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Clin Med II - Exam 5 > Wright - OBGYN - Cancer > Flashcards

Wright - OBGYN - Cancer Flashcards

1
Q

mc gynecological malignancy in developed countries

A

endometrial ca

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2
Q

rf for endometrial ca

A

45 yo or older

lynch syndrome → 50% increased risk

unopposed estrogen

tomoxifen

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3
Q

post menopausal woman w. uterine bleeding

A

endometrial ca until proven otherwise

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4
Q

labs for endometrial ca

A

CBC → H/H

Hcg

tumor markers

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5
Q

mc imaging for endometrial ca

A

pelvic US

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6
Q

gs imaging for endometrial ca

A

office bx vs hysteroscopy vs D&C

need to have histology for dx

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7
Q

endometrial thickening/stripe

A

US findings of endometrial ca

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8
Q

tumor marker CA125

A

endometrial ca

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9
Q

is there screening for endometrial ca

A

no

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10
Q

endometrial cancer is same-same

A

uterine cancer

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11
Q

third mc gynecologic malignancy and cause of death among gynecologic cancers in US

A

cervical ca

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12
Q

2nd mc malignancy in the world where no access to screening or vaccination

A

cervical ca

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13
Q

__ is detected in 99.7% of cervical ca

A

HPV

HPV causes cervical ca

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14
Q

rf for cervical ca (6)

A

early onset sexual activity

multiple sexual partners

high risk sexual partner

hx of STDs

hx of vulvar/vaginal squamous intraepithelial neplasia or ca

immunosuppression

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15
Q

dz burden of genital HPV infxn (5)

A

vulvar ca

vaginal ca

penile ca

anal ca

anogenital warts

head and neck cancers

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16
Q

which types of HPV are found in >70% of all cervical cancers

A

16 and 18

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17
Q

Gardasil 9 targets

A

16

18

6

11

you need to know this

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18
Q

mc cervical ca

A

squamous

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19
Q

less common type of cervical ca

A

adenocarcinoma

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20
Q

__ infection is a cofactor in cervical ca pathogenesis

A

HSV2

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21
Q

can cervical cancer occur in teenagers

A

no! pathogenesis is very slow moving

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22
Q

if cervical ca is symptomatic, what are some early sx

A

irregular/heavy bleeding → mc

postcoital bleeding

+/- discharge

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23
Q

advanced sx of cervical ca

A

pelvic/lower back pain

bowel or urinary sx

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24
Q

when should you perform PE for cervical cancer

A

any woman w. symptoms suggestive of cervical ca

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25
Q

indication for bx for cervical ca PE findings

A

anything raise or friable

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26
Q

diagnostic testing for cervical ca

A

cervical cytology → PAP

cervical bx → most useful

colposcopy

+/- CT for staging

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27
Q

for cervical ca bx, use sample from suspicious area, but avoid

A

grossly necrotic tissue

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28
Q

cervical ca screening recs for < 21 yo

A

no screening recommended

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29
Q

cervical ca screening rec for 21-30 yo

A

pap q 3 years

+/- hpv testing

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30
Q

cervical ca screening recs for 30-65 yo

A

pop and hpv q 5 years

OR

pap q 3 years

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31
Q

cervical ca screening recs for > 65 yo

A

d.c screening if no hx abnormal cells or 3 negative paps in a row

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32
Q

why might you adjust cervical ca screening recs for a patient

A

known hpv infxn

33
Q

2nd mc cancer worldwide

A

breast

34
Q

leading cause of cancer death in women worldwide

2nd mc cause of cancer death in US

A

brest ca

35
Q

rf for breast ca

A

personal or fam hx ovarian ca, peritoneal, or breast ca

genetic predisposition

chest wall xrt btw 10-30 yo

36
Q

mc presentation of breast ca in countries w. screening

A

abnormal mammogram

37
Q

describe breast ca mass

A

hard, immobile, single dominant

38
Q

signs of locally advanced breast ca

A

axillary adenopathy

erythema, thickening, dimpling of skin → peau d’orange

39
Q

3 mc sites of metastasis in breast ca

A

bone

liver

lungs

40
Q

if breast ca that has spread to lymph considered metastatic

A

no

41
Q

hypoechogenicity, calcifications, shadowing, spiculated/indistinct/angular margins

