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Women's Health > Lawrd She got Cancer > Flashcards

Lawrd She got Cancer Flashcards

1
Q

What percent of women diagnosed with cervical cancer never recieved cervical cytology?

A

50%

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2
Q

What percent of women had not be screened within 5yrs of being diagnosed with cervical cancer?

A

10%

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3
Q

What is dysplasia?

A

epithelium is replaced by cells showing atypia

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4
Q

How is cervical cancer staged?

A

Besthada- Cervical Intraepithelial Neoplasia

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5
Q

Reflects a recent HPV infection?

A

CIN 1

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6
Q

Large inter-observer variability?

A

CIN 2

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7
Q

Strong predicator of progression to cervical cancer

A

CIN 3

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8
Q

Since 1975 mortality due to cervical cancer has?

A

decreased

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9
Q

Where is cervical cancer much more common?

A

in countries without screening programs

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10
Q

What is the most common type of epi cell abnormalities?

A

undetermined significance (ASC-US)

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11
Q

Cervical cancer screening begins at ?

A

21 yrs

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12
Q

Age at which cervical cancer shouldn’t be screened regardless of age of sexual initiation or behavior related risk?

A

< 21 yr

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13
Q

How many cases of cervical cancer occur before age 20?

A

0.1% (1-2 cases out of 1,000,000)

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14
Q

What are 6 risk factors for cervical cancer?

A 
Young age at first coitus
multiple sexual partners
sexual partener w/ multiple partners
young age @ first preggo
low socioeconomic status
SMOKING!
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15
Q

What is not a risk factor related to cervical cancer??!

A

FAMILY HISTORY

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16
Q

Which strain of HPV has the highest carcinogenic potential?

A

HPV 16

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17
Q

Which strain of HPV has the 2nd highest carcinogenic potential?

A

HPV 18

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18
Q

How many HPV genotypes are associated with cervical cancer?

A

12

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19
Q

What accounts for 55-60% of cervical cancer?

A

HPV 16

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20
Q

What accounts for 10-15% of cervical cancer?

A

HPV 18

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21
Q

What are some known cofactors that increase the risk of HPV infection?

A

smoking
compromised immune system
HIV infection

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22
Q

Young women immune response usually clears the immune system on average of …

A

8 months

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23
Q

Young women immune response usually decreases the viral load to undetectable levels in….

A

8-24 months

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24
Q

Persistent HPV infection at 1 and 2yrs after infection strongly predicts what?

A

risk of CIN 3 or cancer

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25
Q

What is the best HPV vaccination to receive?

A

9-valent

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26
Q

When can the HPV vaccine be given?

A

9 to age 26 (now extended to 45)

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27
Q

HPV screening for 21-29yr?

A

pap smear every 3 years

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28
Q

HPV screening for 30-65yr?

A

HPV and pap smear every 5 yrs or Pap smear w/ cytology every 3 years

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29
Q

HPV screening for >65?

A

NO SCREENING

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30
Q

HPV screening for women who underwent total hysterectomy AND never had CIN 2 or higher?

A

NO SCREENING

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31
Q

HPV Screening for women who underwent total hysterectomy AND have a history of CIN 2 or higher in the past 20 yrs or cervical cancer

A

SCREEN

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32
Q

What 4 women need to be screened more often for cervical cancer?

A

Women HIV infected
Immunocompromised women
Women exposed to DES in utero
Women previously txt for CIN2,3, or cancer

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33
Q

Abnormal pap smear what’s next?

A

colposcopy

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34
Q

Treatment for CIN 2-3?

A

Cryotherapy
LEEP (Loop Electrical Excision Procedure)
Cold Knife Cone

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35
Q

A visible lesion seeing during pelvic exam needs what?

A

a biopsy for diagnosing NOT A SCREENING PAP

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36
Q

Who created the pap test?

A

Georgios Papanikolaou

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37
Q

90% of cases of genital warts are cause by what genotypes?

A

6 and 11

38
Q

What is the dosing for HPV?

A

3 dose
2nd is given at least 1-2mo after 1st
3rd is @ least 6mo after 1st

39
Q

T/F Vaccine is less effective in previous infected individuals?

A

TRUE

40
Q

4TH most common cancer in women?

A

uterine cancer

41
Q

4th and 5th leading cause of cancer death?

A

ovarian and endometrial cancer

42
Q

3rd most common cancer among and women and 2nd most frequent cause of related death worldwide

A

cervical cancer

43
Q

??? cancer is a sexually transmitted disease

A

cervical cancer

44
Q

high risk HPV genotypes

A

16, 18, 31, 33, 35, 39 45, 51,52, 58

45
Q

Low risk HPV genotypes

A

6, 11, 40, 42, 43, 44, 54

46
Q

90% of anogenital warts

A

HPV 6, 11

47
Q

50% of vaginal and vulvar cancer?

