Carcinoma of Uterus and Ovaries - Tieman Flashcards Preview

REPRO II Exam 1 > Carcinoma of Uterus and Ovaries - Tieman > Flashcards

Flashcards in Carcinoma of Uterus and Ovaries - Tieman Deck (50):
1

leiomyoma regression

stimulated by estrogen
-so post-menopausal women - regresses

2

ovary gonadostromal tumor

produce estrogen
-so get endometrial hyperplasia**

3

most common female genital tract malignancy

uterine carcinoma

4

abnormal vaginal bleeding in perimenopausal/postmenopausal women

uterine carcinoma

5

risk fx for uterine carcinoma

obesity
unopposed estrogen stimulation - permarin
tamixifen
nulliparity
diabetes
late menopause
PCOS
lynch syndrome

6

ovarian carcinoma

most LETHAL

because presents late

7

obesity

increased estrogen - fat cells secrete androstenedione - converted to estrogen

8

decreased risk of uterine carcinoma

ovulation
progestin therapy
combo BCPs**
eraly menopause
multiparity

9

complex atypical hyperplasia

not cancer - but 8x increased risk

recommend TAH-BSO

10

endometrial carcinoma staging

done surgically**

11

stage 1a endometrial carcinoma

confined to endometrium

12

stage 1b endometrial carcinoma

invasion to <1/2 myometrium

13

stage 1c endometrial carcinoma

invasion to >1/2 myometrium

14

stage 2 endometrial carcinoma

invades endocervical canal

15

stage 3 endometrial carcinoma

tumor in peritoneum, vagina, nodes

16

stage 4 endometrial carcinoma

distant mets

17

evaluation of abnormal vaginal bleeding

pelvic exam/pap smear
endometrial sampling
transvaginal U/S
fractional D and C

18

endometrial stripe

should be <5mm

19

favorable histo of endometrial carcinoma

endometroid

20

grade

differentation

21

lymph drainage of endometrial cancer

iliac/para-aortic nodes

22

stage 1, grade 1 and 2 endometrial cancer

TAH-BSO
peritoneal washings
removal enlarged nodes

23

stage 1c or 2, grade 3 endometrial cancer

TAH-BSO
cytology
iliac/paraaortic node dissection - with radiation

24

stage 3 and 4 endometrial cancer

surgical debulking
radiation
chemotherapy

remove everything that looks bad - to make chemo/rad work better

25

fractional D and C

to see if cancer to endocervical canal

stage 1 vs. 2

26

increased risk of ovarian carcinoma

white
nulliparity/infertile
late childbearing
late menopause
fam hx
BRCA**

27

decresed risk of ovarian carcinoma

ovulation interrupted

oral contraceptives
multiparity
breast feeding
tubal ligation
hysterectomy

28

most lethal cancer female genital tract

ovarian

due to late stage of disease at diagnosis

increasing girth, pelvic fullness, pelvic discomfort

most patient - stage 3 or 4 age 50-70yo

29

ovarian cancer screening

non proven to be effective

30

beta-HCG

choriocarcinoma

31

AFP

dermoid ovarian cancer

32

CA125 and 19-9

epithelial derived

33

most ovarian cancers

majority serous epithelium

B9 and low grade - not removed - young women who still want children

34

ovarian cancer spread

internal iliac, common iliac, paraaortic nodes

35

germ cell tumors

dysgerminomas and teratomas

36

granulosa thecal cell tumor

secrete E/PR

37

sertoli-leydig cell tumor

secrete androgens

38

ovarian cancer staging

done surgically

39

stage 1 ovarian cancer

confined to ovary

40

stage 2 ovarian cancer

tumor spread confined to pelvis

41

stage 3 ovarian cancer

confined to abdominal peritoneal surfaces or retroperitoneal nodes

42

stage 4 ovarian cancer

distant mets

43

optimal cytorecuduction

get rid of every part of tumor

44

ovarian cancer treatment

radiation or platinum based chemotherapy dependent upon stage, histology, and grade of tumor

45

stage 1 low grade ovarian cancer tx

no further tx

46

stage 1 high grade ovarian cancer tx

platinum based chemo - paclitaxel

47

germ cell tumor of ovary tx

platinum based chemo, blemycin, etoposide

48

gonadal-stromal tumors of ovary

relatively chemoresistant

49

most important aspect of tx for long term prognosis of ovarian cancer

excision of any visible tumor

50

bowel prep

mandatory for ovarian ca surgery

bc may be location of spread - and may need to take it