Gynecology Flashcards
cervical cancer path
HPV infection -> 16, 18, 30s
cervical cancer pt
asx screen = pap (pre-cancer)
post-coital bleeding
reproductive age female
cervical cancer dx
pap smear - start screen @ 21, then q3y - ASCUS: q1y Pap or HPV DNA colposcopy - ectocervical lesions - endocervical lesions staging
cervical cancer tx
ecto: local ablation (LEEP, cryo)
endo: cone biopsy
stage IIa or < : local resection
stage IIb or > : chemo + radiation
cervical cancer screen
pap smear
cervical cancer ppx
HPV vax 11-26
endometrial cancer path
PROgesterone is PROtective Estrogen Exposure - old age - nulliparity - obesity - PCOS - HRT
endometrial cancer pt
postmeno female with postmeno bleeding
endometrial cancer dx
endometrial sampling or D&C (bx)
endometrial cancer tx
hyperplasia: progesterone
cancer: TAH + BSO
+/- radiation
+/- chemo
vulvar cancer path
squamous cell (HPV) melanoma (sun exposure)
vulvar cancer pt
black and itchy
vulvar cancer dx
1st and best = bx
vulvar cancer tx
vulvectomy and LN dissection
paget’s path
usually noninvasive
paget’s pt
RED and itchy
paget’s dx
1st and best = bx
paget’s tx
local resection (no need for vulvectomy)
germ cell ovarian cancer subtypes
dysgerminomas: chemo, LDH
endometrial sinus: AFP
teratoma: struma ovarii
chorio: ß-hCG
germ cell ovarian cancer path
nonmalignant
germ cell ovarian cancer pt
teenge girl with an adnexal mass
stage I
germ cell ovarian cancer dx
TVUS
best: biopsy
germ cell ovarian cancer tx
unilateral salpingo-oopherectomy (conservative)
epithelial cell ovarian cancer subtypes
serous
mucinous
endometrioid
brenner’s
epithelial cell ovarian cancer path
epithelial trauma = ovulation
malignant
epithelial cell ovarian cancer pt
postmeno female null/low parity stage IIIb or worse (even w/ screen) - asx, seed peritoneally - renal failure, SBO, ascites BRCA1 or 2, HNPCC
epithelial cell ovarian cancer dx
NO screen
1st: TVUS
then: CT - stage
track: CA 125
best: bx
epithelial cell ovarian cancer tx
TAH + BSO
paclitaxel
epithelial cell ovarian cancer special
BRCA1 or 2 screen
- TVUS and CA-125 w/ ppx TAH+BSO @35
stromal cell ovarian tumors
granulosa theca - estrogen
sertoli leydig - testosterone
vaginal cancer - SCC
just like cervical cancer except no pap
vaginal cancer - adeno
DES exposure in mom while your patient in front of you was in mom’s uterus
‘grape-like’ mass in vagina in a child
complete mole path
completely molar = no fetal parts completely chromosomal = 46, XX completely spermal =no egg genetics normal fertilization broken egg
complete mole pt
size-date discrepancy ß-hCG too high for dates hyperthyroidism (from ß-hCG) hyperemesis gravidarum adnexal mass (simple cyst) grape-like mass exiting cervix
complete mole dx
1st: U/S = snowstorm **
complete mole tx
suction curettage