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EOR OB/GYN > Neoplasms - Cervical CA and Endometrial CA > Flashcards

Neoplasms - Cervical CA and Endometrial CA Flashcards

1
Q

Cervical carcinoma is a common cancer associated with

A

human papillomavirus (HPV), a sexually transmitted infection

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2
Q

RF cervical CA

A

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

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3
Q

high risk HPV types

A

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

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4
Q

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

A

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

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5
Q

The transformation zone is located

A

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

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6
Q

Most cervical carcinomas occur

A

in the transformation zone

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7
Q

MC type of cervical CA

A

squamous cell CA

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8
Q

definitive tx cervical CA

A

total hysterectomy with a bilateral salpingo-oophorectomy

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9
Q

when is Loop electrosurgical excision an appropriate therapy in cervical CA

A

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

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10
Q

cervical CA sx

A

most asx
sx - abnormal vaginal bleeding, postcoital bleeding

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11
Q

practice chart question 6 neoplasms

A

you got this

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12
Q

what should pts avoid 24H before colposcopy

A

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

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13
Q

third most common gynecological cancer

A

cervical CA

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14
Q

average age dx cervical CA

A

45

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15
Q

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

A

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

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16
Q

the diagnosis method of choice for cervical cancer

A

colposcopy with biopsy

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17
Q

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

A

Clear cell adenocarcinoma

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18
Q

how long can cervical CA take to develop

A

up to 15 years to develop after an initial HPV infection

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19
Q

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

A

adenocarcinoma

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20
Q

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

A

true

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21
Q

Abnormal findings on Pap smear include

A

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

22
Q

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

A

1 year with repeat Pap smear and HPV testing

23
Q

colposcopy should be performed on patients with

A

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

24
Q

Abnormal changes in colposcopy

A

white patches and vascular atypia

25
Q

if abnormal changes are seen on colposcopy

A

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

26
Q

he loop electrosurgical excision procedure (LEEP) is used for

A

HSIL lesions and those lesions that are completely visible without magnification

27
Q

Conization

A

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

28
Q

practice chart for question 19

A

you got this

29
Q

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

A

cervical insufficiency

30
Q

memorize chart for question 21

A

HAH same as 19 - do it tho

31
Q

memorize chart for question 26

A

YOU GOT IT LAST ONE

32
Q

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

A

true

33
Q

second most common cancer of the female genital tract

A

endometrial CA

34
Q

MC type of endometrial CA

A

adenocarcinoma of the endometrium

35
Q

who is MC affected by endometrial CA

A

Postmenopausal women between 50–70 years of age

36
Q

RF endometrial CA

A

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

37
Q

sx endometrial CA

A

abnormal uterine bleeding without any other symptoms. Pain is a late finding.

women who are pre- or perimenopausal may present with menorrhagia or metrorrhagia

38
Q

dx endometrial CA

A

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

39
Q

TVUS endometrial CA postmenopausal women

A

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

40
Q

TVUS - what can exclude endometrial CA in premenopausal women

A

an endometrial thickness of < 5 mm can exclude endometrial carcinoma

41
Q

All postmenopausal women with abnormal vaginal bleeding should undergo

A

endometrial sampling

42
Q

tx endometrial CA

A

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.

43
Q

What other factors may cause a thickened endometrial stripe?

A

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

44
Q

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

A

endometrial CA

45
Q

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

A

TVUS

46
Q

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

A

Hysteroscopy and dilation and curettage

47
Q

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

A

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

48
Q

Patients with endometrial hyperplasia with cellular atypia should undergo

A

hysterectomy plus or minus bilateral salpingo-oophorectomy

49
Q

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

A

PCOS

50
Q

The findings on cervical cytology that suggest possible endometrial cancer

A

endometrial cells, atypical glandular cells, and adenocarcinoma

51
Q
A

EOR OB/GYN (18 decks)

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