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ABOG written boards > Gyn onc > Flashcards

Gyn onc Flashcards

1
Q

Most common type of cervical cancer

A

Squamous cell carcinoma, 70-75%
Favorable prognosis with early detection and treatment

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2
Q

Second most common cervical cancer

A

Adenocarcinoma, 25%
Favorable prognosis with early detection and treatment
Mostly associated with HPV16 (more oncogenic)

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3
Q

Type 2 endometrial CA

A

10-20% of EC
- Clear cell/papillary serous, high grade with poor prognosis
- risk factors: smoking, non-white, age, underweight
- arises in atrophic endometrium

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4
Q

Stage IA-B uterine sarcoma

A

Limited to uterus
A: 5 cm or less in diameter
B: >5 cm

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5
Q

Stage IIA-B uterine sarcoma

A

Extends beyond uterus within pelvis
A: adnexa
B: other pelvic tissues

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6
Q

Stage IIIA-C uterine sarcoma

A

Infiltrates abdominal tissues
A: one site
B: more than one site
C: Regional lymph node mets (para-aortic/pelvic)

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7
Q

Stage IVA-B uterine sarcoma

A

Tumor spreads to distant sites
A: bladder/rectum
B: distant mets

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8
Q

BRCA1 cancers, chromosome

A

Chromosome 17 (DNA repair)
breast, ovarian, prostate

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9
Q

BRCA2 cancers, chromosome

A

Chromosome 13 (DNA repair)
breast, ovarian, prostate, melanoma, pancreas

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10
Q

Lynch genes and cancers

A

MLH1, MSH2/6, PMS2, EPCAM (DNA mismatch repair)
Ovarian, endometrial, colon, gastric, ureteral, biliary, pancreatic, glioblastoma, renal pelvic

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11
Q

Li-Fraumeni

A

TP53, breast and colon CA
tumor suppressor

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12
Q

Cowden

A

PTEN
Breast, endometrial, colon, GI hamartomas

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13
Q

Indication for radical hyst

A

Stage 1B1-1B2 (sometimes 1B3 and IIA1)
Type C1 = nerve sparing, C2 = not nerve sparing
Uterine artery divided at medial aspect of internal iliac

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14
Q

Psammoma bodies

A

Papillary serous CA
Concentric rings of calcifications
- Serous cystadenoCA of ovary, serous endometrial CA (10% of endometrial CA, type 2)

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15
Q

Hobnail cells

A

Clear cell endometrial CA (similar to ovarian clear cell), 5% of endometrial CA, type 2

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16
Q

Type 1 endometrial CA genes

A

PTEN, KRAS, Lynch, ER+
5y survival with type 1 endometrial CA up to 85%

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17
Q

Type 2 endometrial CA genes

A

p53

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18
Q

Choriocarcinoma tumor marker

A

hCG

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19
Q

Dysgerminoma tumor marker

A

LDH, hCG

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20
Q

Embryonal tumor marker

A

hCG, AFP

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21
Q

Endodermal sinus/yolk sac tumor marker

A

AFP

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22
Q

Epithelial tumor marker

A

CA125

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23
Q

Granulosa tumor marker

A

Inhibin

24
Q

Mucinous tumor marker

A

CEA

25
Q

Sertoli-Leydig cell tumor symptoms/findings

A

Sex cord stromal tumor that secretes testosterone
- 75-85% of pts report the following: oligo/amenorrhea, breast atrophy, acne, hirsutism, clitoromegaly, deep voice, receding hairline

26
Q

Choriocarcinoma tumor marker

A

hCG

27
Q

Immature teratoma tumor marker

A

AFP, LDH, CA125

28
Q

Schiller Duval bodies

A

Endodermal sinus tumor

29
Q

Call Exner bodies

A

Granulosa cell tumor

30
Q

Reinke crystals

A

Leydig cell tumors

31
Q

Hobnail cells

A

Clear cell CA

32
Q

Psammoma bodies

A

Serous cystadenoma

33
Q

Signet ring cells

A

Krukenberg tumors

34
Q

Stage 1A-B ovarian CA staging

A

1A: one ovary or tube
1B: both ovaries or tubes

35
Q

Stage 1C1-3 ovarian CA staging

A

Cancer in one or both ovaries/tubes, can now be found on surface
1C = chemo

1C1: surgical spill
1C2: capsule rupture before surgery
1C3: found in ascites washings after surgery