A

HPV 16, 18

48
Q

95% of cervical HPV infection

A

Squamous Cell Carcinoma

49
Q

30% of cervical HPV infection

A

Adenocarcinoma

50
Q

Symptoms of cervical cancer?

A

irregular of heavy vaginal bleeding
Postcoital bleeding
Vaginal Discharge

51
Q

HPV screening in HIV +

A

screening X2 in 1st yr after diagnosis

then ANNUALLY

52
Q

What is done at a HIV + initial evaluation

A

Colposcopy

53
Q

HPV Screening for immunosuppressive pt?

A

started after one yr of sex activity or by age 21

54
Q

HPV Screening for Immunosuppressive <30yr

A

screen w/ yearly PAP test for 3 yrs

55
Q

HPV Screening for Immunosuppressive normal results for 3 yrs?

A

move to screening every 3 years (NEVER 5)

56
Q

ASCUS

A

atypical squamous cells of undetermined significance

57
Q

Stage I cervical cancer

A

confined to cervix

58
Q

Stage II cervical cancer

A

disease beyond cervix but not to pelvic wall or lower 1/3 of vagina

59
Q

Stage III cervical cancer

A

disease to pelvic wall or lower 1/3 vagina

60
Q

Stage IV cervical cancer

A

invades bladder rectum or metastasis

61
Q

What can prevent almost all cervical cancers

A

vaccination and regular screening

62
Q

If over >15 what HPV vaccine dose is recommended?

A

3 dose

63
Q

Gardasil 9 is not approved for whom?

A

27-45yr

64
Q

Potential allergic reaction to HPV?

A

previous dose, yeast, amorphous aluminum hydroxyphosphate sulfate or polysorbate 80

65
Q

Most common GYN malignancy in U.S.

A

Endometrial cancer

66
Q

What the two phenotypes for endometrial cancer?

A

Type I and Type II

67
Q

Where does Type I endometrial cancer arise from?

A

estrogen stimulation

68
Q

Where does Type II endometrial cancer arise from?

A

NOT associated w/ estrogen stimulation

69
Q

Grade I and 2

A

Type I

70
Q

Grade 3

A

Type II

71
Q

Presentation of endometrial cancer?

A 
Abnormal vaginal bleeding
Postmenopausal bleeding (90%)
Abnormal discharge
72
Q

Diagnosis of endometrial cancer?

A

Endometrial biospy

73
Q

Endometrial stripe thickness <4mm

A

low risk

74
Q

Endometrial stripe thickness > 4mm

A

high risk.. proceed w/ biospy

75
Q

Gold standard diagnosis for endometrial cancer?

A

fractional curettage +/- hysteroscopy

76
Q

What is used to check endometrial thickness

A

transvaginal U/S

77
Q

What stage of endometrial cancer has the highest 5 yr survival rate

A

Ia (91%)

78
Q

What stage of endometrial cancer has the lowest 5 yr survival rate

A

IVb (20%)

79
Q

Largest number in GYN deaths

A

ovarian cancer

80
Q

cancer rises with age, peak at 54-64yr

A

ovarian cancer

81
Q

3 risk factors for ovarian cancer?

A
  • BRCA 1 mutation (35-46%)
  • BRCA 2 (13-23%)
  • Lynch Syndrome (3-14%)
82
Q

What are two red flags for hereditary breast and ovarian cancer?

A

breast cancer before 50

ovarian cancer any age

83
Q

Two common presenting symptoms in ovarian cancer?

A 
abdominal discomfort (50%)
Vaginal bleeding (15%)
84
Q

When should a postmenopausal woman be referred to GYN Onc?

A 
w/ pelvic mass and 1:
CA-125 above normal
Ascites
Fixed or nodular mass
evidence of mets
Family hx of >1 1st degree relatives
85
Q

When should a premenopausal woman be referred to GYN Onc?

A

CA-125 > 200u/ml
Ascites
Evidence distant mets
Family hx or >1 1st degree relatives

86
Q

Surgery plan for ovarian cancer?

A

TAH, BSO complete staging and tumor debulking

87
Q

Chemotherapy for ovarian cancer?

A

Carboplatin and Paclitaxel

88
Q

Peak age for vulvar neoplasm

A

70yr

89
Q

Peak age for vaginal neoplasm

A

50yr

90
Q

Treatment for vaginal neoplasm

A

radiation therapy

91
Q

Treatment for vulvar neoplasm

A

surgical excision, radiation therapy, chemotherapy

92
Q

Risk factor vulvar neoplasm

A

HPV

Women's Health (11 decks)

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