Neoplasms - Cervical CA and Endometrial CA

Question 1

Cervical carcinoma is a common cancer associated with

Answer 1

human papillomavirus (HPV), a sexually transmitted infection

Question 2

RF cervical CA

Answer 2

tobacco use, HIV, and infection with high-risk HPV types

sexual activity, multiple sexual partners, smoking, low Vitamin A and C, and history of a sexually transmitted infection

Question 3

high risk HPV types

Answer 3

16, 18, 31, 33, 45, 52, 58

Question 4

Patients who have an abnormal Pap smear or high-risk HPV types should undergo

Answer 4

colposcopy, a diagnostic procedure in which a dissecting microscope called a colposcope is inserted into the vagina, allowing the clinician to examine the vagina and the transformation zone of the cervix

During a colposcopy, acetic acid or Lugol solution may be applied to the cervix to detect for the presence of abnormal areas that need to be biopsied

Question 5

The transformation zone is located

Answer 5

between the squamous epithelium and columnar epithelium of the cervix and is an area of active squamous metaplasia

Question 6

Most cervical carcinomas occur

Answer 6

in the transformation zone

Question 7

MC type of cervical CA

Answer 7

squamous cell CA

Question 8

definitive tx cervical CA

Answer 8

total hysterectomy with a bilateral salpingo-oophorectomy

Question 9

when is Loop electrosurgical excision an appropriate therapy in cervical CA

Answer 9

In whom there is no endocervical involvement and invasive cervical carcinoma has been ruled out

Question 10

cervical CA sx

Answer 10

most asx
sx - abnormal vaginal bleeding, postcoital bleeding

Question 11

practice chart question 6 neoplasms

Answer 11

you got this

Question 12

what should pts avoid 24H before colposcopy

Answer 12

patients should be instructed to avoid douching, tampon use, vaginal medications, and sexual intercourse for 24 hours prior to a colposcopy

Question 13

third most common gynecological cancer

Answer 13

cervical CA

Question 14

average age dx cervical CA

Answer 14

45

Question 15

American Cancer Society and the United States Preventative Services Task Force screening guidelines for cervical CA

Answer 15

Pap smear alone should be done every 3 years for those between the ages of 21 to 29, followed by co-testing with a Pap smear along with HPV testing every 5 years for all women between the ages of 30 and 65

Question 16

the diagnosis method of choice for cervical cancer

Answer 16

colposcopy with biopsy

Question 17

What form of cervical cancer is linked closely to diethylstilbestrol exposure?

Answer 17

Clear cell adenocarcinoma

Question 18

how long can cervical CA take to develop

Answer 18

up to 15 years to develop after an initial HPV infection

Question 19

btwn adenocarcinoma and squamous cell carcinoma cervical CA, which has a worse prognosis

Answer 19

adenocarcinoma

Question 20

True or false: cigarette smoking is associated with an increased risk of squamous cell carcinoma of the cervix but not of adenocarcinoma

Answer 20

true

Question 21

Abnormal findings on Pap smear include

Answer 21

squamous cells of unknown significance (ASC-US), low-grade or high-grade squamous intraepithelial lesion (LSIL or HSIL), cervical intraepithelial neoplasia III, carcinoma in situ, and invasive cancer

Question 22

Women with ASC-US and a negative HPV screening should follow-up in

Answer 22

1 year with repeat Pap smear and HPV testing

Question 23

colposcopy should be performed on patients with

Answer 23

positive HPV test with ASC-US, HSIL, LSIL, or atypical glandular cells

Question 24

Abnormal changes in colposcopy

Answer 24

white patches and vascular atypia

Question 25

if abnormal changes are seen on colposcopy

Answer 25

punch biopsy or endocervical curettage should be obtained for further tissue evaluation

Question 26

he loop electrosurgical excision procedure (LEEP) is used for

Answer 26

HSIL lesions and those lesions that are completely visible without magnification

Question 27

Conization

Answer 27

surgically removes the entire transformation zone and endocervical canal. It is reserved for severe dysplasia or carcinoma in situ, especially with endocervical extension

Question 28

practice chart for question 19

Answer 28

you got this

Question 29

Which complication of loop electrosurgical excision procedure is characterized by recurrent second-trimester miscarriage?

