Gynecological Oncology Lecture Powepoint

Question 1

Dysplasia

Answer 1

Disorders of cellular growth and development, may result from abnormal cell size, number, or differentiation

Question 2

Neoplasia

Answer 2

Process of accelerated or uninhibited division and growth of abnormal cells

Question 3

Hyperplasia

Answer 3

An increase in number of cells, usually an adaptive response to demans for increased tissue function

Question 4

Benign characteristics

Answer 4

-well differentiated, slow growth, localized, noninvasive, defined margins

Question 5

Malignant characteristics

Answer 5

Poorly differentiated, fast growth, invasive spread, margins not clear

Question 6

Carcinoma

Answer 6

A cancer of epithelial cell origin

Question 7

Sarcoma

Answer 7

A cancer of connective tissue origin

Question 8

Doubling time of a tumor determines….

Answer 8

….how aggressive it is

Question 9

Direct spread

Answer 9

Invasion of cancer into surrounding tissues, lack of demarcated borders

Question 10

Metastasis

Answer 10

Invasion of cancer into vessels or lymphatics

Question 11

TNM classification

Answer 11

Varies with different types of cancers and how far they are developed, as well as how they are treated and their prognosis, T standing for size (0-4) N for number of regional lymph nodes involved (0-4) and M0 for abscence of metastatis or M1 for presence of it

Question 12

Most common causes of vulvar, cervical, and vaginal cancer

Answer 12

HPV subtypes 16 and 18

Question 13

VIN

Answer 13

Vulvar intraepithelial neoplasia, classified by depth and epithelial cell maturation, with I being mild and III being severe dysplasia

Question 14

Paget’s disease

Answer 14

Vulvar skin disease most often seen in post menopausal white women, treated with surgical removal

Question 15

Cancer of the vulva is most often what type?

Answer 15

Squamous cell carcinoma

Question 16

1/3 of patients with vulvar cancer will also have…

Answer 16

….A 2nd malignancy usually cervical or vaginal

Question 17

When you find VIN or paget’s disease you should look for….

Answer 17

…additional cancers of the vagina, cervix, or uterus

Question 18

Paget’s disease with nodal involvement

Answer 18

Invariably fatal presentaiton

Question 19

Paget’s disease of the breast

Answer 19

A rare form of breast cancer that starts on the nipple and extends to the areola, related to paget’s disease of the vulva

Question 20

Key to surviving cancer of the vulva

Answer 20

Early detection and treatment

Question 21

Most common vaginal cancer

Answer 21

Cervical cancer extension into adjacent vaginal tissue

Question 22

Best time to diagnose vaginal cancer

Answer 22

Looking at vaginal mucosa when moving or removing speculum

Question 23

Treatment for vaginal cancer

Answer 23

Surgery or radiation, chemo is not effective

Question 24

Gravida/parity/abortus

Answer 24

Times been pregnant/times given live birth/lost pregnancies

Question 25

Cervical cancer treatment even in early stages includes...

Answer 25

...hysterectomy

Question 26

Most common gynecologic malignancy

Answer 26

Endometrial cancer

Question 27

Triad risk factors for endometrial cancer

Answer 27

Obesity, hypertension, diabetes mellitus

Question 28

Other endometrial cancer risk factors (5)

Answer 28

- PCOS - exogenous estrogen - nulliparity - multiple endocrine neoplasia syndrome - tamoxifen

Question 29

Endometrial cancer number 1 symptom

Answer 29

Abnormal uterine bleeding

Question 30

Any menopausal or postmenopausal paatient with abnormal bleeding must be evaluated for....

Answer 30

...endometrial cancer

Question 31

Endometrial cancer diagnosis (also, what specific thing do you never do for this)

Answer 31

Biopsy (never a pap smear)

Question 32

Tumor marker in endometrial cancer or ovarian cancer

Answer 32

CA 125

Question 33

Endometrial cancer treatment (both standard and non standard of care)

Answer 33

- Hysterectomy and bilateral salpingo-oophorectomy is standard - Progestational agents to produce antitumor response is nonstandard but preserves fertility

Question 34

Common uterine sarcoma presentation

Answer 34

Usually after 40 yrs, rapid enlargement of uterus or a leiomyoma

Question 35

Ovarian cancer risk factors

Answer 35

Low parity and family history

Question 36

2 preventative measures against ovarian cancer

Answer 36

Multiple pregnancies or oral contraceptives

Question 37

2 syndromes associated with ovarian cancer

Answer 37

- Lynch II | - Breast ovarian cancer syndrome

Question 38

Primary mode of dissemination of ovarian cancer

Answer 38

Implantation on peritoneal surfaces

Question 39

Ovarian cancer is often ____ until it has already progressed into stage III or IV

Answer 39

Asymptomatic

Question 40

Sister Mary Joseph's nodule

Answer 40

Metastatic implant in the umbilicus and a screeing test for ovarian cancer

Question 41

Ovarian cancer diagnosis

Answer 41

Ultrasound imaging (often false positives) followed by diagnostic laporoscopy

Question 42

Elevated CA-125 cannot ___ a patient with ovarian cancer, it is only ___

Answer 42

diagnose definitively, supplemental

Question 43

BRCA 1 and 2 mutations

Answer 43

Associated with increased rates of breast, ovarian, and prostate cancer