Day 13 - Gyn3 Flashcards Preview

Step 2 DIT Rapid Review > Day 13 - Gyn3 > Flashcards

Flashcards in Day 13 - Gyn3 Deck (7):

Most important prognostic factor in endometrial CA

Histologic grade (more important than depth of myometrium invasion)


Current recommendations for pap smears in pts w/ no history of abnormal pap

Start age 21; q 2 yrs if age 21-29; q 2-3 yr if 30+; Women 30+ yrs old may have HPV testing q 3-5 yrs in addition Pap smear cytology; Screening may be stopped at 65; If hysterectomy, no need to screen (may need cuff pap smears if uterus taken out due to cancer)


General tx strategies for squamous cell CA of vagina

Similar to squamous cell CA of cervical (VIN1-3); Stage 1 CA (less than 2 cm) - Surgical removal or intracavitary radiation; Stage 1 CA (greater than 2 cm) - External beam radiation; Stage 3 or 4 CA - External beam radiation +/- other therapies (generally not chemotherapy)


Lichen sclerosis - Definition, typical pt pop, Classic findings,

Chronic inflammatory condition of anogenital region, most commonly affecting postmenopausal women; Classic but Late findings - Ivory or porcelain plaques and papules w/ pruritus;


Tx Lichen sclerosis

Presents similary to squamous cell CA, so low threshold for punch bx to r/o squamous ca; Steroids (topical clobetasole - can thin skin; pimecrolimus)


Gynecomastia - DDx

Abnormal breast tissue in male pts; DDX - Puberty (resolves spontaneous, 6 mo - 2 yr age), Meds (spironolactone, digoxin, cimetidine, amiloride, ketoconazole, haloperidol, HIV HAART), Drugs (alcohol - cirrhosis, marijuana, heroin, anabolic steroids), Herbal agents (tea tree oil, lavendar oil), Cirrhosis, Hypogonadism, Testicular germ cell tumors (estrogen-secreting), Hypothyroidism, Hemodialysis


W/u for fibroadenoma appearing mass in F

F/u 3-5 days after menstruation for eval; If mass persists, start w/ FNA; If solid & benign or inconclusive, repeat FNA, core bx, or excisional bx; If solid & malignant, tx like breast CA; If cystic with clear fluid & mass disappears, reassurance & discard fluid, f/u in one month (assume fibrocystic change); If cystic with bloody fluid, send for cytology, may or may not want core or excisional bx; If cystic or residual thickening, core or excisional bx; Mammogram not part of this w/u - do above regardless of mammogram findings

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