Uwise - Gyn Onc

Question 0

Risk factors for molar pregnancy?

Answer 0

Asian, extremes of age, frolic acid deficiency

Question 1

Complete vs partial mole - karyotype? HCG? Uterus size? Risk of chorioCA? Fetal parts?

Answer 1

46 X- vs 69 X–
Very high vs elevated
Larger vs normal
Higher vs lower

Question 2

do not need to acquire biopsy to confirm this cancer?

Answer 2

ChorioCA

Question 3

Pt with molar pregnancy - when to try to get pregnant again?

Answer 3

6 months after negative ß-HCG

Question 4

Tx of vulvar CA?

Answer 4

excisional biopsy if <1mm invasion

Otherwise radial vulvectomy

Question 5

Tx of vulvar Intraepithelial neoplasm grade 2? Grade 3? CA?

Answer 5

CO2 laser ablation (or skinning vulvectomy, but this is disfiguring)

Excision

Radical vulvectomy

Question 6

Pt with history of warts – now presents with lesions. Type of lesions that would suggest dysplastic lesions from HPV related condition?

Answer 6

Multifocal, flat, white lesions on the labia bilaterally

Question 7

Paget’s disease of the vulva description? Typical pt?

Answer 7

Skin cancer with red velvety area with islands white tissue

Question 8

PAP smear schedule in patients with HIV?

Answer 8

1. Twice in first year after diagnosis, and if normal, annual surveillance
2. any abnormal smear, undergo colposcopy and biopsy

Question 9

Indications for cervical conization?

Answer 9

1. Unsatisfactory colposcopy
2. Inability to visualize squamocolumnar junction
3. Positive cervical curettage
4. Pap smear indicates adenocarcinoma in situ
5. Discrepancy between Pap smear biopsy results (ex HSIL on PAP and normal biopsy)

Question 10

Risk factors for cervical cancer?

Answer 10

1. Anything that increases HPV exposure (early sexual activity, no partners, history of HPV, lack of regular PAP smears)
2. Immunosuppression
3. Smoking

Question 11

Treatment of a patient with ASCUS Pap smear?

Answer 11

1. It’s under 20, repeat in one year
2. In older women, HPV DNA testing or repeat in 6-12 months or colposcopy
   a. DNA negative, repeat in 12 months
   b. If HPV positive, repeat in 6-12 months
3. If infection/inflammation, treat and repeat 4-6 weeks

Question 12

1. Ectropion
2. Mosaicism
3. Punctations

Answer 12

1. Area other columnar epithelium that has not undergone squamous metaplasia – appears as reddish ring tissue surrounding external us
2. Blood vessels on their sides
3. Blood vessels on end

Question 13

Major symptom of fibroids? Mechanism?

Answer 13

Menorrhagia

1. Increase in surface area – increase in endometrial sloughing
2. Obstruction of vasculature leads to venous congestion and hypermenorrhea

Question 14

Treatment of fibroid in pregnancy?

Answer 14

No treatment

Question 15

Treatment of fibroids in perimenopause?

Answer 15

1. if irregular bleeding, endometrial biopsy

2. GnRH analogue to carry her into menopause

Question 16

Dx?

1. Perimenopausal women who does not ovulate regularly
2. Postmenopausal woman with bleeding
3. Menstruating woman with bleeding, pelvic pain, uterine enlargement
4. Postmenopausal women with bleeding, pelvic pain, uterine enlargement, vaginal discharge
5. Symmetrically enlarged boggy uterus with dysmenorrheaFindings to differentiate

Answer 16

1. Endometrial hyperplasia
2. Endometrial carcinoma
3. Fibroids
4. Uterine Leiomyosarcoma
5. Adenomyosis

Question 17

Patient possible endometrial cancer – when to perform D&C?

Answer 17

1. Persistent symptoms

2. Findings suggestive of endometrial malignancy – any amount of atypical cells