Brainscape's Knowledge GenomeTM

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


See full index

Undeleted > GYN malignancy > Flashcards

GYN malignancy Flashcards

1
Q

what is endo CA

A

most common

- epithelial tumor

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

2 types of edno CA

A

type 1 - E dependent

type 2 E indep

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

risk factors for E dep

A
  1. obesty
  2. chronic anov (PCOS)
  3. unopposed E use
  4. tmoxifen
  5. early menarche/late meno
  6. Fam hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

prevention

A

avopid risk factors

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

screening for endo**

A

none

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

3 warning signs for endo

A
  1. post-meno bleeds
  2. irreg vag. bleeds
  3. abdo bloating, pain, bowel sx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

diagnostic test for endo ca

A
  • endo biopsy with pipelle instrument

- US is not appropriate replacement

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

morphology of type 1

A
  • resembles normal endo
  • increased gland to stroma
  • cribiform architecture
  • nuclear atypia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is grading in endo

A

amount of solid area

- more solid area is worse

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

what can be seen in E dependent before

A

precursor lesions

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

4 types of lesions

A

simple vs. complex
with or without atypia
complex with atypia has 50% risk

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

2 types of type 2

A

serous (papillary)
clear cell
- both are high grade

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

morpho of serous

A
  • papillary archi
  • high grade nuclear
  • macro nuleai
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

morpho of clear cell

A
  • clear cytoplasm
  • high nuclear grade
  • various architecture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

precursors for serous and clear cell

A

serous - endometrial intraepitheliam carcinoma

clear cell - none

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

4 prognostic factors

A
  1. myoinvasion
  2. lymphovascular invasion
  3. cervical invasion
  4. mets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

mgmt of edno CA

A

surgical

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

outcomes for 2 types

A

type 1 - usually found early and cured

type 2 - usually found late and poor

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

etiology of cerv. CA

A

HPV- most only dev. sublincal infection

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

3 cofactors

A
  1. smoking
  2. immunocompromise
  3. OCP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

2 types of cerv. prevention

A

1ry - avoid HPV and cofactors

2ry - paps

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

2 types of 2ry prevention

A
  1. traditional - pap smear
  2. liquid based cytology medium
    - less false neg
    - increase sens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

tips for collection

A
  • before bimanual
  • don’t contam. with lube
  • collect before STD swabs
  • ensure visualization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are challenges in cerv. screening

A
  • high false neg
  • less reduction in adenocarcinoma
  • is opportunitic - relies on pt and halthcare provider
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

when to start screen

A

21 - long time to dev SIL and LSIL is transient

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

how often

A

annual is standard practice, but if have negs, can do every 2-3 years because of sig. lead time

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

when to stop

A

consider stopping at 65-70 or hysterectomy with normal pap Hx

  • continue if at risk
  • continure in hyterectomy if HSIL in past
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what to do with abnormal result

A

colposcopic eval

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

*** bethesda classification

A

satisfactory vs. unsat

neg vs. epithelial cell abnormal

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

2 types of abnormal

A
  1. squamous
    - ASC (us or H)
    - LSIL
    - HSIL
    - carcinoma
  2. glandular
    - AGC atypical glandular cells
    - AGC favour neoplasia
    - adenocarcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is only one that doesn’t need colposcopy

A

ASC-US

- up to 5%

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

option for ASC-US

A
  1. immed. colposcopy
  2. repeat smears q6mox3
  3. HPV DNA test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

5 alternative causes for abnormal smears

A
  1. atrophic changes
  2. inflamm/infection
  3. regen after injury
  4. CA of other source
  5. previous radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is pap test NOT

A

screening test, not a diagnostic test

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

4 types of squamous lesions

A

normal squam cell
LSIL
HSIL
SCC

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

** what is cytopathology

A

koilocyte - HPV infected cell

  • enlarged nuc
  • irreg nuc
  • hyperchromasia
  • binucleation
  • cytopasmic halo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

3 types of glandular leasion

A

normal endo glands
adenocarcinoma in situ
adenocarcinoma

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

what is done in colposcopy

A

look inside and biopsy if abnormal

39
Q

2 options for lesions

A
  1. exision
    - cone biopsy - general
    - LEEP - in office
  2. ablation - no patho
    - laser
    - cautery
    - cryotherapy
40
Q

5 warning signs of cerv CA

A
  1. abnormal pap
  2. abnormal bleeds - ESP post coital
  3. pelvic pain/discharge
  4. bowel or bladder
  5. flank pain/sciatica/lower limb edema (terrible triad)
41
Q

** prototypical case

A

42 yo female
heathy smoker
no pap for a few years
new onset coital bleeds

42
Q

what is role for imaging

A

none- do a physcial

43
Q

clinical mgmt plan

A
  1. refer to gyn onc
  2. determine stage
  3. determine optimal ther
44
Q

** what is special about staging of cervical

A

only one done clincally - with hands

45
Q

what is mgmt

A

tailored to pt

  • advanced - chemorad
  • early - surg or chemo rad
46
Q

2 most common histo types

A

SCC

endocervical adenocarcinoma

47
Q

morpho of SCC

A

sheets of malignant cells

- sometimes keratinzation

48
Q

morpo of adenocarcinoma

A

presence of atypical glands growing in disorganized fashion and invading cervial stroma

