Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

The ultimate test - Last Keystone exam > Endometrial Cancer/ Cervical cancer. > Flashcards

Endometrial Cancer/ Cervical cancer. Flashcards

1
Q

risk factors for endometrial carcinoma

A
  • increasing age
  • estrogen (estrogen therapy, nulliparity, late menopause)
  • obesity
  • polycystic ovary syndrome
  • diabetes
  • HNPCC
  • tamoxifen therapy.!!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

types of endometrial cancer

A

Type 1 = Endometrioid -estrogen dependent

  • most common
  • favorable prognosis

Type 2 - non-estrogen dependent - 4 types

  • worse prognosis
  • p53 mutations common.
  • papillary serous
  • clear cell
  • adenosquamous
  • undifferentiated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

symptoms of endometrial carcinoma

A

1 most common presenting symptom = post-menopausal bleeding!!!

also. ..
- postmenopausal endometrial cells on cervical cytology
- abnormal uterine bleeding - irregular/heavy menses
- abnormal uterine bleeding with history of anovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T/F Endometrial cancer is staged surgically

A

True!

Endometrial and ovarian cancer is staged surgically - while cervical cancer is staged clinically.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how is endometrial cancer usually spread?

A 
Through direct extension
ALSO
transtubal (goes to fallopian tubes)
-lymphatic - pelvic, then para-aortic nodes
-blood - rare.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Most common gynecologic cancer

A

endometrial cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When does endometrial cancer happen, typically?

A

-60-70 years old.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the precursor to type 1 endometrial cancer?

A

-atypical endometrial hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the precursor to type 2 endometrial cancer?

A

there isn’t one.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the #1 cause of post menopausal bleed?? Hint - not endometrial cancer

A

atrophic endometritis/ vaginitis from low estrogen state.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the difference between Simple and Complex Endometrial hyperplasia?

A

Simple or complex refers to architecture.

LESS important than if atypia is present (atypia is much more related to progression to cancer)
-only the “atypic” varieties of both of these confer significantly increased risk of cancer progression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Workup for a pt suspected to have endometrial cancer

A

Endometrial biopsy!!

-can do a transvaginal ultrasound along with it or not. BUT always do the biopsy. it is 90% sensitive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If an endometrial biopsy comes back positive, what is the next step?

A

-evaluate for surgery.(labs, CT scan to detect advanced disease, CXR, EKG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do positive lymph nodes affect staging in endometrial cancer?

A

-positive nodes change it from stage 2 to stage 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T/F - most endometrial cancer is detected at stage 2 or later.

A

FALSE.

72% of endometrial cancer is detected at stage 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the most important predictor of survival in endometrial cancer?

A

stage/histologic type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most important predictor of recurrence rate in early endometrial cancer?

A

lymph node metastasis

18
Q

Treatment for endometrial cancer

A

-primary treatment is surgery.
remove uterus (hysterectomy) + remove ovaries (high risk of metastasis) = BSO - bilateral salpingo oophorectomy
-lymph node dissection may also be done
-radiation for those who can’t tolerate surgery
-adjuvant treatment depends on pathologic risk factors.

19
Q

Post-op follow up for endometrial cancer

A

similar to cervical cancer. Everyone can recur, and it usually happens in the first 2 years.

-clinical exam every 3-4 months for 2 years, every 6mo for 3 years, then yearly after 5 yrs.

20
Q

T/F - recurrence is quite fatal in endometrial cancer.

A

False. It is quite fatal in cervical cancer. But 80% of recurrences are cured in endometrial cancer

21
Q

T/F - biopsy/endometrial sampling is needed for diagnosis of endometrial cancer.

A

true.

22
Q

T/F - Pap smears can reduce incidence of cervical cancer by 70%

A

true

23
Q

T/F: 75% of cervical cancer occurs in developing countries.

A

true

24
Q

T/F: infection with HPV 16 almost invariably leads to cancer.

A

False. High risk HPV infection is necessary but insufficient for cervical cancer.

25
Q

these strains of HPV cause warts

A

6 and 11

26
Q

risk factors for cervical cancer (besides HPV)

A
  • immunocompromised
  • smoking
  • multiple partners
  • low Socioeconomics
27
Q

This type of cancer makes up 80% of cervical cancers.

A

Squamous cell carcinoma

adenocarcinoma 2nd most common

28
Q

Recommendations for Pap smear screening

A
  • start at age 21.
  • every three years from 21-65 years old.

exceptions: HIV, immunocompromised, or previously had cervical cancer

29
Q

pathogenesis of cervical neoplasia

A

almost exclusively due to HPV.

30
Q

how is cervical cancer staged?

A

clinically (physical exam/rectovaginal exam/chest Xray, etc)

31
Q

What is the usual pattern of spread for cervical cancer? How does this affect treatment options

A

Most often, it spreads/ invades locally.
It can also spread via lymphatics
-hematogenous/intraperitoneal spread is rare.

32
Q

Pros and cons of surgery vs. radiation for early stage cervical cancer.

A 
Surgery
-preserves ovarian fxn
-you get histology information
But..
-surgery has risks/morbidity
-may also need radiation after surgery anyway.

Radiation:
-no surgery, done as an outpatient treatment
But…
-permanent ovarian failure (radiation kills em)
-permanent bowel issues.
-risk of bowel and bladder fistulae, strictures

33
Q

what does CIN stand for?

A

Cervical intraepithelial neoplasia. It is a precursor to cervical cancer (30% probability of becoming cancer if untreated)

34
Q

T/F The HPV vaccine has been readily accepted in the US, vaccination rates for girls 13-17 are >90% now.

A

False. Only 33% of girls get the full series.

Even lower for boys.

35
Q

symptoms of cervical cancer

A

(usually not present until late)

  • abnormal bleeding (between periods, with intercourse, after menopause)
  • vaginal discharge
  • leg pain/ pelvic pain with advanced disease
36
Q

T/F: biopsy is needed for disagnosis of cervical cancer.

A

true

37
Q

Treatment for the different stages of cervical cancer.

A

Stage determines treatment!
Early (1-1B1 - very small tumor) = radical hysterectomy with lymph node dissection, OR chemoradiation

Locally advanced = primary chemoradiation

Metastatic disease = systemic chemotherapy

38
Q

Is it possible to get pregnant again after treatment for cervical cancer?

A

Yes - they can do a “radical trachelectomy” - removing cervix, reattaching uterus to the vagina! 70% can get pregnant after this.

39
Q

Describe Post-surgery surveillance for cervical cancer

A

appointments / physical exam (ROS, lymph nodes, pelvic exam)

  • every 3 mo for 2 years
  • every 6 mo for 3 years.
  • annually after 5 years.
  • From the beginning, pap smear and chest x ray yearly.
40
Q

describe recurrence rates for cervical cancer

A

80% of recurrences occur in 2 years.

  • overally poor prognosis for these patients.
  • The higher the stage, the higher the recurrence and the higher mortality.

The ultimate test - Last Keystone exam (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions