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Gynec Onco Flashcards

1
Q

Mc symptoms in ca cervix

A

Bleeding

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2
Q

Ca cervix eith hydroneph

A

3B

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3
Q

Ca cervix with prametrial inv

A

2 b

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4
Q

Lesion inv upper third epithelium

A

Cin 3

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5
Q

Mc abn Pap test result

A

Ascus 2-9%

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6
Q

Ascus best mgt

A

Hpv dna test

Alts trial

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7
Q

Adenoca instiu cin express ihc? Tsg?

A

P16 30-60%

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8
Q

Fertility sparing sx not done when

A

Gastric type adenoca
Small cell neuroendocrine
Adenoma malignum

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9
Q

Fertility sparing prefered for

A

Less than 2 cm

Upto 1B2

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10
Q

How much neg margin cone excision in fertility sparing

A

3 mm

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11
Q

Preferred method of cone biopsy in malignancy

A

Cold knife conization

Leep in hsil

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12
Q

Treatment for 1B3

A

Chemorad

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13
Q

2A1

A

Surgery

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14
Q

Modified rad hysterectomy

A

1a1 with lvi

and 1a2

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15
Q

Microinvasive ca

A

Less tha 5 mm depth

Largest extension les than 7mm

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16
Q 
• When to do revision surgery after incidental
finding in simple hysterectomy
sAwithvs
@ l3 with negative margins
© 3 with positive margins
a Gross residual disease
A

None

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17
Q

Sedlis criteria

A 
Lvsi
Strimal invasion
Tr size
Criteria for extrenal pevic rad after radical hysterectomy in 
Node neg
Margin neg
Parametria neg
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18
Q

