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MRCOG part 2 bits > Staging/ incidences > Flashcards

Staging/ incidences Flashcards

1
Q

Timing of delivery in preeclampsia?

A

inability to control maternal blood pressure despite using 3 or more classes of antihypertensives in appropriate doses

  • maternal pulse oximetry less than 90%
  • progressive deterioration in liver function, renal function, haemolysis, or platelet count
  • ongoing neurological features, such as severe intractable headache, repeated visual scotomata, or eclampsia
  • placental abruption
  • reversed end-diastolic flow in the umbilical artery doppler velocimetry, a nonreassuring cardiotocograph, or stillbirth
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2
Q

Spread of the growth to –> distant organs

Extend beyond true pelvis

A

Stage IV B cervical cancer

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3
Q

Tumor invades bladder and/or bowel mucosa, and/or distant metastases

A

stage IV uterine cancer

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4
Q

Extended beyond the true pelvis

or has involved (biopsy proven)
the mucosa of the bladder or rectum.

bullous edema, as such, does not permit a case to be allotted to Stage IV.

A

Stage IV cervical cancer

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5
Q

Distant metastasis,

including intra-abdominal metastases and/or inguinal nodes

A

Stage IVB uterine cancer

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6
Q

Distant metastasis excluding peritoneal metastasis

A

Stage IV - ovarian cancer

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7
Q

Tumor of any size fixed to bone,

or fixed, ulcerated lymph node metastases,

or distant metastases

A

Stage IV vulva cancer

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8
Q

The cancer has spread to distant organs such as the lungs or bones (M1).

It can be any size
and might or might not have grown into nearby structures or organs (Any T)

It might or might not have spread to nearby lymph nodes (Any N)

A

Stage IV B vagina cancer

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9
Q

Tumor invasion of bladder and/or bowel mucosa

A

Stage IVA uterine cancer

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10
Q

Extend beyond true pelvis

Spread of the growth to –> adjacent pelvic organs

A

Stage IVA cervical cancer

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11
Q

Parenchymal metastases

metastases to extra-abdominal organs

(including inguinal lymph nodes

& lymph nodes outside of the abdominal cavity)

A

Stage IVB ovarian cancer

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12
Q

distant metastases

A

Stage IVB vulva cancer

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13
Q

Disease fixed to pelvic bone,

or fixed or ulcerated regional lymph node metastases

A

stage IVA vulva cancer

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14
Q

The cancer is growing into the bladder or rectum or is growing out of the pelvis (T4)

It might or might not have spread to lymph nodes in the pelvis or groin (inguinal area) (Any N).

It has not spread to distant sites (M0)

A

Stage IV A vaginal cancer

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15
Q

Pleural effusion with positive cytology

A

Stage IVA ovarian cancer

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16
Q

Regional lymph node metastases

with extracapsular spread

Nonfixed, nonulcerated lymph nodes

A

Stage IIIC vulva cancer

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17
Q

The cancer is growing into the pelvic wall,
and/or growing into the lower one-third of the vagina

and/or has blocked the flow of urine (hydronephrosis), which is causing kidney problems (T3)

It has not spread to nearby lymph nodes (N0) or to distant sites (M0)

A

Stage III vagina cancer

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18
Q

Macroscopic peritoneal metastasis
beyond the pelvis

more than 2 cm in greatest dimension,

with or without metastasis to the retroperitoneal lymph nodes
(includes extension of tumour to capsule of liver and spleen without parenchymal involvement of either organ)

A

Stage IIIC ovarian cancer

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19
Q

Involvement of pelvic and/or para-aortic lymph nodes (including micrometastases),

irrespective of tumor size and extent

A

Stage IIIC cervical cancer
Stage IIICp - detected on pathology
Stage IIICr - detected on imaging

