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OBGYN > Gyn Cancer > Flashcards

Gyn Cancer Flashcards

1
Q

FSH stimulates _____ cells to make _____.

A

sertoli/granulosa, estrogen

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2
Q

LH stimulates _____ cells to make _____.

A

leydig/theca, testosterone & progesterone

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3
Q

highest mortality for GYN cancers…

A

Ovarian > Endometrial > cervical

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4
Q

highest incidence of GYN cancers….

A

Endometrial > cervical > ovarian

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5
Q

highest incidence of cancer in women…

A

breast > lung > colon

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6
Q

highest mortality of cancer in women…

A

lung > breast > colon

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7
Q

Which GYN cancer is controlled with estrogen?

A

endometrial cancer

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8
Q

Which GYN cancer risk increases with ovulation?

A

ovarian(germ, stem & epithelial)

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9
Q

Which GYN cancers are you at increased risk for with HPV? which strains?

A

Cervical, vulvar, vaginal. HPV 16, 18, 45

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10
Q

Which strains of HPV are associated with warts?

A

6 & 11

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11
Q

which GYN cancer is most highly associated with post-coital bleeding?

A

cervical

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12
Q

which GYN cancer is most associated with post-menopausal bleeding?

A

endometrial

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13
Q

Cervical cancer staging…

A

1: at the cervix a is smaller than b.
2: just outside the cervix in vagina(a) or fallopian tubes(b)
3: further away from cervix than 2. if in vagina =a if in fallopian tubes = b.
4a = bowels, 4b = mets

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14
Q

pap smear screening

A

21q3

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15
Q

mamogram screening

A

40q2

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16
Q

how long does it take for cervical cancer to develop?

A

3-7 years

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17
Q

do a pap smear and it comes out showing ASCUS. what do you do?

A

ASCUS = atypical squamous cells of uncertin significance.
1. repeat pap q3 months untill resolves or do an HPV DNA screen.

  • ASCUS and HPV + = Colposcopy
  • ASCUS and HPV - = q3y
  • ASCUS and +repeat = Colposcopy
  • ASCUS and -repeat = q3y
18
Q

Who gets vaccinated for HPV?

A

EVERYONE!
Female: 13-26
male: 12-21 or 26 still up for debate.

19
Q

when does CIN become SCC?

A

CIN 1 = mild dysplasia; CIN 3 = full thickness dysplasia but once it breaks though the BM it bc SCC

20
Q

What age group should you be considering for cervical, vaginal & vulvar cancers? why?

A

sexually active women! this is because its caused by HPV

21
Q

what age group should you be considering for endometrial cancers? why?

A

post-menopausal women, these cancers are estrogen driven and increased exposure to estrogen will increase the chances of development

22
Q

____ are protective against endometrial cancers.

A

OCPs

23
Q

Risk factors for endometrial cancer.()

A

anovulation(PCOS) > Obesity(increased peripheral estrogen) > tamoxifen use >age > nulliparity >early menarche >late menopause

24
Q

how do you dx endometrial cancer?

A

this will be seen in post meno women wiht abnormal bleeding = do endometrial sampling and a D&C, can also do pelvic ultrasound to see if thickness is <5mm.

25
Q

do bx for endometrial sampling and you see hyperplasia tx? adenocarinoma tx?

A 
hyperplasia = progesterone --| estrogen via blocking FSH
Adenocarcinoma = TAH + BSO

*if there is mets tx w/Carboplatin & Paclitaxel

26
Q

Tx of most GYN cancers w/mets?

A

Carboplatin & Paclitaxel

27
Q

What will ovarian tumors present with? how do you f/u?

A

usually as an adenxal mass = do u/s if smooth w/o septations = simple cysts = do nothing. if complex w/septations = look at age and other sx! young = germ; old = epithelial

28
Q

what are the 3 cell layers of the ovary? what tumors do you get from them?

A
  1. Stromal = sertoli-leydig & granulosa-theca
  2. germ cell = dysgerminoma, endodermal sinus, choriocarcinoma, teratoma
  3. epithelial = serous, mucinous, endometroid cystadenocarcinoma & brenner tumor
29
Q

sx of sertoli-leydig tumor? what cell layer?

A

excess testosterone! from stromal layer

30
Q

sx of granulosa-theca tumor? what cell layer?

A

excess estrogen! from stromal layer

31
Q

sx of dysgerminoma tumor? what cell layer? age group? tx? assoc?

A

germ cell = young female; increased LDH, adenxal mass; unilateral oophorectomy or chemo!(very sensitive for pacitaxal)

32
Q

sx of endodermal sinus tumor? what cell layer? age group? tx? assoc?

A

germ cell = young female; AFP, adenxal mass, unilateral oophorectomy

33
Q

sx of teratoma tumor? what cell layer? age group? tx? assoc?

A

germ cell = young female; struma ovarrii, adenxal mass, unilateral oophorectomy

34
Q

sx of choriocarcinoma tumor? what cell layer? age group? tx? assoc?

A

germ cell = young female; B-HCG elevation, often seen after pregnancy. dx w/u/s tx w/D&C. stage w/CT.

tx: D&C, TAH, Methotrexate then Actinomycin D(preserves fertility)

35
Q

Types of Epithelial ovarian Cancers tumor? path? RF? Sx? Dx? Tx?

A

Serious, Mucinous, Endometroid Cystadenocarcinoma. due to repeated trauma of epithelium(ovulation) = see in older women/post meno.
RF: HNPCC/Lync, BRCA1 >BRCA2 =>having kids or 5yr OCP is protective.

spread by peritoneal seeding = renal failure, SBO, ascites.
dx: U/S then CT or MRI
Tx: TAH + BSO then Paclitaxel & Carboplatin since its usually late stage.
**monitor recurrence w/CA125

36
Q

which mole has 69 chromosomes? pathogenesis?

A

incomplete mole, x2 sperm + 1 egg

37
Q

which mole has 46 chromosomes? pathogenesis?

A

complete mole, 1 sperm + empty egg that duplicates.

38
Q

Sx of a complete/incomplete mole?

A

elevated B-HCG, rapid increasing size compared to date, Hyperthyroidism(bhcg looks like TSH), Hyperemesis Gravidarum(severe, dehydrating morning sickness w/electrolyte abnormalities), snowstorm on pelvic U/S, grapelike mass

tx: D&C and give OCP to prevent pregnancy

39
Q

MCC of Vulvar cancer? MC type?

A

SCC caused by HPV

40
Q

sx of vulvar cancer…

A

pruritis! usually will be dark unless its pagents which will appear red/pink.

41
Q

DES is associated wiht….

A

Adenocarcinoma of the vagina

42
Q

how do you tx vaginal and vulvar cancers?

A

resect lesion and lymph node biopsy

OBGYN (25 decks)

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