Lecture 11- Gyn Oncology Flashcards
What is the # cells/ tumor actively involved in cell division that excludes G0 phase?
Growth fraction
What decreases with tumor growth?
Growth fraction (less O2 and vascular supply)
What type of radiation produces free radicals and disrupts cancer cells DNA & ability to divide?
Ionizing radiation therapy
What is a benign vulvar disease that is 2ndary to irritant dermatitis and has the CC of progressive vulvar pruritis/ burning. Will have diffuse erythema w/ red or red-brown plaques
Lichen simplex chronicus
Name that benign vulvar disease-Wickham striae, patchy erythema. Ctyology: WBCs, few bacteria. recurrence is likely
Lichen planus
Name that benign vulvar disease: PE: Atrophic, thin, hyperkeartotic patches. Have a risk of squamous cell CA. (parchment paper) Hx: dyspareunia, pruritus
lichen sclerosis
Are vulvar diseases with the work “lichen” in front of them malignant or benign?
Benign
What stage of VIN is associated w/ the presence of condyloma acuminata?
VIN 1
What does VIN, usual type look like? Commonly seen in smokers
Dusky red or white lesions, patchy
What is VIN?
Vulvar intraepithelial neoplasm
What does VIN, differentiated type look like?
Warty papule, ulcer, hyperderatotic
Which type of VIN is more at risk of developing into invasive carcinoma and needs to be completely excised?
VIN, differentiated type
What type of vulvar disease is fiery red w/ white hyperkeratotic areas and is treated w/ wide local excision or vulvectomy? Patients have hx of breast or colon cancer
Vulvar Paget’s
What is the most common type of vulvar cancer?
Squamous cell carcinoma
What is VAIN?
Vaginal intraepithelial neoplasm
What is a rare pediatric vaginal cancer that is a grape like mass at the introitus?
Sarcoma botryoides
What drug therapy can help treat hyperplasia associated with uterine neoplasia?
Progestin therapy Medorxyprogesterone acetate (10-14 days/month) or daily (no periods)
Which type of endometrial cancer are a majority estrogen dependent; majority are adrenCA.
Type I
What type of endometrical cancer is unrreleated to estrogen or endometrial hyperplasia. Will typical have an atrophic endometrium
type II endometrial cancer (poorer prognosis)
What tyep of endometrical cancer is unrreleated to estrogen or endometrial hyperplasia.
type II endometrial cancer (poorer prognosis)
Most is the most common side effect of antineoplastic drugs?
Myelosupression
How do you treat VIN, usual type?
Use acetic wash and do multiple site biopsies
do a complete excision to r/o SCC
If a women over 40 has a inflamed bartholin’s gland what should you do?
Get a biopsy
If a women has ASC-US and a negative HPV what do you do?
Pap in 1 year
for post menopausal women, how thick should the endometrial lining be?
less than 4 mm
for uterine hyperplasia with atypia what do you?
D & C
What is a corpus luteum cysts associated w/?
Missed menses
What hormone does corpus luteum release?
Progesterone
What is clomiphene used for?
Ovulation induction
What type cyst is associated with : IUP, clomiphene & gonadotropin ovulation induction
Theca lutein cyst
What are the 2 types of non-functional neoplasms?
Epithelial cell tumors
Germ cell tumors (termatoma)
What are 2 types of functional neoplasms?
Stomal cell (grnaulosa theca cell- estrogen) Sertoli-Leydig (androgenic)
is there a screening tool for ovarian CA?
No, very hard to detect in early stages
Levels of ________ are used to track ovarian CA.
CA-125
What phase of the cell cycle is not affected by chemo or radiation?
G0 phase
What are the 6 types of benign vulvar diseases?
- lichen simplex chronicus
- lichen planus
- lichen sclerosis
- psoriasis
- Dermatitis- Eczema
- Dermatitis- Seborrheic
What is a pale lesion with oily scale or crust that doesn’t usually need a biopsy?
Seborrheic dermatitis
What disease should you avoid speculum use because there is pain with insertion of objects into the vagina?
Localized vulvodynia
What is the prescription for vulvar lipomas and fibromas?
excision
With lichen simplex chronicus, what should you do if there is no response to Rx within 3 months?
biopsy
According to Dr. B, this PE is most characteristic of Lichen planus
Wickham striae
According to Dr. B, this PE is most characteristic of Lichen sclerosis
parchment like epithelium
What is the way to diagnose the usual type of VIN and how is this a different diagnosis from the other two forms of VIN?
Usual type: colposcopy with acetic wash and multiple site biopsies
VIN 1 and differentiated just do a biopsy
What age range is vulvar cancer most associated with?
70-80 y/o
What do you need to rule out before diagnosis of VAIN?
cervical neoplasia
invasive vaginal carcinoma
What other problem is associated with Uterine neoplasia?
AUB
What are risk factors for uterine neoplasia?
FHx breast, colon, other gyn CA
Chronic anovulation
Unopposed estrogen (Endogenous/Exogenous)
What are the two types of endometrial cancer?
I: majority estrogen dependent; andenocarcinoma
II: unrelated to estrogen or endometrial hyperplasia
What are 3 types of non-neoplastic functional ovarian cysts?
corpus luteum cysts
follicular cysts
theca lutein cyst
Stromal cells, a type of benign ovarian neoplasm, are estrogenic or androgenic?
Estrogenic
What CA has the highest mortality of all gyn CA?
ovarian
What are two types of proteomic research for ovarian CA?
Tumor vaccine (introduce own tumor cells to immune system) Proteins encoded by genome (deliver normal P53 gene to tumor to inhibit growth)