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20
Q

Liver capsule/ Spleen capsule

A

Stage IIIC Ovarian cancer

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21
Q

Positive para-aortic nodes with or without positive pelvic lymph nodes

A

Stage IIIC2 uterine cancer

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22
Q

Para-aortic lymph node metastasis

A

Stage IIIC2 cervical cancer

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23
Q

Tumor invades the

serosa of the corpus uteri

and/or adnexa

A

Stage IIIA uterine cancer

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24
Q

The carcinoma involves the lower third of the vagina,

with no extension to the pelvic wall

A

Stage IIIA cervical cancer

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25
Q

The cancer can be any size and might be growing into the pelvic wall, and/or growing into the lower one-third of the vagina and/or

has blocked the flow of urine (hydronephrosis), which is causing kidney problems (T1 to T3).

It has also spread to nearby lymph nodes
in the pelvis or groin (inguinal) area (N1) but not distant sites (M0)

A

Stage III vagina cancer

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26
Q

Vaginal involvement and/or parametrial involvement

A

Stage IIIB uterine cancer

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27
Q

Extension to the pelvic wall

and/or hydronephrosis or nonfunctioning kidney (unless known to be due to another cause)

A

Stage IIIB cervical cancer

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28
Q

Macroscopic peritoneal cancer >2cm

Beyond pelvis

A

Stage IIIC ovarian cancer

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29
Q

Positive pelvic nodes

A

Stage IIIC1 uterine cancer

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30
Q

Pelvic lymph node metastasis only

A

Stage IIIC1 cervical cancer

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31
Q

hydronephrosis

kidney problems

A

stage III vaginal cancer

Stage IIIB cervical cancer

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32
Q

Macroscopic peritoneal metastasis beyond the pelvis

up to 2 cm in greatest dimension,

with or without metastasis to the retroperitoneal lymph nodes

A

Stage IIIB Ovarian cancer

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33
Q

Regional lymph node metastases >5 mm

Nonfixed, nonulcerated lymph nodes

A

Stage IIIB vulva cancer

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34
Q 
Microscopic extrapelvic  (above the pelvic brim) 
peritoneal involvement

with or without positive retroperitoneal lymph nodes

A

Stage IIIA2 Ovarian cancer

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35
Q

Positive retroperitoneal lymph nodes only
(cytologically or histologically proven):

Metastasis > 10 mm

in greatest dimension

A

IIIA1-(II): Ovarian cancer

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36
Q

Tumor of any size

with disease extension to upper two-thirds of the urethra,
upper two-thirds of the vagina, bladder mucosa, rectal mucosa,

or regional lymph node metastases ≤5 mm
Nonfixed, nonulcerated lymph nodes

A

Stage IIIA vulva cancer

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37
Q

Positive retroperitoneal lymph nodes only
(cytologically or histologically proven):

Metastasis upto 10 mm

in greatest dimension

A

IIIA1 (i): ovarian cancer

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38
Q

Invasive carcinoma >5 mm depth of stromal invasion and ≤2 cm in greatest dimension

Invasive carcinoma with measured deepest invasion >5 mm; lesion limited to the cervix uteri with size measured by maximum tumor diameter

A

Stage IB1 cervical cancer

Stage IB cervical cancer

39
Q

Invasive carcinoma ≤4 cm in greatest dimension

Involvement limited to the upper two-thirds of the vagina without parametrial involvement

A

Stage IIA1 cervical cancer

Stage IIA cervical cancer

40
Q

Invasive carcinoma >2 and ≤4 cm in greatest dimension

Invasive carcinoma with measured deepest invasion >5 mm; lesion limited to the cervix uteri with size measured by maximum tumor diameter

A

Stage IB2 cervical cancer

Stage IB cervical cancer

41
Q

The carcinoma invades beyond the uterus,

but has not extended onto the lower third of the vagina or to the pelvic wall

A

Stage II cervical cancer

42
Q

The cancer has grown through the vaginal wall,

but not as far as the pelvic wall and is larger than 2.0 cm (4/5 inch) (T2b) = >2cm

It has not spread to nearby lymph nodes (N0) or to distant sites (M0)

