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EOR - Women's Health > Neoplasms > Flashcards

Neoplasms Flashcards

1
Q

6 women’s health neoplasms to know

A

breast cancer
cervical carcinoma
cervical dysplasia
endometrial cancer
ovarian neoplasms
vaginal/vulvar neoplasms

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2
Q

mc malignancy in women

A

breast ca

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3
Q

4 rf for breast ca

A

menarch before 12 yo
advanced maternal age w. first full term pregnancy
nulliparity
menopause after 52 yo

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4
Q

describe a malignant breast mass (2)

A

irregular
immobile

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5
Q

3 PE findings of breast ca

A

immobile irregular mass
nipple retraction
bloody nipple d.c

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6
Q

4 types of breast ca to know

A

infiltrating intraductal carcinoma (IIC)
infiltrating lobular
paget’s dz of the nipple
inflammatory breast ca

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7
Q

mc type of breast ca

A

infiltrating intraductal carcinoma (ICC)

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8
Q

which type of breast ca is frequently bilateral

A

infiltrating lobular

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9
Q

which breast ca is characterized by chronic, eczematous itchy, scaling rash on the nipples and areola

A

paget’s dz of the nipple

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10
Q

which breast ca is characterized by red, swollen, warm and itchy breast; nipple retraction, and peau d’orange

A

inflammatory breast ca

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11
Q

which type of breast ca is not associated w. a mass

A

inflammatory breast ca

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12
Q

3 types of breast ca tumors (hormones)

A

-estrogen receptor positive (ER)
-progesterone receptor positive (PR)
-human epidermal growth factor receptor positive (HER2)

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13
Q

breast ca tumors from most to least common

A

ER
PR
HER2

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14
Q

tx for breast ca

A

-segmental mastectomy (lumpectomy) followed by xrt in all pt’s +/- chemo
-anti-estrogen tamoxifen
-aromatoase inhibitors (estrogen inhibitors)
-monoclonal abs

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15
Q

indications for chemo w. breast ca

A

positive nodes stage I and II w. tumors < 4 cm in diameter

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16
Q

what pharm tx is most effective for ER positive breast ca tumors

A

tamoxifen

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17
Q

moa for tamoxifen

A

binds/blocks estrogen receptors in breast tissue

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18
Q

what pharm tx is most effective for postmenopausal ER positive breast tumors

A

aromatase inhibitors (anastrozole)

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19
Q

moa for aromatase inhibitors

A

reduces estrogen production

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20
Q

what pharm tx is most effective for HER2 positive breast tumors

A

monoclonal abs

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21
Q

triad associated w. cervical ca extension into the pelvic wall

A

unilateral leg edema
sciatic pain
ureteral obstruction

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22
Q

cervical ca is the _ mc type of ca

A

third

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23
Q

80% of pt’s w. cervical ca present w.

A

abnormal vaginal bleeding

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24
Q

mc age group for cervical ca

A

postmenopausal

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25
Q

besides abnormal vaginal bleeding, 3 less common sx of cervical ca

A

postcoital bleeding
vaginal d.c
pain

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26
Q

mc type of cervical ca _

mc arises from _

A

squamous cell

arise from squamocolumnar junction/ectocervix (transformational zone)

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27
Q

5 rf for cervical ca

A

multiple sex partners
early age of intercourse
early first pregnancy
HPV
smoking

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28
Q

99% of cervical ca is due to

A

HPV

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29
Q

which types of HPV are associated w. cervical ca

A

16
18
31
33

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30
Q

PE finding of cervical ca

A

friable, bleeding cervical lesion

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31
Q

gs dx for cervical ca (2)

A

bx of gross lesions
colposcopically directed bx

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32
Q

tx for cervical ca stages 1 and 2

A

stage 1: conservative, simple, or radical hysterectomy
stage 2: chemo +/- xrt

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33
Q

what age shold pt’s receive first pap regardles of sexual activity

A

21 yo

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34
Q

indications for pap earlier than 21 yo

A

at the time of intercourse for women who are:
-HIV (+)
-chronic immunosuppression (SLE, post organ transplant)

35
Q

cervical ca screening guidelines for women 21-29

A

cytology only q 3 yaers

36
Q

cervical ca screening guidelines for women 30 yo and older

A

q 5 years:
cytology
PLUS
HPV testing

37
Q

4 indications for annual cervical ca screening

A

HIV (+)
immunosuppression
in utero DES exposure
past tx for cervical ca

38
Q

guidelines for d.c of pap smears

A

-total hysterectomy if for benign condition
-65 yo if 3 negative cytology tests OR 2 consecutive negative HPV/pap co-tests 10 years before stopping w most recent test w.in 5 years

39
Q

pap pathology:
asc-us:
lsil:
hsil:

A

asc-us: atypical squamous cells of undetermined significance
lsil: low grade squamous intraepithelial lesion -> mild dysplasia (CIN I)
hsil: high grade squamous intraepithelial lesion -> mod-sev dysplasia (CIN II-III, carcinoma in situ)

40
Q

management of pt w. negative pap cytology but hpv positive

A

repeat both tests in 12 mo

41
Q

management of ASC-US, LSIL, and CIN-1

A

reflex HPV testing:
if negative or < 25 yo -> retest in 12 mo
if positive and >/= 25 yo -> colposcopy

42
Q

management of HSIL, CIN-2, CIS

A

colposcopy::
outside cervix -> LEEP vs cryotherapy
inside cervix: cone bx

43
Q

gardasil 9 guidelines

A

-females and males 11-12 yo (as early as 9 yo)
-catch up: females 13-26 yo, msm 22-26 yo, immunocompromised
-27-45 yo: shared decision making

44
Q

dosing of gardasil 9

A

<15 yo: 2 doses 6 months apart
>15 yo and immunocompromised: three doses at 0, 1-2mo, and 6 mo

45
Q

mc gyn malignancy

A

endometrial ca

46
Q

cardinal sx of endometrial ca

A

postmenopausal vaginal bleeding

47
Q

bleeding in postmenopausal women is _ until proven otherwise

A

endometrial ca

48
Q

mc type of endometrial ca

A

adenocarcinoma

49
Q

9 rf for endometrial ca

A

obesity
nulliparity
early menarche
late menopause
unopposed estrogen therapy
HTN
gallbladder dz
DM
prior ovarian/endometrial/breast ca

50
Q

50% of women w. endometrial ca will have an

A

abnormal pap

51
Q

dx for endometrial ca

A

endometrial bx

52
Q

all women w. postmenopausal vaginal bleeding should get a

A

endometrial bx

53
Q

tx for endometrial ca

A

1.total hysterectomy w. bilateral salpingoophorectomy
2. pelvic xrt +/- chemo

54
Q

2nd mc type of gyn ca

A

ovarian

55
Q

age range for ovarian ca

A

40-60

56
Q

if a woman has _ ovarian ca is the most likely tumor to be found

A

ascites

57
Q

2 sx associated w. ovarian ca at advanced age

A

ascites
abd pain

58
Q

3 protective factors against ovarian ca

A

multiparity
OCP
breast feeding

59
Q

5 rf for ovarian ca

A

nulligravidity
infertility
early menarche
late menopause
endometriosis

60
Q

mc type of ovarian ca

A

epithelial

61
Q

dx for ovarian ca

A
  1. transvaginal US
  2. bx
62
Q

serum tumor marker for ovarian ca

A

ca-125

63
Q

what gene is associated w. ovarian ca

A

BRCA1

64
Q

tx for ovarian ca stages 1-2

A

hysterectomy w. bilateral salpingoophorectomy

65
Q

tx for ovarian ca stages III-IV

A
  1. hysterectomy w. bilateral salpingoophorectomy
  2. chemo + xrt
66
Q

what is used to monitor tx of ovarian ca

A

ca-125

67
Q

4 rf for vulvar/vaginal carcinoma

A

hpv
smoking
cervical carcinoma
in utero des exposure

68
Q

vaginal ca is rare and is usually caused by

A

other gyn cancer

69
Q

peak age of vaginal ca

A

60-65 yo

70
Q

mc type of vaginal ca

A

squamous cell

71
Q

squamous cell vaginal ca is associated w. what rf:

adenocarcinoma vaginal ca is associated w. what rf:

A

sqamous cell: hpv
adenocarcinoma: in utero DES exposure

72
Q

mc location of vaginal carcinoma

A

upper one-third of posterior vaginal wall

73
Q

2 mc presenting sx of vaginal carcinoma

A

abnormal vaginal bleeding
changes in menstruation

74
Q

tx for vaginal carcionma

A

xrt

75
Q

peak incidince of vulvar ca

A

50 yo

76
Q

mc presenting sx of vulvar ca

A

vaginal pruritis

77
Q

what 2 types of vulvar ca represent 90% of cases

A

squamous cell
melanoma

78
Q

rf for vulvar ca

A

hpv 16, 18, 31

79
Q

PE finding of vulvar ca

A

pruritic black lesions -> hpv

80
Q

dx for vulvar ca

A

bx

81
Q

what guides bx location for vulvar ca

A

toludine blue
OR
acetic acid staining

82
Q

tx for vulvar ca

A

vulvectomy
PLUS
lymph node dissection

83
Q

what do pruritic red lesions on the vulva make you think

A

paget’s dz

EOR - Women's Health (15 decks)

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