PMB and Endometrial cancer Flashcards
1
Q
Causes of post-menopausal bleeding
A
- genital atrophy
- malignancy
- polyps
- endometrial hyperplasia
- iatrogenic
- trauma
- infections
- rare (bleeding disorders)
2
Q
Treatment of simple endometrial hyperplasia
A
- progestin (oral, depot, mirena)
3
Q
Treatment of complex hyperplasia with atypia
A
- hysterectomy and bilateral salpingo-oophorectomy
4
Q
Primary malignancies of the uterus
A
- endometrial carcinoma
- carcinosarcomas
- sarcomas
5
Q
Features of Type 1 endometrial cancer
A
- oestrogen driven
- on the background of hyperplasia
- develop in 6th decade
- endometrioid adenocarcinoma
- oestrogen and progesterone receptor positive
- less aggressive
6
Q
Features of Type 2 endometrial cancer
A
- not oestrogen driven
- background of atrophy
- older patients >70
- clear cell and uterine papillary serous cancer
- p53 positive
- more aggressive
7
Q
Risk factors for type 1 endometrial cancer
A
- obesity
- wide oestrogen window
- low parity
- exogenous oestrogen
- endogenous oestrogen (PCOS)
8
Q
Familial cancers linked to endometrial cancer
A
- Lynch 2 syndrome
9
Q
Staging for endometrial cancer
A
1: confined to uterus
2: spread to cervical stroma
3: invaded adnexal structures, vagina/parametria or lymph nodes
4: spread to bladder/rectum or distant
10
Q
Treatment of endometrial cancer
A
Stage 1+2
- TAH, BSO, peritoneal washings, pelvic lymph node dissection
- adjuvant pelvic radiation/ chemo
Stage 3+4
- radiation, chemo or high-dose progestogens
