oncology Flashcards
referral criteria for colposcopy
postcoital bleeding abnormal looking cervix abnormal smear three consecutive inadequate smear keratinizing cells
management of CIN
CIN1 followup every 6 months/ LLETZ
CIN2 AND 3- LLETZ
HPV vaccine
HPVLP against 4 and 6 types prevents CIN and anogenital warts
presentation of cervical cancer
postcoital bleeding PMB rare PV discharge ureteric obstruction and hydronephrosis vesicovaginal fistula bowel disturbance weight loss
histology of cervical cancers
squamous cell carcinoma adenocarcinoma (cGIN) neuroendocrine (argyrophil cells) clear cell carcinoma (DES in utero) glassy cell sarcoma botyrides lymphoma
management of cervical cancer
1b hysterectomy+ radiotherapy and pelvic lymphadenectomy to check for LN involvement
radical trachelectomy of LN- is fertility sparing
higher stages chemoradiotherapy
vulvar cancer risk factors
HPV 16,18,31,33
lichen sclerosus
diabetes, obesity, HTN, CVD, smoking
immunosuppression
vulvar cancer presentation
65 yrs old, itching, pain or ulceration
treatment of lichen sclerosus
high potency topical steroids
treatment of high grade VIN
topical chemotherapy
laser ablation
wide local excision
vulvectomy
invasive vulvar cancer
radical vulvectomy + regional lymphadenectomy ± chemoradiotherapy
vaginal cancer risk factors
immunosuppression
chronic irritation with pessaries
cervical cancer
DES exposure (younger women= clear cell adenocarcinoma)
