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COMAT - OBGYN > GYN Neoplasms > Flashcards

GYN Neoplasms Flashcards

1
Q

What is a uterine Leiomyoma?

A

Benign smooth muscle tumor

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2
Q

What is the course of a uterine Leiomyoma? Why?

A

They may be symptomatic until menopause and then they will shrink and be asymptomatic because they are hormone sensitive

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3
Q

What are some possible symptoms of uterine Leiomyomata?

A
  • Heavier bleeding
  • Pelvic pressure
  • Constipation/Urinary retention
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4
Q

How will the uterus feel on examination with uterine Leiomyomata? What diagnostic can you obtain?

A

Irregularly enlarged uterus
–> TVUS

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5
Q

What medications and surgeries can you try for symptomatic uterine leiomyomas?

A

Medications:
- OCPs/Medroxyprogesterone and NSAIDs
Surgeries:
- Myomectomy or Hysterectomy

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6
Q

What is the malignant form of a uterine fibroid?

A

Leiomyosarcoma

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7
Q

Type 1 and Type 2 Endometrial cancers are what?

A

Type 1 = Endometrioid
Type 2 = Serous/Mucinous

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8
Q

How does Type 1 Endometrial cancer arise usually?

A

Type 1 = Endometrioid
–> UNOPPOSED ESTROGEN

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9
Q

What are some protective factors against Endometrial Cancer type 1?

A

OCPs
Multiparity
Progestins
Breast feeding

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10
Q

What mutations are often present with Type 2 Endometrial cancer?

A

Type 2 = Serous/Mucinous
=> P53, PTEN, BRCA genes

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11
Q

How will Endometrial cancer present?

A

Post-menopausal bleeding or intermenstrual/heavier bleeding in premenopausal women

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12
Q

What 2 diagnostics should be obtained if you are concerned about Endometrial cancer?

A

TVUS – most often if premenopausal
Biopsy – especially if postmenopausal

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13
Q

An endometrial stripe > ____ mm is concerning for Endometrial hyperplasia/cancer

A

> 4 mm

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14
Q

What medication can be used for Endometrial Hyperplasia?

A

Progestins

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15
Q

What cells are normally found at the Endocervix? Ectocervix?

A

Endocervix = Columnar cells
Ectocervix = Squamous cells

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16
Q

What are some risk factors for Cervical cancer?

A

HPV 16/18
Tobacco use, HIV, STDs
Multiparity

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17
Q

How will Cervical cancer present?

A

Post-coital bleeding +/- heavier and IMB

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18
Q

HPV infection is often the cause of Cervical cancer. What cells may be present and what do they look like?

A

Koilocytes = bilobed nucleus + perinuclear halo

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19
Q

With a majority of abnormal pap smears, what is often done next?

A

Colposcopy +/- biopsy/endocervical curretage

20
Q

If a patients pap result is ASC-US with a history of normal paps and (-) HPV, what is the workup?

A

Repeat pap in 1 year

21
Q

If a patients pap result is ASC-US with a history of that on prior paps or they are HPV (+), what is the workup?

A

Colposcopy

22
Q

If a patients pap result is ASC-Glandular, what is the workup?

A

Colposcopy + Endocervical curretage + Endometrial biopsy

23
Q

If a patients pap result is ASC-H, LSIL, HSIL, what is the workup?

A

Colposcopy

24
Q

What pap result is CIN1?

A

LSIL

25
Q

What pap result is CIN2 and CIN3?

A

HSIL

26
Q

What are some risk factors for Vulvar cancer?

A

HPV 16/18
Lichen Sclerosus and chronic irritation
Tobacco use

27
Q

What are the symptoms/signs of Vulvar cancer?

A

Ulceration/mass
Itching and pain

28
Q

What is the workup for possible Vulvar cancer?

A

Punch biopsy

29
Q

How does Lichen Sclerosus present?

A

Whitening and thinning of the vulvar skin with itching and pain usually

30
Q

What is the treatment for Lichen Sclerosus?

A

Topical corticosteroids

31
Q

If a woman has Clear Cell Vaginal carcinoma, what what she exposed to?

A

DES

32
Q

What are some risk factors for Vaginal cancer?

A

HPV 16/18
Chronic irritation
Tobacco use
DES exposure

33
Q

Ovarian cancers can often be asymptomatic. What features on US are concerning?

A

Solid mass with thick septations
+/- ascites

34
Q

What is the tumor marker for Epithelial Ovarian Carcinoma?

A

CA-125

35
Q

What is the tumor marker for a Yolk Sac (Endodermal Sinus) ovarian tumor?

A

AFP

36
Q

If there is a high AFP and concern for an Ovarian mass, what may be seen on histology?

A

Schiller Duval bodies – looks like glomerulus
= Yolk Sac/Endodermal Sinus tumor

37
Q

What is the tumor marker for a Choriocarcinoma?

A

Beta-hCG

38
Q

What is the tumor marker for a Dysgerminoma at the ovary?

A

LDH

39
Q

If there is a high LDH and concern for an ovarian mass, what cells may be seen on histology?

A

Fried egg cells
= Dysgerminoma

40
Q

What is the tumor marker and hormone elevated with Granulosa Theca cell ovarian tumors?

A

Inhibin
Estrogen

41
Q

If there is high Inhibin and concern for an ovarian mass, what cells may be seen on histology?

A

Call-Exner bodies
= Granulosa theca cell tumor

42
Q

Granulosa theca cell tumors produce what hormone which may cause physical signs?

A

Estrogen!

43
Q

Sertoli-Leydig tumors at the ovaries often produce what hormone?

A

Testosterone!

44
Q

If a patient has an ovarian mass with high testosterone and NORMAL DHEAS, what may be seen on histology?

A

Reinke crystals
= Sertoli-Leydig tumor

45
Q

List some signs in a female of a Sertoli-Leydig tumor

A

Hirsutism
Acne
Deep voice
Clitoromegaly
Menstrual changes

COMAT - OBGYN (12 decks)

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