancer?

A

Tumor invades NODES

59
Q

Definition of stage IIIC1 uterine cancer?

A

Tumor invades NODES. Pelvic nodes

60
Q

Definition of stage IIIC2 uterine cancer?

A

Tumor invades NODES. Para aortic

61
Q

Definition of stage IVA uterine cancer?

A

Tumor invades bladder or rectum

62
Q

Definition of stage IVB uterine cancer?

A

Distant metastases

63
Q

Management of Stage I uterine cancer

A

Simple hysterectomy +/- lymphnodes

64
Q

5 year survival for stage I uterine cancer

A

80-90%

65
Q

Management of Stage II uterine cancer

A

Radical hysterectomy, LND, adjuvant RT therapy

66
Q

5 year survival for stage II uterine cancer

A

70 - 80%

67
Q

Management of Stage III uterine cancer

A

Total abdominal hysterectomy, LND, Cytoreduction, RT, Chemotherapy

68
Q

5 year survival for stage III uterine cancer

A

60%

69
Q

Management of Stage IV uterine cancer

A

IV Chemotherapy, hormone TX and RT

70
Q

5 year survival for stage IV uterine cancer

A

20%

71
Q

True or False: Risk of positive lymphnodes increase with the depth of invasion and grade of tumor

A

True

72
Q

What is the treatment strategy for a patient who has positive nodes at the time of surgery?

A

addition of chemotherapy or extended field radiation therapy

73
Q

What did the LAP2 trial show in terms of outcomes and survival between patients who underwent TLH vs. TAH

A

No difference in survival between TLH and TAH, fewer adverse events associated with TLH and better recovery with TLH

74
Q

In stage I disease, When should you add on radiation therapy?

A

positive LN, age > 70, Grade 2-3, outer 1/3 uterine invasion, LVSI

75
Q

What stage of uterine cancer requires addition of chemotherapy?

A

Stage III-IV

76
Q

What chemotherapy agents are generally used to treat uterine cancer?

A

Paclitaxel, Carboplatin

77
Q

What agent should be used in a MSI+/MSI high tumor?

A

Pembrolizumab

78
Q

What agent should be used in a Her2 positive tumor?

A

Trastuzumab

79
Q

How many weeks of Provera should be given for conservative hormonal therapy?

A

26 weeks

80
Q

What is the risk of ovarian recurrence in a patient who underwent hysterectomy without BSO for uterine cancer?

A

19%

81
Q

Follow up Surveillance for endometrial cancer

A

q 3 months for 2 years
q 6 months for 3 years
yearly after 5 years

82
Q

When does most endometrial cancer recurrence occur?

A

first 3 years

83
Q

What is the treatment or local recurrence in a patient without prior RT therapy?

A

RT therapy

84
Q

What is the treatment or local recurrence in a patient with prior RT therapy?

A

pelvic exenteration

85
Q

True or False: Estrogen therapy is safe to use for HRT in a patient with stage I or II disease

A

True

86
Q

Uterine sarcomas comprise what percentage of uterine cancer?

A

3-9%

87
Q

What are the three types of uterine sarcomas?

A
  1. Leiomyosarcoma
  2. Endometrial stromal sarcoma
  3. Carcinosarcoma (MMMT)
88
Q

What is the most common type of uterine sarcoma?

A

Leiomyosarcoma

89
Q

What are the most common presenting symptoms in a patient with a leiomyosarcoma?

A

vaginal bleeding, pain

90
Q

True or False: Leiomyosarcomas always present with a rapidly enlarging fibroid?

A

False

91
Q

What are 2 risk factors for Leiomyosarcoma?

A

Long term tamoxifen use and previous pelvic RT therapy

92
Q

What is the common location for leiomyosarcoma?

A

usually intramural

93
Q

Endometrial Stromal Sarcoma typically affects what age group?

A

Younger patients

94
Q

What is the common location for endometrial stromal sarcoma?

A

Usually within endometrial cavity

95
Q

Definition of stage IA Leiomyosarcoma OR Endometrial Stromal Sarcoma

A

Tumor < 5 cm

96
Q

Definition of stage IB Leiomyosarcoma OR Endometrial Stromal Sarcoma

A

Tumor > 5 cm

97
Q

Definition of stage IIA Leiomyosarcoma OR Endometrial Stromal Sarcoma

A

Tumor involves adnexa

98
Q

Definition of stage IIB Leiomyosarcoma OR Endometrial Stromal Sarcoma

A

Tumor invades other pelvic structures

99
Q

Definition of stage IIIA Leiomyosarcoma OR Endometrial Stromal Sarcoma

A

Tumor invades 1 abdominal site

100
Q

Definition of stage IIIB Leiomyosarcoma OR Endometrial Stromal Sarcoma

A

Tumor invades more than 1 abdominal site

101
Q

Definition of stage IIIC Leiomyosarcoma OR Endometrial Stromal Sarcoma

A

Tumor invades regional lymph nodes

102
Q

Definition of stage IVA Leiomyosarcoma OR Endometrial Stromal Sarcoma

A

Tumor invades bladder or rectum

103
Q

Definition of stage IVB Leiomyosarcoma OR Endometrial Stromal Sarcoma

A

Distant Metastases

104
Q

What is the risk of sarcoma in a patient with a uterine fibroid?

A

0.5%

Gynecologic Oncology (11 decks)

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