A

Stage IIB vaginal cancer

43
Q

regional lymph node metastases ≤5 mm

Nonfixed, nonulcerated lymph nodes

A

Stage III A vulva cancer

44
Q

Positive retroperitoneal lymph nodes only

cytologically or histologically proven

A

Stage IIIA1: ovarian cancer

45
Q

Tumor of any size with extension to upper part of
adjacent perineal structures,

or with any number of nonfixed, nonulcerated lymph node

A

Stage III vulva cancer

46
Q

VTE incidence

A

2/ 10 000 — non pregnant women background risk
29/ 10 000 — pregnant
300 - 400/ 10 000 puerperium

47
Q

Tumour involves one or both ovaries or fallopian tubes,

or peritoneal cancer,

with cytologically or histologically confirmed spread to the peritoneum outside the pelvis

and/or metastasis to the retroperitoneal lymph nodes

A

Stage III ovarian cancer

48
Q

Tumour involves one or both ovaries or fallopian tubes

with pelvic extension
(below pelvic brim)

or peritoneal cancer

A

Stage II ovarian cancer

49
Q

Above pelvic brim

A

Stage IIIA2 ovarian cancer

50
Q

Below pelvic brim

A

Stage II ovarian cancer

Distal ureter injury

51
Q

Local and/or regional spread of the tumor

A

Stage III uterine cancer

52
Q

Retroperitoneal Lymph nodes positive

A

Stage III ovarian cancer

53
Q

Tumor of any size

with extension to lower one-third of the urethra,
lower one-third of the vagina,
lower one-third of the anus

with negative nodes

A

Stage II vulva cancer

54
Q

Macroscopic peritoneal metastasis

A

Stage IIIB ovarian cancer

Stage IIIC ovarian cancer

55
Q

nonfixed, nonulcerated lymph node positive

A

Stage III vulva cancer

56
Q

Extension and/or

implants on uterus

and/or fallopian tubes and/or ovaries

A

Stage II A ovarian cancer

57
Q

With parametrial involvement

but not up to the pelvic wall

A

Stage IIB cervical cancer

58
Q

Tumor invades cervical stroma, but does not extend beyond the uterus

A

Stage II uterine cancer

59
Q

Parametrium

A

Stage IIB cervical cancer

Stage IIIB uterine cancer

60
Q

lower one-third of the vagina

A

Stage II vulva cancer

61
Q
  • Extension to other pelvic intraperitoneal tissues

- Tumour involves one or both ovaries or fallopian tubes with pelvic extension (below pelvic brim) or peritoneal cancer

A

Stage IIB ovarian cancer

Stage II ovarian cancer

62
Q

Microscopic extrapelvic (above the pelvic brim) peritoneal involvement

A

Stage IIIA2 ovarian cancer

63
Q

The cancer has grown through the vaginal wall, but not as far as the pelvic wall and is no larger than 2.0 cm (4/5 inch) (T2a)

It has not spread to nearby lymph nodes (N0) or to distant sites (M0)

A

Stage IIA vaginal cancer

64
Q

lower one-third of the anus

A

Stage II vulva cancer

65
Q

Malignant cells in the ascites or peritoneal washings

A

Stage IC3: ovarian cancer

66
Q

Nodes negative

A

Stage II vulva

67
Q

The carcinoma involves the lower third of the vagina
and/or extends to the pelvic wall

and/or causes hydronephrosis or nonfunctioning kidney

and/or involves pelvic and/or para-aortic lymph nodes

A

Stage III cervical cancer

68
Q

The cancer is only in the vagina

and is larger than 2.0 cm (4/5 inch) (T1b)

It has not spread to nearby lymph nodes (N0) or to distant sites (M0

A

Stage I vaginal cancer

69
Q

Invasive carcinoma ≤4 cm in greatest dimension

Involvement limited to the upper two-thirds of the vagina without parametrial involvement

