Cervix, Uterus, Ovaries, Vagina Flashcards
(96 cards)
1
Q
When to start pap smear
A
Within 3 years of onset of sexual activity At 21 years old
2
Q
How often does a woman need to undergo pap smear?
A
3
Q
When to discontinue pap smear?
A
65-70 years old provided that negative for 3 consecutive years No abnormal results for the past 10 years, no new sexual partner Post hysterectomy
4
Q
Management of CIN 1 biopsy result
A
5
Q
Evaluation for squamous cell abnormalities in Pap smear
A
Colposcopy
6
Q
Management of CIN 2,3 biopsy result
A
Colposcopy, excision or ablation of transformation zone
7
Q
2nd most common cancer among women
A
Cervical
8
Q
Necessary cause of cervical cancer
A
HPV
9
Q
Most common type of cervical cancer
A
Squamous cell CA
10
Q
Squamous cell CA of the cervix arises from what structure
A
Ectocervix
11
Q
Most common symptom in cervical cancer
A
Vaginal bleeding
12
Q
Cervical cancer stage where lower 1/3 of the vagina is affected
A
Stage 3
13
Q
Cervical cancer stage where it extends beyond the cervix but not pelvic wall or lower third of vagina
A
Stage 2
14
Q
Cervical cancer stage where there is bladder or rectal invasion
A
Stage 4
15
Q
First line combination chemotherapy for cervical cancer
A
Cisplatin Paclitaxel
16
Q
Single agent chemotherapy for cervical cancer
A
Cisplatin
17
Q
Treatment for stage 1 cervical cancer if not desirous of pregnancy
A
Hysterectomy
18
Q
Treatment of cervical cancer from stage 2 onwards
A
Chemotherapy
19
Q
MANAGEMENT FOR PREMENOPAUSAL WOMEN: Hyperplasia WITH atypia
A
- If desirous of pregnancy
- Continuous MPA 10-20mg OD x 3 months
- Megestrol acetate 40-200mg OD
- DMPA 150mg every 3 months
- LNG-IUS for 1-5 years
- Do UTS & sample endometrium after 3 mos:
- Normal: decrease MPA 10mg OD x 14 days for 12 more months
- Persistent: increase MPA to 40-100mg daily for 3 months, OR shift to Megestrol acetate 40mg 2-4x a day for 3 months then repeat biopsy, if persistent: EH +/- BSO
- No desire for pregnancy: EH +/- BSO
20
Q
MANAGEMENT FOR PREMENOPAUSAL WOMEN: Hyperplasia WITHOUT atypia
A
- For simple hyperplasia: OCP x 6 cycles
- MPA 10-20 mg OD x 14 days
- Do UTS & sample endometrium after 3 mos:
- Normal: MPA, 5mg x 10days/month for 12 months
- Persistent: increase dose 40-100mg daily for 3 months, then repeat biopsy
21
Q
MANAGEMENT FOR POSTMENOPAUSAL WOMEN: Endometrial Hyperplasia WITHOUT atypia
A
- If desirous for uterine preservation, of if poor surgical risk, same as in premenopausal
- If not desirous of uterine preservation, EHBSO
22
Q
Treatment for endometrial hyperplasia with atypia for postmenopausal
A
EHBSO
23
Q
Most common type of endometrial CA
A
Adenocarcinoma
24
Q
Stage of endometrial cancer reaching the cervix
A
Stage 2
25
Stage of endometrial cancer outside the uterus
Stage 3
26
Stage of endometrial cancer reaching the bladder
Stage 4
27
Treatment for endometrial cancer
EHBSO Chemotherapy if stage 3
28
Most popular theory for endometriosis
Retrograde menstruation
29
Classic symptoms of endometriosis
Cyclic pelvic pain and infertility
30
Classic PE finding in endometriosis
Fixed retroverted uterus with scarring and tenderness posteriorly
31
Definitive treatment for endometriosis
Hysterectomy
32
Medical treatment for endometriosis to induce pseudomenopause
Danazol-atrophic changes to implants GnRH agonists like leuprolide OCP, NSAID Aromatase inhibitors like letrozole
33
Size of the ovaries that may suggest malignancy
\>8cm
34
Most common cause of simple cystic adnexal mass in the reproductive age
Functional cyst
35
Most common cause of complex adnexal mass
Benign cystic teratoma
36
Most common cause of pelvic mass
Pregnancy
37
This type of ovarian cyst can rupture and cause intraperitoneal bleeding
Corpus luteum cyst
38
This ovarian cyst can cause adnexal torsion and massive bleeding
Theca lutein cyst
39
Halban triad in a corpus luteum cyst
Spotting with delayed menses Unilateral pelvic pain Small, tender adnexal mass
40
Functional ovarian cyst that is usually more than 10cm in size, due to prolonged stimulation by HCG, honeycomb appearance and tends to be bilateral
Theca lutein
41
Most frequent ovarian epithelial tumor
Serous cystadenoma
42
Transitional cell tumor that has similar lining to the urinary bladder Coffee bean appearing nucleus
Brenner tumor
43
Most common neoplasm in prepubertal female
Benign cystic teratoma
44
Most common benign solid tumor of the ovary Whorled pattern on cross section
Fibroma
45
Triad of: Ovarian fibroma Ascites Hydrothorax
Meig syndrome
46
Tumor markers for epithelial ovarian tumors
CA 125, CEA
47
Tumor markers for germ cell ovarian tumors
AFP LDH HCG
48
Tumor markers for sex cord ovarian tumors
Estrogen Testosterone
49
Stage of ovarian cancer where it spread to the fallopian tube
Stage 1
50
Stage of ovarian cancer where it spread to the pelvis
Stage 2
51
Stage of ovarian cancer where it spread to the peritoneal surface
Stage 3
52
Epithelial ovarian tumor that is associated with DES exposure
Clear cell
53
These are cells in clear cell ovarian tumor where the cells contain abundant glycogen
Hobnail cells
54
Chemotherapy for epithelial ovarian cancer
Paclitaxel + carboplatin
55
Most common ovarian malignancy in women \<30 years old
Germ cell tumor
56
Tumor marker for dysgerminoma
LDH
57
Tumor marker for endodermal sinus/ yolk sac tumor
AFP
58
Schiller Duval bodies
Yolk sac tumor
59
Tumor marker for immature teratoma
AFP
60
Chemotherapy for germ cell and sex cord tumors
BEC VAC Bleomycin Etoposide Cisplatin Vincristine Actinomycin Cyclophosphamide
61
Call Exner bodies
Granulosa cell tumor
62
Nipple projections in dermoids
Tubercle of rokitansky
63
Ovarian tumor that Presents as virilization
Sertoli leydig
64
Ovarian tumor with numerous hyaline droplets
Yolk sac
65
Presence of thyroid tissue in the ovary
Struma ovarii
66
Analogous to seminoma in males
Dysgerminoma
67
Ovarian tumor that presents as vaginal bleeding in adults
Granulosa theca cell tumor
68
Most common MALIGNANT tumor in patients less than 30 years old
Dysgerminoma
69
Eosinophilic bodies surrounded by granulosa cells ovarian tumor
Granulosa theca tumor
70
Epithelial vulvar lesions that result from reactive changes to chronic scratching and rubbing
Lichen simplex chronicus
71
Multiple shiny flat purple papiles usually on inner aspect of the labia minora, vagina and vestibule Atrophic inflammatory condition usually seen in postmenopausal
Lichen planus
72
Histology: Liquefaction degeneration at the basal layer Well defined band like infiltrate below the basal layer
Lichen planus
73
Most common tumor found in the vulva
Epidermal inclusion cyst
74
Benign cyst in the vulva due to occlusion of apocrine sweat glands
Hidradenitis suppurativa
75
Obstruction cyst in the vulva at 4 and 8 o clock position, usually asymptomatic
Bartholin duct cyst
76
Bartholin duct cysts must be biopsied in women this age to rule out carcinoma
40 years old
77
Treatment for recurrent bartholin duct cyst
Marsupialization
78
Paraurethral gland cyst is also called
Skene's gland cyst
79
Dysontogenic cyst that is a remnant of the mesonsphric duct, most commonly found in the anterolateral aspect of the upper part of the vagina
Gartner's duct cyst
80
Most common benign solid tumor of the vulva
Fibroma
81
Permanent epithelialized sac like projection in the anterior bahinal wall
Urethral diverticulum
82
3 Ds of urethral diverticulum
Dysuria Dyspareunia Dribbling of urine
83
Hyperplastic dystrophy of the vulva where there is elongation and widening of the rete ridges which may be confluent White, firm, cartilaginous lesions with hyperkeratotic changes
Squamous cell hyperplasia of the vulva
84
Treatment for vulvar squamous cell hyperplasia
Topical steroids
85
Rare intraepitheloal disorder in the vulva that is associated with adenocarcinoma Reddish eczematoid appearance
Paget disease of the vulva
86
Most contagious of all STIs
Pediculosis Phthrius pubis
87
Caused by pox virus Flesh colored dome shaped papules with umbilicated center
Molluscum contagiosum
88
Treatment for chancroid
Azith
89
Treatment for lymphogranuloma venereum
Doxy
90
Treatment for donovanosis
Doxycycline 100 mg BID
91
Most common organisms involved in PID
Chlamydia trachomatis Neisseria gonorrhea
92
Complication of PID where there are numerous adhesions
Fitz-Hugh-Curtis
93
Treatment for Acute PID
Ceftriaxone 250mg IM single dose Plus doxycycline 100mg PO BID x 14 days Metronidazole 500mg PO BID x 14 days
94
Anti retro viral therapy for pregnant women
Tenofovir Lamivudine Efavirenz
95
CERVICAL CYTOLOGY
* **Most common** squamous abnormality
* Few cells may show features associated with squamous intraepithelial lesions, but there are few of these cells present or the changes are not consistent with a more precise diagnosis
ASC-US
96
Management of cervical cytologic abnormalities
