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Oral board studying Prep book > GYN Oncology- Vulvar Neoplasia, Ovarian cancer > Flashcards

GYN Oncology- Vulvar Neoplasia, Ovarian cancer Flashcards

1
Q

What is VIN?

A

Vulvar intraepithelial neoplasia
High risk disease
Vulvar HSIL

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2
Q

What are the categories of VIN?

A

Differentiated VIN
or
Usual type VIN

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3
Q

What is differentiated VIN?

A

Not associated with HPV
Associated with dermatologic conditions

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4
Q

What is usual type VIN?

A

Associated with carcinogenic genotypes of HPV, smoking and immunosuppression

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5
Q

What is the treatment for VIN?

A
  1. Wider local excision
  2. Laser ablation
  3. medical therapy
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6
Q

What is the follow up after treatment for VIN?

A

Surveillance at 6 and 12 months and then yearly

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7
Q

In the case of genital warts when should you perform a biopsy?

A

If patient is menopausal
or
In any patient in which topical therapy fails

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8
Q

How many stages of ovarian cancer are there?

A

4 stages

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9
Q

What is stage 1 ovarian cancer?

A

Confined to 1 or both ovaries or fallopian tubes

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10
Q

What is stage 2 ovarian cancer?

A

Spread to pelvis below pelvic brim or primary peritoneal cancer

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11
Q

What is stage 3 ovarian cancer?

A

Peritoneal metastasis outside pelvic or positive retroperitoneal nodes

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12
Q

What is stage 4 ovarian cancer?

A

Distant metastasis

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13
Q

What are the features of a benign adnexal mass?

A
  1. Younger age
  2. Unilateral
  3. Size <6cm
  4. No solid component
  5. No septation
  6. Not complex
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14
Q

What are the features of a malignant adnexal mass?

A
  1. Persistent
  2. Older age
  3. Solid
  4. Papillary projections
  5. Increased septations
  6. Increased complexity
  7. Size >10 cm
  8. Bilateral
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15
Q

What is the management for a simple adnexal mass?

A

Can observe no matter if pre or post menopause.

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16
Q

What is the differential diagnosis for solid adnexal mass?

A
  1. Fibroid
  2. Thecoma
  3. Fibroma
  4. Brenner
  5. Granulosa cell tumor
  6. Dysgerminoma
17
Q

What is the differential diagnosis for cystic adnexal mass?

A
  1. Functional cysts
  2. Serous and mucinous tumors
  3. Mature cystic teratoma
18
Q

What can cause a false positive Ca125?

A

Appendicitis
Cholecystitis
PID
Fibroids
Endometriosis
Diverticulosis

19
Q

What is Ca125 a marker for?

A

Serous epithelial tumors

20
Q

What can cause a false negative Ca125?

A

Nonepithelial ovarian tumor

21
Q

What is the tumor marker CEA representative of?

A

Mucinous epithelial tumors

22
Q

What is the tumor marker AFP representative of?

A

Endodermal sinus tumor
Embryonal tumors

23
Q

What is the tumor marker hCG representative of?

A

Choriocarcinoma
Embryonal carcinoma
dysgerminoma

24
Q

What is the tumor marker Estrogen representative of?

A

Granulosa cell tumor

25
Q

What adnexal masses has androgens as tumor marker?

A

Thecoma
Fibroma
Sertoli leydig cell

26
Q

What is the tumor marker inhibin representative of?

A

Granulosa cell tumor

27
Q

What is the tumor marker LDH representative of?

A

Dysgerminoma

28
Q

What tumor marker(s) does a dysgerminoma have?

A

hCG, LDH

29
Q

What tumor marker(s) does endodermal sinus tumor have?

A

AFP

30
Q

What tumor marker(s) does choriocarcinoma have?

A

hCG

31
Q

What tumor marker(s) does immature teratoma have?

A

AFP
Ca125
LDH

32
Q

What tumor marker(s) does embryonal carcinoma have?

A

AFP, hCG

33
Q

What is representative of a borderline tumor?

A

Nuclear typia
Epithelial stratification

34
Q

What is the order of work up for a postmenopausal patient with an adnexal mass?

A
  1. History and Physical
  2. Ultrasound
  3. Tumor markers
  4. Consider CT scan
  5. Bowel prep
  6. Surgery
  7. Cytological lashings upon entry in abdomen
  8. Frozen section
  9. Definitive treatment for malignancy (hyst, BSO, omentectomy, lymphadenectomy, debulking
35
Q

What is a dysgerminoma?

A

Malignant ovarian germ cell tumor derived from the embryonic gonads

36
Q

What is the treatment of dysgerminoma?

A

Sensitive to radio and chemo therapy (BEP) Bleomycin, Etoposide, Cisplatin

Surgery: Unilateral Salphingoopherectomy, limited staging, serial tumor markers

37
Q

What do you see on histology with granulosa cell tumor?

A

Call Exner bodies
Coffee bean nuclei

38
Q

Ovarian cancers associated with underdeveloped or streaked gonads?

A

Gonadoblastoma
Dysgerminoma

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