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1 Obs & Gyn > Ovarian cancer > Flashcards

Ovarian cancer Flashcards

1
Q

What is the age group of highest incidence for ovarian cancer?

A

75-79

53% >65y

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2
Q

List two types of ovarian tumours

A

epithelial
germ cell
ovarian stromal

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3
Q

Name one example of metastasis associated with ovarian cancer

A

Krukenburg tumour

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4
Q

What is the most common primary site for Krukenberg tumour?

A

GI tract

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5
Q

What are the two types of epithelial ovarian cancers?

A

High grade serous (fallopian tube type mucosa)

Ovarian surface epithelium- endometriod, clear cell, mucinous, low grade serous

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6
Q

List two modes of spread in ovarian cancer

A

direct extension= transcoelemic
exfoliation into the peritoneal cavity
lymphatic invasion

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7
Q

List three risk factors for ovarian cancer

A

smoking
early menarche
late menopause
low parity

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8
Q

Name one factor that is protective against ovarian cancer

A

oral contraceptive use >5 years

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9
Q

Is there screening for ovarian cancer?

A

no

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10
Q

Name four criteria for a population screening programme

A
  1. important health condition with good understanding and that is treatable
  2. cost effective
  3. simple safe and cost effective test available
  4. the test itself must be suitable for the pop (e.g. collection)
  5. further diagnostic testing available
  6. Proof of effective intervention, proof that screening provides better outcome
  7. Evidence outlining which patients should be screened and how often
  8. benefit should outweigh any harms
  9. Adequate facilities and testing resources available to staff to carry out screening
  10. Evidence for consequences of screening
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11
Q

List two familial ovarian cancers

A

BRCA1
BRCA2
Lynch syndrome/HNPCC

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12
Q

List one risk reducing surgery for ovarian cancer

A

prophylactic bilateral salpingo-oopherectomy

important to remove ovary AND entire fallopian tube

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13
Q

What are the symptoms of ovarian cancer?

A 
vague and non specific
altered bowel habit
abdo pain/bloating
feeling full quickly
difficulty eating
urinary/pelvic symptoms
bowel obstruction
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14
Q

List two clinical signs of ovarian cancer

A

abdo distension- pelvic mass, ascites
upper abdo mass
pleural effusion
nodules on pelvic exam

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15
Q

Outline two investigations for ovarian cancer

A

USS
Ca125
RMI

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16
Q

What are the components of the RMI score?

A

=risk of malignancy index

The RMI is a product of the ultrasound scan score, the menopausal status and the serum CA125 level (IU/ml).

17
Q

Name three malignancies in which CA 125 is raised

A

ovary, pancreas, breast, lung, colon

18
Q

Name two benign gynae conditions in which CA 125 is raised

A 
menstruation
endometriosis
PID
pleural and pericardial effusion
recent laparotomy
Fibroids
Adenomyosis
Liver disease
Pregnancy
19
Q

How is RMI calculated?

A

U X M X CA 125

U= USS, M= menopausal status

20
Q

Calculate the RMI score:

60y, Postmenopausal, CA125 is 300, Bilateral complex ovarian masses, solid areas, ascites.

A

U3 x M3 x 300= 2700

21
Q

WHat are the USS components of the RMI score?

A 
multilocular
solid areas 
ascites
intra abdominal metastasis
0=0
1=1
>2=3 points
22
Q

What RMI score would warrant referral?

A

> 200

23
Q

How is ovarian cancer diagnosed?

A

cytology- pleural/ascitic fluid

biopsy- percutaneous US/CT guided OR laparoscopic

24
Q

What is the treatment of ovarian cancer?

A

mostly surgery

chemo- neoadjuvant and adjuvant

25
Q

Which drug is used 1st line for adjuvant therapy for ovarian cancer?

A

carboplatin= platinum agent

26
Q

Aside from carboplatin, which other chemo agents can be used?

A

antiangiogenesis
VEGF inhibitors
Hormonal therapy- tamoxifen/aromtase inhibitor

27
Q

What is the triad in Meig’s syndrome?

A

Ovarian fibroma (a type of benign ovarian tumour)
Pleural effusion
Ascites
(common MCQ!)

1 Obs & Gyn (31 decks)

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