Reproductive Geriatrics

Question 1

10% postmenopausal bleeding is due to

Answer 1

endometrial CA

Question 2

dx postmenopausal bleeding

Answer 2

TVUS
Endometrial bx if stripe > 4 mm

Question 3

when is uterine prolapse MC

Answer 3

after childbirth

Question 4

sx uterine prolapse

Answer 4

vaginal fullness
urinary urgency, frequency, incontinence
low back pain, abdominal pain

Question 5

tx uterine prolapse

Answer 5

kegels
pessaries
estrogen treatment
hysterectomy or uterus-sparing techniques

Question 6

what is a cystocele

Answer 6

bladder moves into vagina

Question 7

what is a rectocele

Answer 7

The rectum bulges into or out of the vagina

Question 8

dx cystocele, rectocele, uterine prolapse

Answer 8

speculum exam

Question 9

MC type vaginal CA

Answer 9

squamous cell

Question 10

what causes most of vaginal CA

Answer 10

HPV 16 & 18

Question 11

sx vaginal CA

Answer 11

abnormal bleeding

Question 12

grades of uterine prolapse

Answer 12

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

Question 13

2nd MC gynecologic CA

Answer 13

ovarian

Question 14

highest mortality of all gynecologic CA

Answer 14

ovarian

Question 15

RF ovarian CA

Answer 15

increased number of ovulatory cycles (nulliparity, infertility, > 50 years, early menarche, late menopause)
BRCA1 and 2

Question 16

decreased risk ovarian CA

Answer 16

combo OCPs
decreased number of ovulatory cycles

Question 17

sx ovarian CA

Answer 17

rarely sx until later
abdominal fullness, early satiety
weight loss
back/abdominal pain

Question 18

PE ovarian CA

Answer 18

palpable abdominal/ovarian mass
ascites
pleural effusion

Question 19

dx ovarian CA

Answer 19

pelvic US
CA-125 - can be used to monitor

Question 20

MC gynecologic malignancy in US

Answer 20

endometrial CA

Question 21

MC type endometrial CA

Answer 21

adenocarcinoma

Question 22

RF endometrial CA

Answer 22

increased estrogen (ovulatory cycles, PCOS, obesity, estrogen only therapy, tamoxifen, DM, Lynch syndrome)

Question 23

decreased risk endometrial CA

Answer 23

combo OCPs and decreased ovulatory cycles

Question 24

sx endometrial CA

Answer 24

AUB (esp postmenopausal bleeding)

Question 25

dx endometrial CA

Answer 25

TVUS - thickened endometrial stripe > 4 mm
bx - definitive

Question 26

RF Breast CA

Answer 26

increased number of menstrual cycles
increased estrogen
BRCA1 and 2

Question 27

MC type of Breast CA

Answer 27

infiltrative ductal carcinoma

Question 28

what Breast CA presents as eczematous nipple lesion

Answer 28

Paget disease of the breast

Question 29

what is considered a premalignant condition for Breast CA

Answer 29

lobular carcinoma in situ

Question 30

which breast CA presents as peau d’orange

Answer 30

inflammatory Breast CA

Question 31

dx Breast CA

Answer 31

mammography
US
MRI
Bx

Question 32

bx options for Breast CA

Answer 32

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

Question 33

what tx for estrogen + Breast CA in premenopausal

Answer 33

tamoxifen

Question 34

what tx for estrogen + Breast CA in postmenopausal

Answer 34

aromatase inhibitors (letrozole, anastrozole)