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MOHD Keystone exam 3 > Ovarian Cancer > Flashcards

Ovarian Cancer Flashcards

1
Q

adnexa

A

uterine appendages; Fallopian tubes/ovaries/supporting tissue

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2
Q

5-year survival of ‘distant’ stage ovarian cancer

A

28%

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3
Q

most prevalent stage of ovarian cancer

A

‘distant’ stage (60%); 5 year survival = 28%

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4
Q

ovarian cancer is staged clinically or surgically?

A

surgically

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5
Q

ovarian cancer that has spread to upper abdomen or regional LNs is stage:

A

stage III (most common - 60%)

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6
Q

ovarian cancer that is limited to pelvis is stage:

A

II

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7
Q

ovarian cancer found in liver or lungs is stage:

A

IV

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8
Q

median age of presentation of ovarian cancer

A

65 y.o.

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9
Q

most common type of ovarian cancer:

  • germ cell
  • epithelial ovarian cancer (EOC) or
  • sex-cord stromal
A

EOC (80%); germ cell (15%); sex-cord stromal (5%)

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10
Q

serous, mucinous, endometroid, clear cell, transitional cell, undifferentiated are all types of ____ ovarian cancer and are derived from:

A

epithelial ovarian cancer (EOC); ovarian surface mesothelial cells

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11
Q

tend to occur in 6th decade of life

A

EOC

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12
Q

80% of malignant ovarian tumors are of what type?

A

epithelial ovarian cancer (EOC)

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13
Q

tend to occur in 2nd and 3rd decade of life

A

germ cell tumors

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14
Q

type of ovarian cancer with better prognosis

A

germ cell tumors

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15
Q

dysgerminoma, endometrial sinus tumor, teratomas, embryonal carcinoma, choriocarcinoma, mixed are all types of ____ ovarian cancer

A

germ cell tumors

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16
Q

type of ovarian cancer that often produces biological markers

A

germ cell tumors

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17
Q

type of germ cell tumor that produces LDH

A

dysgerminoma

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18
Q

tumors of younger women

A

sex cord stromal tumors and germ cell tumors

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19
Q

granulosa cell tumor

A

most common tumor of sex cord origin (1-2% of all ovarian neoplasms)

20
Q

associated with hyperestrogenism; may cause precocious puberty (girls), adenomatous hyperplasia and vaginal bleeding in postmenopausal women

A

granulosa cell tumor (sex cord-stromal origin)

21
Q

Risk factors for ovarian cancers

A

family history, age (older), endometriosis, nulliparity, early menarche/late menopause, late childbirth, environmental factors

22
Q

risk reduction for ovarian cancer

A

oral contraceptive pills, multiparity, oophorectomy, tubal ligation/salpingectomy (from FT?), breastfeeding

23
Q

non-specific and vague symptoms of ovarian cancer include:

A

-increase in abdominal girth, bloating, fatigue, abdominal pain, back pain, intercourse pain, early satiety, indigestion, constipation, unexplained weight loss, urinary frequency or incontinence

24
Q

benign gynecologic differential for ovarian cancer symptoms:

A

functional cyst, leiomyomata, endometrioma, ectopic, teratoma, cystadenoma, TOA (tubo-ovarian abscess)

25
Q

malignant gynecologic differential for ovarian cancer symptoms:

A

EOC, germ cell, sex-cord stromal

26
Q

non-gynecologic differential for ovarian cancer symptoms:

A
  • benign: diverticular or appendiceal abscess, nerve sheat tumor, pelvic kidney;
  • malignant: colon, breast, gastric cancer
27
Q

account for 10% epithelial ovarian cancers (EOC)

A

hereditary ovarian cancer

28
Q

HNPCC associated with ovarian cancer

A

Lynch II

29
Q

HBOC genes

A

BRCA1, BRCA2

30
Q

40% ovarian cancer risk if this gene is mutated

A

BRCA1 chromosome 17; (10-20% if BRCA 2, chromosome 13)

31
Q

10-15% ovarian cancer risk if this gene is mutated

A

HNPCC (lynch 2) – autosomoal dominant

32
Q 
Screening for ovarian cancer can include:
A. physical exam
B. pap smear
C. TVUS
D. biomarkers: CA125, ROMA, He4, OVA-1
E. All of above
A

all EXCEPT pap smear

33
Q

Sister Mary Joseph’s Nodule indicates

A

stage IV ovarian cancer; specific nodule found at umbilicus

34
Q

mobile, cystic, unilateral, smooth lymph node indicates ____ process

A

benign

35
Q

fixed, solid or firm, bilateral, nodular indicates ___ process

A

malignant

36
Q

TVUS findings of no blood flow to unilateral mass with septations

A

benign

37
Q

TVUS findings of solid or cystic and solid, strong blood flow, multiple septations > 3 mm in size, bilateral and ascites suggests ___ process

A

malignant

38
Q

TVUS findings of 9 cm simple cyst with calcifications suggests ____ process

A

benign

39
Q

T or F: CA125 value of 100 u/mL in premenopausal patient indicates no tumors

A

could be true or false: may show normal value in 50-70% of stage I tumors and in 20-25% of advanced tumors. Abnormal values are thought to be >200 u/mL premenopausal and > 35 postmenopausal

40
Q

T or F: simultaneous screening with CA125 and TVUS compared with usual care reduces ovarian cancer mortality

A

FALSE: did not reduce ovarian cancer mortality

41
Q

characteristics of ultrasound findings of benign cyst

A

unilocular, thin-walled

42
Q

ACOG (American Congress of OB/GYN) referral guidelines for pelvic mass in postmenopausal include:

A

postmenopausal women with suspicious pelvic mass that contains at least one:
-CA125 >35; -fixed or nodular pelvic mass; -FHx of ovarian or breast cancer; -distant mets; -ascites

43
Q

ACOG referral guidelines for pelvic mass in premenopausal include:

A

-CA125>200; -ascites; -evidence of mets; -FHx of breast or ovarian cancer

44
Q

T or F: 30 y.o. female with suspicious pelvic mass and CA125 of 40 should be referred

A

False: if was postmenopausal, then yes. (premenopausal needs CA125 >200)

45
Q

T or F: 1 example of therapy plan for ovarian cancer would be giving platinum agent and taxane only.

A

False: usually combo of surgery and chemotherapy (platinum agent and taxane)

46
Q

treatment for ovarian cancer:

A

combo of surgery ( staging, debulking, interval debulking) & chemo (adjuvant, neoadjuvant, taxane adn platinum agent)

47
Q

CA125 tumor marker has many false negatives or false positives?

A

false positives

MOHD Keystone exam 3 (9 decks)

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