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gyn onco Flashcards

1
Q

which is more common vaginal or vulvar cancer?

A

vulvar cancer

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2
Q

sx of vulvar cancer

A

vulvar lesion
itching
pain
bleeding
ulceration

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3
Q

is vulvar cancer always symptomatic?

A

no half the time its not

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4
Q

average age of vulvar cancer

A

70 yo

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5
Q

diagnosis of vulvar cancer

A

biopsy
enlarged inguinal nodes
CXR and pelvic CT

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6
Q

why would you do CXR and pelvic CT when evaluating vulvar cancer?

A

r/o advanced dz or inguinal lymphadenopathy

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7
Q

histology of vulvar & vaginal cancer

A

squamous cell carcinoma

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8
Q

tx of vulvar cancer

A

surgical
radiation therapy

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9
Q

surgeries for vulvar cancer

A

wide local excision
radical vulvectomy
inguinal lymphadenectomy

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10
Q

DES exposure, preinvasive dz are RF for what kind of cancer

A

vaginal cancer

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11
Q

sx of vaginal cancer

A

early dz asymptomatic
adv has bleeding, mass, foul-smelling, discharge & pain

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12
Q

tx for vaginal cancer?

A

upper 1/3– partial or complete radical vaginectomy
whole pelvic radiation + brachytherapy
pelvic exenteration

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13
Q

what must you do if a patient has postmenopausal bleeding?

A

must get endometrial biopsy

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14
Q

most common cause of postmenopausal bleeding

A

exogenous estrogen & atrophic things

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15
Q

least common cause of postmenopausal bleeding

A

endometrial hyperplasia

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16
Q

what is the most common gyn malignancy in the US

A

endometrial cancer

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17
Q

endometrial CA is predominantly dz of…

A

obese
postmenopausal women of low parity

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18
Q

histology for endometrial CA

A

epithelial and smooth muscle tumors
epithelial more common

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19
Q

RF for endometrial CA

A

unopposed estrogen use is biggest one
nulliparity
wt >175
BMI over 29, early menarche, DM, tamoxifen

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20
Q

sx of endometrial CA

A

abnormal vaginal bleeding!!
bowel or bladder abnormalities
pelvic pain

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21
Q

screening for endometrial CA

A

US and endometrial biopsy
colon screening

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22
Q

what age do you start US and endometrial biopsy screening for endometrial CA

A

30-35

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23
Q

what age do you start colon screening for endometrial CA?

A

20-25 every 1-2 yrs or 5yrs before earliest cancer in family

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24
Q

what do you use to diagnose endometrial CA in symptomatic ppl w/ negative endometrial biopsies?

A

hysteroscopy D & C

25
what imaging allows you examine endometrial stripe thickness?
transvaginal US
26
what is the normal endometrial stripe thickness?
<5mm
27
what biopsy result has highest chance of developing endometrial carcinoma?
complex hyperplasia w/ atypia
28
tx for endometrial CA if too sick for surgery
whole pelvic radiation or IUD
29
tx for endometrial CA if you wanna have kids
progesterone IUD or PO repeat biopsy to see if its working
30
tx for endometrical CAs
remove anatomy peritoneal washings pelvic & periaortic lymphadenectomy omental and peritoneal biopsy if aggressive debulking
31
stages of endometrial CA
stage 1-- uterus stage 2-- cervix stage 4-- bladder, bowel, inguinal node, distant metastases
32
most lethal gyn caner
ovarian cancer
33
which cancer is the silent killer/dz that whispers
ovarian cancer
34
why is ovarian CA whispering?
bc the sx are vague
35
sx of ovarian CA
bloating fatigue GI issues urinary sx pelvic/tummy pain menstrual irregularities
36
3 things that increases risk of ovarian CA
age fam infertility & meds for it
37
which BRCA gene has the higher lifetime risk for causing ovarian CA
BRCA 1
38
who can get ovarian CA risk reduction surgery?
35yo for BRCA1 40yo for BRCA2
39
4 things that can decrease risk of ovarian CA
OCP multiple pregnancies tubal ligation breast feeding
40
most effective risk reduction procedure
prophylactic oophorectomy--95% risk of primary peritoneal CA remain
41
ovarian CA histologies
epithelial-- majority germ cell sex cord stroma
42
what do germ cell tumors secrete?
beta hCP LDH AFP
43
where do germ cell tumors come from?
primordial ovarian cell
44
what is the most common germ cell tumor
dysgerminoma
45
two sex cord stromal cells
granulosa cell and leydig cell
46
what is the majority of epithelial histology with ovarian CA
papillary serous
47
3 ways to screen for ovarian CA
CA125 testing US screening annual rectovaginal pelvic exam
48
when is CA125 testing elevated? what does this mean for how we use the test?
elevated in stage 1 cancers not good for general population-- poor specificity in premenopause
49
ovarian CA screening recommendation if no fam hx or 1 fam hx
fam hx + annual rectovaginal pelvic exam
50
ovarian CA screening recommendation if 2+ fam hx
genetic counseling/testing, annual exam, CA125, transvaginal US?
51
5 diagnostic modalities for ovarian CA
rectovaginal pelvic exam transvaginal US CT scan MRI CA125
52
ovarian CA staging
stage 2--- pelvis stage 3--- abdomen stage 4--- distant metastasis
53
at what stage is most ovarian CA diagnosed?
stage 2
54
tx for ovarian CA (not advanced)
surgical debulking and chemotherapy
55
tx for advanced ovarian CA
TAH-BSO omentectomy lymph node dissection bowel resection debulking splenectomy, appendectomy
56
what three surgeries can you do in early stage if they dont desire kids
TAH-BSO LND remove ovary and lymph node
57
triad of fallopian tube carcinoma
prominent watery vaginal discharge pelvic pain pelvic mass
58
what is fallopian tube CA similar to?
epithelial ovarian CA

WH 2 (8 decks)

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