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Women's Health > Gynecologic Malignancies > Flashcards

Gynecologic Malignancies Flashcards

1
Q

Majority of vulvar caners are _____ lesions and occur in women ___

A

squamous lesions; > 50 years

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2
Q

What are some risk factors for vulvar cancer?

A

HPV, smoking, vulva skin disorders, preinvasive disease

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3
Q

Vulvar cancer is the ___ most common gyn cancer

A

4th

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4
Q

What are the two pathways that can cause vulvar cancer?

A

HPV or chronic irritation

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5
Q

Immune disease of vulva that can lead to vulvar cancer

A

lichen schlerosis

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6
Q

Symptoms of vulvar cancer

A

itching, vulvar mass/ulcer, bleeding

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7
Q

How do you diagnose vulvar cancer?

A

biopsy of atypical vulvar lesion

colposcopy to identify areas for biopsy

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8
Q

If the vulvar cancer is small invasive basal cell carcinoma, what is treatment?

A

lesion excision

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9
Q

If vulvar cancer is unresectable, positive for nodal spread, or there is recurrence, how do you treat this patient?

A

radiation

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10
Q

In addition to surgery, if there is distant spread, recurrence or poor response to previous therapy, what would you give the patient?

A

chemotherapy

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11
Q

what is the most common cause of vaginal cancer?

A

metastases from adjacent gyn cancer → lymph, local, or hemtologic

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12
Q

where in the vagina is vaginal cancer MC?

A

posterior upper 1/3 wall

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13
Q

symptoms of vaginal cancer

A

bleeding, pain, postcoital bleeding, discharge, local mass

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14
Q

What are some methods to diagnose vaginal cancer?

A

cytology, colposcopy and biopsy

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15
Q

Treatments for vaginal cancer → depends on extent and severity/recurrence

A

surgery, radiation, chemotherapy

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16
Q

what is the primary risk factor for developing cervical neoplasia?

A

HPV

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17
Q

what is the screening recommendations for cervical dysplasia?

A

start at age 21 with pap smear every 3 years → ages 30-65 either pap + HPV q5yr or just the pap q3yr → can stop at 65

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18
Q

In the Bethesda System, what does ASC-US stand for?

A

atypical squamous cells of unknown signifiance

reflex to HPV

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19
Q

In the Bethesda System what does AGUS stand for?

A

most recently added → endocervical, endometrial, UK

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20
Q

IN the Bethesda System, what does LSIL and HSIL stand for?

A

low grade squamous intraepithelial lesion → CIN I

high grade squamous intraepithelial lesion → CIN II-III

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21
Q

In the Bethesda System, what does CIN stand for?

A

cervical intraepithelial neoplasia

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22
Q

According to Bethesda 2001 system how should you manage abnormal cervical cytology?

A

colposcopy with biopsy to assess → cryosurgery, CO2 laser, loop excision, conization of cervix

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23
Q

third most common gyn cancer

A

cervical cancer

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24
Q

symptoms of cervical cancer

A

abnormal vaginal bleeding (postcoital), vaginal discharge (bad smell due to necrotic tissue), pelvic pain

25
Q

workup for patient suspected of having cervical cancer

A

pelvic/rectal exam, Pap smear (screen), HPV testing, biopsy, surgery (diagnostic!)

26
Q

Most common type of cervical cancer

A

squamous cell → HPV 16 (16 > 18)

27
Q

Stage I cervical cancer is located

A

junctional zone of cervix

28
Q

Stage II cervical cancer has spread to

A

upper vagina/parametrium

29
Q

Stage III cervical cancer has spread to and what may your patient present with

A

pelvic side wall → hydronephrosis (blocks kidney)

30
Q

What is the treatment for early stage cervical cancer?

A

conization, cryotherapy

31
Q

More advanced stages of cervical cancer may need?

A

hysterectomy (simple or radical), radiation, chemo

32
Q

Treatment of choice for any cervical cancer if the woman does not want any more children

A

hysterectomy

33
Q

most common cancer in female genital tract

A

endometrial cancer

34
Q

Risk factors for endometrial hyperplasia and carcinoma

A

obesity, nulliparity, diabetes, polycystic ovaries with prolonged anovulation, unopposed estrogen therapy, extended use of tamoxifen, family history of colon cancer

35
Q

what breast cancer treatment puts women at 2-3x increased risk of endometrial cancer → blocks estrogen receptors at breast cancer cells but upregulates at uterus?

A

tamoxifen

36
Q

If you have to give a post menopausal woman with a uterus estrogen, what should you also give her to decrease endometrial hyperplasia?

A

progesterone

37
Q

This genetic condition that results in hereditary nonpolyposis colorectal cancer puts women at predisposition for endomentrial cancer

A

Lynch Syndrome

38
Q

80% of endometrail cancers are due to excess ___ leading to hyperplasia. Due to ….

A

estrogen

obesity, nulliparity, estrogen excess, diabetes

39
Q

Type II endometrial cancer are unrelated to ___ and are seen in what patient?

A

estrogen

skinny old patient

40
Q

Symptoms of endometrial cancer

A

abnormal bleeding (90%), bleeding after menopause

41
Q

what is the best method for diagnosing endometrial cancer?

A

endometrial biopsy or D&C/hysteroscopy

42
Q

Two histological types of endometrial cancer

A

adenocarcinoma → endometroid is MC

sarcoma

43
Q

treatment of endometrial cancer

A

total hysterectomy and bilateral salpingo-oophrectomy
may need chemo or radiation depending on stage
may get hormones

44
Q

1 cause in gyn cancer death

A

ovarian cancer

45
Q

why does ovarian cancer cause so many deaths?

A

vague symptoms and no way to screen

46
Q

Risks for ovarian cancer

A

nulliparity, early, menarche, late menopause, caucasian, age, family history, history of breast cancer, BRCA1/BRCA2, Ashekenazi jews, HRT, talc powder

47
Q

symptoms of ovarian cancer

A

mild nonspecific GI symptoms, pelvic pressure, early satiety, bloat, weight gain

48
Q

what is a possible lab test that may indicate ovarian cancer?

A

CA 125

49
Q

What also may cause elevated CA 125 levels?

A

benign disease in premenopausal women (endometriosis),

50
Q

What may CA 125 be helpful in screening?

A

follow patient after surgical resection of tumor → look for recurrence or malignancy

51
Q

what imaging test can you use to differentiate benign from malignant ovarian masses?

A

US with color doppler

52
Q

Treatment for benign ovarian neoplasm

A

tumor removal or unilateral oophrectomy

53
Q

Treatment for malignant ovarian cancer

A

abdominal hysterectomy and bilateral salpingo-oophrectomy with omentectomy and selective lymphadenectomy

54
Q

most common variety of ovarian cancer

A

epithelial (85%)

55
Q

why is it hard to treat ovarian cancer?

A

bad seeding

56
Q

what do you do first when treating ovarian cancer?

A

surgical debulking → cryoreduction

57
Q

why do you activate ovarian cancer cells prior to chemo with cryoreduction?

A

reactivate them so they are more responsive the chemo

58
Q

what is the primary chemotherapy regimen for ovarian cancer?

A

carboplatin/Taxol

59
Q

If ovarian cancer recurs, what do you want to see if it is sensitive to?

A

platinum

Women's Health (9 decks)

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