A

US findings of breast ca

42
Q

what is this showing

A

“spiculated” appearance → breast ca

43
Q

breast ca imaging if elevated alk phos or bone pain

A

bone scan

44
Q

breast ca imaging if elevated liver enzymes

A

CT abd/pelvis

45
Q

breast ca imaging if pulmonary sx

A

CT chest

46
Q

breast ca imaging if stage III or higher

A

whole body PET

47
Q

2 types of breast ca pathology

A

ductal vs lobular

48
Q

mc type of invasive breast ca

A

infiltrating ductal carcinoma

49
Q

8% of invasive breast ca

A

infiltrating lobular carcinoma

50
Q

mixed invasive carcinoma

A

mixed ductal/lobular

rare

51
Q

heterogeneous group of precancerous lesions confined to the breast ducts and lobules

A

ductal carcinoma in situ (DCIS)

52
Q

hormone positive breast cancers

A

ER positive/negative

PR positive/negative

HER-2 positive/negative

triple negative

53
Q

poor prognosis receptor testing marker for breast ca

A

triple negative

54
Q

breast ca screening rec for < 40 yo

A

none for average risk pt

55
Q

breast ca screening rec for 40-49 yo

A

mammography q 2 years

56
Q

breast ca screening for 50-74 yo

A

mammorgaphy q 2 years

57
Q

breast ca screening recs for high risk

A

MRI vs US

+/- self breast exams monthly

58
Q

2nd mc gynecologic malignancy in US

A

ovarian

59
Q

mc cause of gynecologic cancer death in US

A

ovarian

60
Q

avg age of ovarian ca dx

A

63 yo

61
Q

rf for ovarian ca

A

age

BRCA

hereditary cancer syndromes

infertility

nulliparity

62
Q

ovarian ca protective factors

A

multiparity

breastfeeding

oral contraceptives

salpingo-oophrectomy

tubal ligation

hysterectomy

63
Q

mc ovarian ca

A

epithelial carcinoma → serous

64
Q

ovarian ca is typically asymptomatic; what is the acute presentation

A

advanced dz →

pleural effusion

bowel obstruction

venous thromboembolism

65
Q

subacute presentation of ovarian ca

A

adenxal mass

pelvic/abdominal sx → bloating, urinary urgency, or frequency, early satiety, pelvic/abd pain

66
Q

dx for ovarian ca

A

full surgical removal

CT abd/pelvis and/or US

CA-125

67
Q

is screening recommended for ovarian ca

A

no

68
Q

4th mc gynecologic malignancy

A

vulvar ca

69
Q

rf for vulvar ca

A

vulvar or cervical intraepithelial neoplasia (VIN)

hx cervical ca

smoking

immunodeficiency

northern european

HPV

70
Q

which types of HPV cause vulvar ca

A

16

33

18

71
Q

mc presentation of vulvar ca

A

abnormal finding on labia majora

72
Q

sx of vulvar ca

A

vulvar pruritis

vulvar bleeding/pain

dysuria, dyschezia, rectal bleeding, enlarged lymph node in groin, LE edema

73
Q

dx for vulvar ca

A

bx

74
Q

mc type of vulvar ca

A

squamous cell

75
Q

sqamous cell carcinoma vulvar ca is not related to

A

hpv

76
Q

which type of vulvar ca is related to hpv 16, 18, 33

A

classic warty or bowenoid type

77
Q

2nd mc vulvar ca

A

melanoma

78
Q

type of vulvar ca w. poor prognosis

A

sarcoma

Clin Med II - Exam 5 (23 decks)

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