upper GU malignancies

Question 1

the most frequent GYN CA in US

Answer 1

endometrial cancer

Question 2

average age of endometrial CA dx

Answer 2

age 61

Question 3

t/f endometrial cancer incidence is rising

Answer 3

TRUE

Question 4

hereditary factor for GYN CA

Answer 4

lynch II syndrome

uterus, ovary, breast, colon

Question 5

main RF for endometrial CA

Answer 5

unopposed estrogen

Obesity, nulliparity, oligomenorrhea, late menopause

Question 6

how to prevent endometrial CA

Answer 6

establish regular cycles
OCP
avoid estrogen only
avoid obesity

Question 7

difference between type I and II CA

Answer 7

1: hormone dependent, early stage, good prognosis
2: no hormonal influence, advanced stage, poor prognosis

Question 8

endometrial cancer pathology

Answer 8

adenocarcinoma

adenoacanthoma

Question 9

grade 2 endometrial cancer

Answer 9

more solid areas, gland formation still seein

Question 10

grade 3 endometrial cancer

Answer 10

sheets of CA cells .. hard to determine organ of origin

Question 11

UPSC

Answer 11

papillary serous tumors of the endometrium

Question 12

papillary serous tumor looks lsike..

Answer 12

complex epithelium with small papillations

atypia is very high

Question 13

endometrial CA sx

Answer 13

postmenopausal bleeding
brown discharge
irregular bleeding and spotting
rare signs of dissemination (pain, mass, ascites)

Question 14

DX endometrial CA

Answer 14

biopsy
U/S
hysteroscopy
D&C

Question 15

endometrial CA tx

Answer 15

1. TAH/BSO staging
2. radiation to vaginal cuff
3. external radiation
4. chemotherapy
5. progestational agents

Question 16

preferred uterine sarcoma tx

Answer 16

TAH/BSO

Question 17

low grade epithelial ovarian tumors

Answer 17

borderline lesions that are well differentiated

Question 18

high grade malignancy is

Answer 18

poorly differentiated lesions

Question 19

where does fallopian tube cancer originate

Answer 19

by the fimbriae

Question 20

largest tumor volume in omentum

Answer 20

adenocarcinoma of peritoneum

Question 21

where does adenocarcinoma of peritoneum originate from?

Answer 21

from endometriosis , endosalpingiosis

Question 22

RF for ovarian cancer

Answer 22

family history 
frequent ovulation 
low parity 
Caucasian 
high fat low fiber diet 
talk exposure  
living in northern country  
high SES and

Question 23

pregnancy and breast feeding is protective for ___ due to __

Answer 23

protective for ovarian cancer
due to prolonged progesterone effect
and reduced ovulations

Question 24

risk of ovarian and breast CA with:

BRCA 1
BRCA 2
Lynch Syndrome

Answer 24

BRCA 1: 40-46% ov, 50-85% breast

BRCA 2: 10-20% ov, breast 40-85%

lynch: 9-12% ova, colon up to 54%, uterine 40-60%