Friday - Uterine Path - Witrak

Question 1

when does a 20 yo get endometreal cancer

Answer 1

tons of estrogen

• obesity
• polycystic ovary

Question 2

two concerns for uterine beeding

when do you biopsy

Answer 2

hemorrhage
cancer

over 45
under 45 if lots of estrogen or failed treatment. or anovulation. lynch syndrome

Question 3

majority of uterine bleeding

Answer 3

anovulation. estrogen but no progesterone

Question 4

differential for postmenopause endometrial bleeding

Answer 4

endometrial atrophy
polyps
hyperplasia
carcinoma

Question 5

endometriual polyps

Answer 5

no risk of carcinoma

can prolapse through cervical os

Question 6

endometrial hyperplasia

Answer 6

from chronic estrogen (usually from obesity)
simple
complex - lots of glands
complex with atypia - risk of carcinoma - do a hysterectomy

Question 7

endometrial carcinoma

Answer 7

most common gyn cancer in developed world
average age 61
risk factor - unopposed esrogen - obesity, diabetes
lynch syndrome

Question 8

type 2 endometrial carcinoma

Answer 8

serous/clear cell
old patients
p53 mutations
5 year survival is 35%

Question 9

Ultrasound, for assessing risk of endometrial cancer

Answer 9

endometrial thickness 3-5 mm, not malignant

Question 10

what is endomertiosis

Answer 10

non-neoplastic endometrium found somewhere else

usually in pelvis, can be in c section scars and actually fluctuate with cycle

Question 11

signs of endometriosis

Answer 11

pelvic pain, bleeding, dysmenorrhea, infertility, normal uterus size

ovaries are common - chocolate cysts. little brown spots