36
Q

Stage 2A-B ovarian CA staging

A

2A: spread to uterus
2B: spread to sigmoid/rectum/bladder

37
Q

Stage 3A-C ovarian CA staging

A

3A1: primary peritoneal or spread to pelvic/para-aortic nodes
3A2: spread above pelvic brim
3B: spread to abdominal organs, up to 2 cm lesions
3C: capsule of liver/spleen, >2cm

38
Q

Stage 4A-B ovarian CA staging

A

4A: pleural effusion
4B: organs outside abdomen/pelvis

39
Q

Stage 1A-B endometrial CA

A

Confined in uterus
1A: <50% of myometrial thickness
1B: >50% myometrial thickness

40
Q

Stage 2 endometrial CA

A

Spread to cervix but still confined within uterus

41
Q

Stage 3A-C endometrial CA

A

Spread outside uterus but not to rectum/bladder
3A: ovary/uterine serosa
3B: vagina/parametrium
3C1: pelvic nodes
3C2: para-aortic nodes

42
Q

Stage 4A-B endometrial CA

A

4A: bladder/rectum/bowel mets
4B: mets to other organs

43
Q

Stage 1A1-2 cervical CA

A

Microscopic invasion confined to cervix
1A1: 3mm or less
1A2: >3-5 mm

1A1 managed with cone or simple hyst
1A2 managed with modified radical or radical hyst

44
Q

Stage 1B1-3 cervical CA

A

Deeper invasion than 5mm but confined to cervix
1B1: >5 mm up to 2 cm
1B2: >2 cm up to 4 cm
1B3: >4 cm
Managed with radical hyst (above this managed with chemoradiation)

45
Q

Stage 2A-B cervical CA

A

Growth outside cervix/uterus but not pelvis or lower vagina
2A: upper 2/3 vagina
2B: parametrium
Managed with cisplatin and radiation (stage 2-4A)

46
Q

Stage 3A-C cervical CA

A

Spread to lower vagina or pelvic sidewall
3A: lower 1/3 vagina
3B: pelvic sidewall/hydronephrosis
3C: involves pelvic (3C1)/paraaortic nodes (3C2)

47
Q

Stage 4A-B cervical CA

A

Spread to bladder, rectum, distant organs
4A: rectal/bladder mucosa, can still be managed with chemoradiation
4B: further mets, managed with palliative chemoradiation

48
Q

Vulvar CA prognostic factors

A

Most important is lymph node involvement
- Node negative: 70-93% 5y survival
- Node positive: 25-41% 5y survival

49
Q

Stage I vaginal CA

A

Limited to vaginal wall

50
Q

Stage II vaginal CA

A

Invades paravaginal tissue, not pelvic sidewall

51
Q

Stage III vaginal CA

A

Extends to pelvic sidewall, does not invade other pelvic organs

52
Q

Stage IVA-B vaginal CA

A

Extends beyond true pelvis or involves bladder/rectum mucosa
A: bladder/rectum or direct extension beyond pelvis
B: distant organs

53
Q

Lynch syndrome screening recommendations

A
  • Colonoscopies starting at 20-25y q1-2y, or 2-5y before earliest cancer diagnosis in family
  • breast: age 25-30 MRI q6mos, exam q6 mos. >30 MRI and mammo alternating q6mos, exam q6mos
  • EMB starting at 30-35y q1-2y
  • Ovarian: >30 can consider annual US with CA125
54
Q

Amsterdam criteria

A

Used to diagnose Lynch syndrome
- 3+ relatives with Lynch-associated cancer
- Involves at least 1 first degree relative and two successive generations
- At least one diagnosed <50yo
- Exclude FAP (familial adenomatous polyposis)

55
Q

BRCA carrier prophylactic BSO timing

A

BRCA1: 35-40yo
BRCA2: 40-45yo

ABOG written boards (5 decks)

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