A

Stage IIA1 cervical cancer

Stage IIA cervical cancer

70
Q

Lower one third of vagina

A

Stage IIIA cervical cancer
Stage IIIB endometrial cancer
Stage III of vaginal cancer
Stage II of vulva cancer

71
Q

Extension to pelvic wall

A

Stage III B cervical cancer

Stage III vaginal cancer

72
Q

Involvement limited to the upper two-thirds of the vagina

without parametrial involvement

A

Stage IIA cervical cancer

73
Q
  • Upper two-thirds of the vagina

- Lower one third of the vagina

A 
Stage IIIA vulva cancer - upper 2/3
Stage IIA cervical cancer - upper 2/3
Stage III endometrial cancer - vagina
Stage II vulva cancer - lower 1/3
Stage IIIA cervical cancer - lower 1/3
74
Q

Surgical spill

A

IC1: ovarian cancer

75
Q

Tumor size >2 cm

or

stromal invasion >1 mm

Tumor confined to the vulva

A

Stage IB vulva cancer

76
Q

fallopian tube surface tumor

A

Stage IC2: ovarian cancer

77
Q

tumour on ovarian surface

A

Stage IC2: ovarian cancer

78
Q

Tumor confined to the vulva

A

Stage I vulva cancer

79
Q

Invasive carcinoma >4 cm in greatest dimension

Involvement limited to the upper two-thirds of the vagina without parametrial involvement

A

Stage IIA2 cervical cancer

Stage IIA cervical cancer

80
Q

Invasive carcinoma >4 cm in greatest dimension

Lesion limited to the cervix uteri with size measured by maximum tumor diameter

A

Stage IB3 cervical cancer

Stage IB cervical cancer

81
Q

Tumor limited to one or both ovaries or fallopian tubes, with any of the following: capsule ruptured, surface tumor, surgical spill, malignant cells in ascites

A

Stage IC ovarian cancer

82
Q

Tumour limited to both ovaries (capsule intact) or fallopian tubes;

no tumour on ovarian or fallopian tube surface;

no malignant cells in the ascites or peritoneal washings

A

Stage IB ovarian cancer

83
Q

Invasion equal to or more than half of the myometrium

A

Stage IB uterine cancer

84
Q

Invasive carcinoma:

with measured deepest invasion >5 mm

(greater than Stage IA);

lesion limited to the cervix uteri with size measured by maximum tumor diameter

A

Stage IB cervical cancer

85
Q

Measured stromal invasion ≤3 mm in depth

Invasive carcinoma that can be diagnosed only by microscopy, with maximum depth of invasion ≤5 mm

A

Stage IA1 cervical cancer

Stage IA cervical cancer

86
Q

Tumor confined to the vulva

Tumor size ≤2 cm and

stromal invasion ≤1 mm

A

Stage IA vulva cancer

87
Q

No or less than half myometrial invasion

A

Stage IA uterine cancer

88
Q

Measured stromal invasion >3 and ≤5 mm in depth

Invasive carcinoma that can be diagnosed only by microscopy, with maximum depth of invasion ≤5 mm

A

Stage IA2 Cervical cancer

stage IA cervical cancer

89
Q

Tumour limited to one ovary (capsule intact) or fallopian tube;

no tumour on ovarian or fallopian tube surface;

no malignant cells in the ascites or peritoneal washings

A

Stage IA ovarian cancer

90
Q

Tumor confined to the corpus uteri

A

Stage I uterine cancer

91
Q

Micro-Invasive carcinoma:

that can be diagnosed only by microscopy, with maximum depth of invasion ≤5 mm

A

Stage IA cervical cancer

92
Q

ovarian capsule intact

A

Stage IA ovarian cancer

stage IB ovarian cancer

93
Q

The carcinoma is strictly confined to the cervix

extension to the uterine corpus should be disregarded

A

Stage I Cervical cancer

94
Q

Tumour confined to ovaries or fallopian tube(s)

A

Stage I: ovarian cancer

MRCOG part 2 bits (6 decks)

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