Reproductive Geriatrics Flashcards
10% postmenopausal bleeding is due to
endometrial CA
dx postmenopausal bleeding
TVUS
Endometrial bx if stripe > 4 mm
when is uterine prolapse MC
after childbirth
sx uterine prolapse
vaginal fullness
urinary urgency, frequency, incontinence
low back pain, abdominal pain
tx uterine prolapse
kegels
pessaries
estrogen treatment
hysterectomy or uterus-sparing techniques
what is a cystocele
bladder moves into vagina
what is a rectocele
The rectum bulges into or out of the vagina
dx cystocele, rectocele, uterine prolapse
speculum exam
MC type vaginal CA
squamous cell
what causes most of vaginal CA
HPV 16 & 18
sx vaginal CA
abnormal bleeding
grades of uterine prolapse
0 - no descent
1 - uterus descent into the upper 2/3 of the vagina
2 - the cervix approaches the Introitus
3 - the cervix is outside the introitus
4 - entire uterus is outside the vagina
2nd MC gynecologic CA
ovarian
highest mortality of all gynecologic CA
ovarian
RF ovarian CA
increased number of ovulatory cycles (nulliparity, infertility, > 50 years, early menarche, late menopause)
BRCA1 and 2
decreased risk ovarian CA
combo OCPs
decreased number of ovulatory cycles
sx ovarian CA
rarely sx until later
abdominal fullness, early satiety
weight loss
back/abdominal pain
PE ovarian CA
palpable abdominal/ovarian mass
ascites
pleural effusion
dx ovarian CA
pelvic US
CA-125 - can be used to monitor
MC gynecologic malignancy in US
endometrial CA
MC type endometrial CA
adenocarcinoma
RF endometrial CA
increased estrogen (ovulatory cycles, PCOS, obesity, estrogen only therapy, tamoxifen, DM, Lynch syndrome)
decreased risk endometrial CA
combo OCPs and decreased ovulatory cycles
sx endometrial CA
AUB (esp postmenopausal bleeding)
dx endometrial CA
TVUS - thickened endometrial stripe > 4 mm
bx - definitive
RF Breast CA
increased number of menstrual cycles
increased estrogen
BRCA1 and 2
MC type of Breast CA
infiltrative ductal carcinoma
what Breast CA presents as eczematous nipple lesion
Paget disease of the breast
what is considered a premalignant condition for Breast CA
lobular carcinoma in situ
which breast CA presents as peau d’orange
inflammatory Breast CA
dx Breast CA
mammography
US
MRI
Bx
bx options for Breast CA
fine needle - smallest amount of tissue taken; doesn’t allow for receptor testing
large need (core) - allows for receptor testing; greater deformity
open - most accurate; removes most tissue
what tx for estrogen + Breast CA in premenopausal
tamoxifen
what tx for estrogen + Breast CA in postmenopausal
aromatase inhibitors (letrozole, anastrozole)
