Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

14 Onco > Surgery Uterus > Flashcards

Surgery Uterus Flashcards

1
Q

third most common genital tract malignancy

A

endometrial ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

risk factors for endometrial ca

A
  • estrogen excess / unopposed estrogen
  • early menarche
  • nulliparity, infertility, pcos
  • obesity
  • diabetes
  • tamoxifen
  • lynch and cowden syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

protective factors for endometrial ca

A
  • estrogen-progestin oc
  • at least 3 mos breastfeeding
  • childbearing at older age
  • smoking
  • exercise
  • coffee and green tea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

s/sx for endometrial ca

A
  • heavy menstrual bleeding
  • vaginal discharge
  • postmenopausal with endometrial cells on pap smear
  • premenopausal with atypical glandular cells on pap smear
  • pelvic pressure and discomfort (late stage)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

indications for endometrial biopsy

A
  • postmenopausal bleeding
  • premenopausal: persistent abnormal bleeding with history of chronic anovulation
  • hormone therapy with bleeding
  • tamoxifen w bleeding
  • > 35 yo with atypical endometrial cells on pap smear
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

most common cause of bleeding in postmenopausal women

A

atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

for patient with initial postmenopausal bleeding you can __

A
  • transvaginal uts then endometrial sampling
  • directly endometrial sampling

if there’s only one test, do endometrial sampling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

t/f any vaginal bleeding in postmenopausal woman requires assessment to exclude malignancy

A

true, can be assessed with endometrial biopsy or transvaginal ultrasonography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

t/f for pts with endometrial thickness less/= 4 mm, you need to do endometrial biopsy

A

false, 1 in 917 is low risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

t/f for pts with emt >4 mm, endometrial sampling is required

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

t/f recurrent bleeding always required further evaluation with endometrial sampling

A

true, even if emt is thin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

t/f ultrasound measurement of endometrial thickness in premenopausal women is required

A

false, has no diagnostic value

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

decision to evaluate endometrium in below 45 yo is based on__

A

symptoms, risk factors, and clinical presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

t/f women with pcos have a 3 fold increased risk and 9% lifetime risk for endometrial ca

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

indications for endometrial sampling in premenomausal women

A
  • persistent abnormal bleeding
  • hx of pcos/ chronic anovulation
  • thickened endometrium on uts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

t/f for pts on hormone therapy with bleeding, endometrial sampling can be done without uts

A

true, thickness doesnt matter

17
Q

primary therapeutic effect of tamoxifen

A

antiestrogen, rr is 2-3x higher

18
Q

t/f asymptomatic women on tamoxifen should undergo routine screening

A

false, only biopsy if they bleed

19
Q

correlation between emt and abnormal pathology in asymptomatic tamoxifen users is poor because of __

A

tamoxifen induced subepithelial stromal hypertrophy

20
Q

management for pre vs post menopausal women taking tamoxifen

A

premenopausal: routine gyne care and watch for bleeding

post meno: monitor for bleeding more often

21
Q

normal histo in cervix

A

squamous cells

22
Q

if patient has atypical endometrial cells at pap smear do ___

A

endometrial and endocervical sampling

if no pathology, do colposcopy

23
Q

if patient has glandular cells (regardless of hpv result) on pap smear do __

A

colposcopy with ecc

if more/= 35 yo or <35 or at risk for endometrial neoplasia, do endometrial biopsy

24
Q

first step when suspecting endometrial pathology is ___

A

endometrial biopsy

25
Q

gold standard for endometrial ca diagnosis

A

hysteroscopic guided endometrial biopsy

26
Q

t/f d&c > hysteroscopic guided d&c

A

false

27
Q

indication for d&c

A
  • if under anesthesia and hysteroscopy is not available
  • pt cannot afford hysteroscopy
  • can scrape entire uterine cavity even if blind
28
Q

2009 figo stading for endometrial ca

A 
IA no invasion or less than half myometrial invasion
IB more/= to hald of myometrium
II invades cervical stroma but does not extend beyond uterus
IIIA invades serosa and/or adnexa
IIIB vaginal metastases
IIIC1 pelvic ln
IIIC2 para-aortic ln
IVA bladder and/or bowel mucosa
IVB distant metastases
29
Q

management for endometrial ca

A

primary surgical approach: peritoneal fluid cytology, extrafascial hysterectomy with bilateral salpingooophorectomy, pelvic and paraaortic lymphadenectomy

adjuvant: radio, chemo, hormonal

30
Q

t/f molecular profile of a tumor may better define prognosis and response to treatment

A

true

pts can have same stage but different responses to tx

14 Onco (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions