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FM II Women's Health > GYN ONCOLOGY > Flashcards

GYN ONCOLOGY Flashcards

1
Q

What is the MC GYN cancer?

A

Endometrial cancer (in postmenopausal women)

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2
Q

Endometrial cancer is what type of cancer?

A

Adenocarcinoma

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3
Q

What is the cardinal symptom of endometrial cancer?

A

Inappropriate uterine bleeding

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4
Q

How do we diagnose endometrial cancer?

A

In post menopausal bleeding do a Pap Smear, endocervical curettage, and endometrial biopsy.

 - Endometrial biopsy has an accuracy of 90-95%
 - Can also do D&C and transvaginal U/S
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5
Q

How do we treat endometrial cancer?

A

Total hysterectomy (bilateral salpingo-oophorectomy)

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6
Q

What type of GYN cancer is the second MC but the highest mortality rate?

A

Ovarian cancer

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7
Q

What are the risk factors for ovarian cancer?

A

Older women, nulliparous, white, and family Hx

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8
Q

What is thought to be protective against ovarian cancer?

A

Long-term OCP’s

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9
Q

What are the sxs of ovarian cancer?

A

Usually none :(

  • Palpable ovary in a postmenopausal woman is a PROBLEM
  • Otherwise ascites, abdominal distention, early satiety, changes in bowel habits, or a fixed mass
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10
Q

How do you diagnose ovarian CA?

A

Transvaginal U/S

- Genetics: BRCA1, CA-125, and mutations in P53

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11
Q

How do you treat ovarian cancer?

A

surgery + chemo and radiation

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12
Q

What is the MC cancer in women?

A

Breast Cancer

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13
Q

What genes are associated with breast cancer?

A

BRCA 1 and BRCA 2

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14
Q

What are some associated risk factors for breast cancer?

A

nulliparity, early menarche, late menopause, long-term estrogen use, radiation exposure, and delayed childbearing, and first degree relatives

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15
Q

How does breast cancer present?

A

lumps, bumps, skin changes, dimpling, red/hot, pain/no pain, regional node enlargement

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16
Q

When do we start mammograms?

A

Age 40 annually or every 2 years

Age 50 annually or every 2 years

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17
Q

if you have a post-menopausal woman with a new mass, discharge, or asymmetry what should you always think about?

A

Presumed cancerous until proven otherwise

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18
Q

What is the GOLD STANDARD of breast mass diagnosis?

A

Aspiration/biopsy = superior to imaging

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19
Q

What’s the most common type of breast cancer?

A

Infiltrating ductal carcinoma = spreads

20
Q

What sxs make you think of infiltrating ductal carcinoma?

A

redness, scaling, dimpling, thickening of the nipple

21
Q

How do you treat infiltrating ductal carcinoma?

A

Lumpectomy (if <2cm) or mastectomy

Sentinel node biopsy

22
Q

What type of breast cancer does not metastasis but has a high incidence of recurrence?

A

Ductal carcinoma insitu

23
Q

What are the systemic treatment options for breast CA?

A

Chemo, hormonal therapy, estrogen receptor downregulators (Tamoxifen) for pre-menopausal

24
Q

If breast CA were to metastasize, where does it most likely go?

A

obvi lymph nodes/muscle/fat/skin around the breast

But vertebral pedicles & ribs

25
Q

What does the F/U involve after breast CA?

A

every 3-6 months x 3 years
Every 6-12 months years 4 & 5
Every year after year 5
*Yearly mammogram + pelvic exams (some drugs can increase uterine cancer)

26
Q

If a pt has itching, burning, pain, scales/thickening of the nipple – what should you think?

A

Not just eczema but possible breast CA!

Paget’s

27
Q

What is cervical cancer associated with 99.7% of the time?

A

HPV

28
Q

What are the risk factors for cervical cancer?

A

early onset sexual activity, multiple partners, high-risk, hx of STIs, smoking

29
Q

What are the sxs associated with cervical cancer?

A

Early on = asymptomatic
Irregular or heavy vaginal bleeding
Postcoital bleeding

30
Q

What would the cervix look like that would make you think cervical cancer? Dx?

A

lesions that are raised, red, and friable

Dx – based on histologic evaluation

31
Q

Where does cervical cancer typically originate on the cervix?

A

transformational zone (SJC)

32
Q

How do we manage cervical cancer?

A

early detection

- Radical hysterectomy, fertility sparing surgery, and radiation

33
Q

When do we start paps?

A

Age 21

34
Q

A 23y/o female has a pap result that shows ASCUS, how do you move forward?

A

repeat pap in 1 year

  • If repeat pap is NORMAL, or ASCUS or LSIL again – screen in 1 year
  • If repeat pap is ABNORMAL – colposcopy
35
Q

A 26y/o female has a pap result that shows ASCUS, how do you move forward?

A

Reflex HPV testing

  • HPV Positive = colposcopy
  • HPV negative = repeat co-testing in 3 years
36
Q

A 23y/o (21-24y/o) female has a pap result that shows LSIL, how do you move forward?

A

repeat pap in 1 year

  • If repeat pap is NORMAL, or ASCUS again – screen in 1 year
  • If repeat pap is ABNORMAL – colposcopy
37
Q

A 28y/o female has a pap result that shows LSIL, how do you move forward?

A

HPV positive = colposcopy

HPV negative = repeat co-testing in ONE YEAR (not 3 like ASCUS)

38
Q

A 22y/o female has a pap result of HSIL, how do you move forward?

A

Colposcopy FOR ALL, no matter the HPV status

*high risk of carcinoma, correlates with CIN II or III

39
Q

A 27y/o has a pap result of ASC-H, how do you move forward?

A

colposcopy

40
Q

What if you 35y/o has a pap result of ASC-H, what do you do?

A

Colposcopy PLUS endometrial sampling if 35 or older

41
Q

What are the grades of CIN?

A

CIN I = mild dysplasia
CIN II = moderate dysplasia
CIN III = severe dysplasia to carcinoma in situ

42
Q

How does a colposcopy work?

A

Magnify the cervix

- Staining to identify areas to be biopsied (acetic acid and iodine)

43
Q

How do we treat the abnormal areas after biopsy via colposcopy?

A

LEEP

Ablation of T-zone with cryotherapy or laser

44
Q

Tell me about vaginal cancer?

A

Rare, mostly SCC
Diagnose via pap and biopsy
Treat with chemo or radiation

45
Q

If on the vulva you note red/white lesion that are itchy for the patient, dx? Tx?

A

Think Vulvar cancer

  • Biopsy
  • Surgery/chemo/radiation

FM II Women's Health (12 decks)

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