Mehl. Endometrial cancer 03-24 (1)

Question 1

M. Highest yield point on USMLE is that it is caused by???

Answer 1

“unopposed estrogen,” usually due to anovulation/PCOS.

Question 2

M. Estrogen normally stimulates growth of??

Answer 2

endometrium;

Question 3

M. Estrogen normally stimulates growth of endometrium; progesterone prevents ….???

Answer 3

overgrowth

Question 4

M. In anovulation/PCOS, …..is not formed?

Answer 4

no corpus luteum is formed, since the latter is the follicular remnant.

Question 5

M. he corpus luteum normally secretes what?

Answer 5

progesterone to maintain the endometrial lining if fertilization occurs. If no corpus luteum is formed, there’s no progesterone produced to balance estrogen. This leads to endometrial hyperplasia, which increases the risk of endometrial adenocarcinoma.

Question 6

M. USMLE can give an overweight female who’s perimenopausal who has breakthrough bleeding (i.e., mid- cycle bleeding), or a post-menopausal woman with any vaginal bleeding –> next step?

Answer 6

they want endometrial biopsy as the answer.

Question 7

M. The fact that the patient has high BMI insinuates that anovulation/PCOS may have been a part of her past, where unopposed estrogen is a part of her history.

Answer 7

.

Question 8

M. Endometrial cancer can occur secondarily as a result of ???

Answer 8

Granulosa cell tumor of the ovary (as discussed above). This is a rare cause of unopposed estrogen.

Question 9

M. Endometrial cancer. Can occur in women who take what???

Answer 9

Who take hormone-replacement therapy (HRT) who stop taking the progesterone component (mentioned in one NBME Q).

Question 10

M. Can be associated with hereditary what??

Answer 10

hereditary non-polyposis colorectal cancer (HNPCC; Lynch syndrome).