Adenoma malignum aw which syndrome

A

Peutz jeghers

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19
Q

Ca cervix figo

Pelvic ln + is

A

3C

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20
Q

Figo staging

A

Read

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21
Q

Lnd which stage onwards in ca cervix

A

Ia1 eith lvi or 1a2

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22
Q

Hsil treatment

A

Leep

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23
Q

Cin 2 is div into lsil and hsil based on

A

P16

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24
Q

Infants squamocolumnar junction at mcly in cervix

A

Ectocervix

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25
Nueroendocarcinoma of cevix most sensitive marker | Most specific
Sensitive CD56 Synaptophysin | Specific Chromogranin
26
Colposcopy | Sharp border inner border sohn ridge sign seen in
Grade 2 major
27
Staging of ca cervix | Pet ct or pet mri in
Nore than or eq 1B1
28
Reid index
Marhin Colour Vessels Iodine staining
29
Swede index
``` Aceto uptake Margins or surface Vessels Lesion size Iodine staining ```
30
Types of hysterectomy | Querlow and morrow
© Type A: Minimum Resection of Paracervix This is an extrafascial hysterectomy. © Type B: Transection of the Paracervix at the Ureter This type has two levels: B1-Without removal of lateral paracervical lymph nodes © B2-With removal of lateral paracervical nodes At least 10 mm of the vagina from the cervix or tumor is resected. • Type C In type C, the paracervix is transected at the junction with the internal iliac vascular system and has two types: © C1-With nerve preservation C2-Without preservation of autonomic nerves The ureter is mobilized completely, and 15 to 20 mm of vagina from the tumor or cervix and the corresponding paracolpos is resected routinely © Type D In type D, the entire paracervix is resected: • D1-Resection of the entire paracervix along with the hypogastric vessels • D2-Resection of the entire paracervix, along with the hypogastric vessels and adjacent fascial or muscular structure
31
Radical hysterectomy tyoe
C1 | Modified is b
32
Radiation dose in cervic ca
80Gy
33
Slnb in ca cervix when size less than
2cm
34
Gardasil 9 includes
31 45 48 52
35
Earliest abn in ca cervix
Blurring of stromoepithelilanjunctiok with protrusion of cells into stoma
36
Senticol trial
Sentinel lnb in ca cervix
37
Lilacs
Lnd in lacacervix
38
Chemo in ca cervix
Cisplatin | If not then carbo
39
Chemo in ne cervic ca
Cisplatin etoposide | Carbo
40
Tests for mets or recurrent ca cervix
MSI NTRK PDL1
41
How many ca endometrium before menopause
20%
42
Msi mc in ca endometrium
Mlh1> msh6
43
Mc histology in ca endometrium
Endometrioid
44
Abn thicknes of endometrium
5 mm
45
Use of ca125 in endometrial ca
``` Use of CA 125 in endometrial cancer A • Pelvic node mets © Para aortic node mets © Predicting treatment response © Surveillance © Extra uterine disease ```
46
Most aggressive histology in ca endo
Serous aka uterine ppilalry serous cancer
47
Mskcc prognostic factors in nomogram for ca endometrium
``` Age at dx Neg ln Stage grade Histology ```
48
Type 1 endo ca
``` > Type 1 with hyper oestrogenism like anovulatory bleeding, infertility, late menopause and endometrium hyperplasia. © Good prognosis © Well differentiated • Less invasion © PI3K/AKT ```
49
Type 2 endo ca
``` • Type 2 lack hyperoestrogenism , older © Poorly differentiated © Extrauterine spread © P53 p16 © In addition to TP53 mutations, type II endometrial cancers are characterized by HER2/neu amplification, loss of ER/PR, and loss of E-cadherin. ```
50
Future 1 and 2 trials
Guardasil
51
Patricia and costarica hpv trial
Cervarix
52
Complex hyperplasia with atypia risk of endo ca
30%
53
Endometrial ca in atypical hyperplasia hysterectomy sample
42%
54
Mc cause of death in ca cervix
Uremia
55
High intermediate risk ca endo
NIf HIR per GOG 249: age 50-69 y with two risk factors or age <50 y with three ris factors, or age 270 y with one risk factor. Risk factors include grade 2 or 3, deptr of invasion to outer half, and LÜSI.
56
Radical hysterectomy from which stage in ca endo
2
57
Portec trial
Endometrium ca
58
Endomteroid ca gentic clases 4 | Molecular markers
``` Mc and excellent prognosis -pole hyper mutation High copy number worst prognosis Copy number low beta catenin mutation Msi hyper mutation Markers- her2 ntrk erpr ```
59
Endo ca clear cell type 4 molecular types
Pole Mismatch repair deficient Copy number high and low
60
Ca endo metrium slnb
Done when limited to uterus without mets Injected into cervix Mc involves ventral to hypogastric Medial to ext ilic and superior to obturator
61
Er staging done when in ca endo
Stage 3,4 recurrent
62
Her2 in ca endo tested when
Recurrnt | Serous
63
Paraortic surgical stagin in endo ca
``` Advanced stage High grade Clear cell Serous And carcinosarcoma ```
64
Fertilitpreservation in ca endometrium
``` Wd endometrioid G1 Linited to endometrium No mets no nodes No ci to medica tt or pregnancy Continous progestin based for 6 m to 1 yr- megestrol medroxyprog levonorgestrel iud ```
65
Mc site of neuroendocrine ca in female GUT
Cervix
66
G1 in endoca how much solid sheets
Endometrioid <5% solid sheets g1 G2- adeno ca 6-50% G3- >50%
67
Mixed mullerian tr
Carcinosarcoma Riskfactor Radiation and tamoxifen
68
Mc sarcoma in endo
Lms
69
Higrsde endometrstromal sarcoma fusion?
YEHAE NUTM 2A/B
70
Node postivity in lms ess
3C
71
Hormonal therapy in uterine sarcoma for
Low grade ess | And receptor postive lms
72
Lms in uterine markers
Sma Desmin Plag1 + inmyxoid Hmb45 and melan A neg
73
Low garde ess positve markers
Jazf1 suz12 Er pr Cd10
74
Drug for sarcoma uterine
Doxo
75
Endo carcin ct
Paclicarbo

Crash (20 decks)

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