49
Q

outcomes

A

early - cured with surg or chemorad

late- maybe cured with chemorad

50
Q

SE of therapy

A
  • loss of fert
  • meno
  • sexual dys
  • bowel bladder tox
51
Q

3 parts of ovary and their potential neoplasms

A
  1. primordial germ cells - germ cell tumors
  2. sex cords - stromal tumors
  3. epitheliom - carcinoma
52
Q

epi of of germ cell tumors

A

the good

  • 10-15%
  • young females
  • typically curable even with mets
53
Q

types of germ cell tumors and their effect

A 
1. mature teratoma (95%) - benign
all the rest are malig
2. immature teratoima
3. dysgerminoma
4. yolk sac carc
5. embryonal carc.
6. choriocarc
7. gonadoblastoma
54
Q

histo of teratoma

A

derivatives of any cell layer

- made up of mature adult type tissue

55
Q

epi of stromal tumors

A

the bad (3-5%)

  • women of all ages
  • usually early stage and cured
56
Q

epi of epithelial tumors

A

the ugly (80-85%)

  • 5 subtypes
  • each has it’s own chars
57
Q

5 subtypes

A
  1. serous - most common
  2. endometriod
  3. mucinous
  4. clear cell
  5. transitionnal
58
Q

histo of serous

A

often bilateral ovaries

- solid and cyctic mass with papillary projections

59
Q

histopath of serous

A
  • pap archi
  • high nuclear grade
  • macronuleaoli
  • abundant mitosis
  • psammoma bodies
60
Q

histopath of mucious

A
  • mucin producing
  • large, unilateral
  • atypia varies
  • pools of mucin
61
Q

endometrioid histopath

A

unilat

  • often hemmoragic
  • morpho ident to endo CA
62
Q

histpath of clear cell

A

unilat

  • solid and cystic mass
  • may be hemorragic
63
Q

2 risk factors for epithelial ovarian Ca

A
  1. incessant oviualtion
    - nulliparity
    - early menarche/ late meno
    - not on OCP
  2. genetics
64
Q

3 related familial sysndromes

A
  1. site specific familial ovarian cancer syndrome
  2. BRCA
  3. lynch
    10% have gentic link
65
Q

prevention/screening

A
  1. avoidance of risk factors - OCP, childbearing
  2. prophylactic surg in high risk women
  3. no good screening - US is NOT good
66
Q

screening for women at high risk (BRCA)

A
  1. transvag US q6 months
  2. mammography
  3. colonoscoly
  4. prophylactic surg
67
Q

warning signs

A

often asymptomatic

  1. abdo bloating
  2. abdo pelvic pain
  3. bowel/bladder
  4. vag bleeds
68
Q

prototypical case

A 
60yo female
- meno 8 years
- 6 month sx
On exam
- fluid wave
- omental cake
- fixed irreg mass
- cul-de-sac nodularity
69
Q

4 diagnositc tests

A
  1. pelvic transvag US
  2. tumor markers
  3. CT
  4. CXR, barium enema
70
Q

what is only type with no tumor markers

A

immature teratoma

71
Q

tumor marker for epi, germ cell, stroma

A

epi - CA-125
germ - LDH, AFP, B-hCG
stromal - inhibin

72
Q

limitations of CA-125

A

premeno - low spec., affected by benigh conditions
post-meno
- very hiogh PPV
- non-mucinous

73
Q

*** what is involved in calculating risk of malig. index for adnexal masses

A

RMI = UxMxCA125

74
Q

what is U

A

U = 1 (U/S 0 or 1)
U = 4 (U/S 2-5)
1 point for presence of: multilocarity, bilateral, solid, ascites, mets

75
Q

what is M

A 
M = 4 for postmeno
M = 1 for premeno
76
Q

CA-125

A

absolute value

77
Q

where is cutoff

A

RMI>200 - refer

78
Q

main treatment

A

surg - unless too unwell

79
Q

4 roles for surg

A
  1. diagnosis
  2. staging
  3. debulking
  4. adjuvant facilitation
80
Q

what is role of debulking

A

relat. between amount of disease left and length of survival

81
Q

3 prognostic factors

A
  1. stage
  2. optimal debulking
  3. tumor biol
82
Q

what is vulvar CA

A

skin CA of the vulva

83
Q

epi of vulvar

A
  • uncommon
  • 90% SCC
  • can often be a second primary malig (cervix/anus)
84
Q

2 types of vulvar

A
  1. type 1 - HPV related

2. type 2 - non HPV

85
Q

risks for type 1 (3)

A

HPV
smoking
immune suppress

86
Q

risk for type 2

A

chronic vulvar disease

- lichen sclerosis

87
Q

prevention/screening

A
  • avoid risk factors
  • no good screen
  • treat preinvasive lesions
  • surveillance colposcopy
88
Q

warning sx

A
  • vulvar itch
  • burning
  • irreg. bleeding
  • vulvar lesion
  • groin pain swelling
  • bowel/bladder pain in advanced
89
Q

diagnostic tests

A
  • physical exam
  • colposcopy if nothing visible on physical
  • skin biopsy
90
Q

keys to surgical mgmt

A
  • wide local margin
  • assess sentinal nodes
  • neoadjuvant chemorad for locally advanced disease
91
Q

histopath

A
  • most are SCC

- look at depth, tumor width, lymph invasion, status of margins

92
Q

reasons behind sentinal LN

A
  • mets to groin nodes
  • risk increases exponentially when depth >1mm
  • node dissection is morbin
  • do sentinal node instead and if clear leave the rest
93
Q

what does sentinal LN allow

A

ultrastaging of this node and detection of small mets

94
Q

outcomes for vulvar

A

depends on the stage

Undeleted (589 decks)

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