Answer 29

cervical insufficiency

Question 30

memorize chart for question 21

Answer 30

HAH same as 19 - do it tho

Question 31

memorize chart for question 26

Answer 31

YOU GOT IT LAST ONE

Question 32

True or false: endocervical curettage cannot be performed in pregnant women

Answer 32

true

Question 33

second most common cancer of the female genital tract

Answer 33

endometrial CA

Question 34

MC type of endometrial CA

Answer 34

adenocarcinoma of the endometrium

Question 35

who is MC affected by endometrial CA

Answer 35

Postmenopausal women between 50–70 years of age

Question 36

RF endometrial CA

Answer 36

obesity, nulliparity, diabetes, polycystic ovarian syndrome (or any other condition characterized by prolonged anovulation due to unopposed estrogen), prolonged unopposed estrogen therapy, and long-term use of tamoxifen hypertension, Lynch syndrome, and endometrial hyperplasia

Question 37

sx endometrial CA

Answer 37

abnormal uterine bleeding without any other symptoms. Pain is a late finding. women who are pre- or perimenopausal may present with menorrhagia or metrorrhagia

Question 38

dx endometrial CA

Answer 38

endocervical and endometrial sampling. A Papanicolaou smear of the cervix may reveal some abnormal endometrial cells, but this is not a sensitive test. A hysteroscopy or hysteroscopically directed biopsy is helpful in visualizing any growths or lesions within the uterine cavity. A vaginal ultrasonography also helps in the diagnosis of this condition by measuring the thickness of the endometrium, also known as the endometrial stripe

Question 39

TVUS endometrial CA postmenopausal women

Answer 39

if the endometrium appears hypertrophic, it may indicate a neoplastic change. An endometrial stripe measurement of 4 mm or less indicates a low likelihood of hyperplasia or endometrial cancer in postmenopasual women. If it is greater than 4 mm or if certain areas of the endometrium appear heterogeneous, there should be a high index of suspicion and an endometrial sample should be obtained

Question 40

TVUS - what can exclude endometrial CA in premenopausal women

Answer 40

an endometrial thickness of < 5 mm can exclude endometrial carcinoma

Question 41

All postmenopausal women with abnormal vaginal bleeding should undergo

Answer 41

endometrial sampling

Question 42

tx endometrial CA

Answer 42

total hysterectomy and bilateral salpingo-oophorectomy. If the cancer has invaded into the myometrium or if the lymph nodes are affected, a combination of radiation with or without chemotherapy (or vice versa) should be initiated postsurgically.

Question 43

What other factors may cause a thickened endometrial stripe?

Answer 43

he presence of endometrial polyps, obesity, diabetes, and current tamoxifen therapy

Question 44

most common cause of gynecologic malignancy in the United States and the fourth most common cause of malignancy in women

Answer 44

endometrial CA

Question 45

For postmenopausal women with abnormal uterine bleeding, what is the most appropriate initial diagnostic test

Answer 45

TVUS

Question 46

what may be necessary if the transvaginal ultrasound and endometrial biopsy are inconclusive for suspicion of endometrial CA

Answer 46

Hysteroscopy and dilation and curettage

Question 47

Patients with endometrial hyperplasia without atypia who desire fertility may be treated with

Answer 47

progestin, either with oral tablets or with a levonorgestrel-releasing intrauterine system

Question 48

Patients with endometrial hyperplasia with cellular atypia should undergo

Answer 48

hysterectomy plus or minus bilateral salpingo-oophorectomy

Question 49

What is the most common cause of anovulatory abnormal uterine bleeding in a premenopausal woman?

Answer 49

PCOS

Question 50

The findings on cervical cytology that suggest possible endometrial cancer

Answer 50

endometrial cells, atypical glandular cells, and adenocarcinoma