Endometriun

Question 1

Endometrial hyperplasia

Answer 1

Either drugs or anovulatory

• menopause
• ERT (relieve menopause symptoms)
• PCOS/granulosa cell tumor
• obesity

Question 2

1% of simple hyperplasia progress to

Answer 2

Adeno ca

Question 3

Cystic hyperplasia occurs in

Answer 3

Hyperplastic endometrium

Menopause or postmenopause

Question 4

Complex hyperplasia vs simple

Answer 4

Simple - crowding

Complex - crowding and branching

Question 5

Complex hyperplasia to adenoCA

Answer 5

3%

Question 6

Complex hyperplasia is a variant of

Answer 6

Adenomatous hyperplasia with mod to severe architectural atypia

Question 7

Commonly progress to adenoCA

Answer 7

Complex hyperplasia

Question 8

Cytologic atypia

Answer 8

• Large nuclei of varied size and shape
• increase N:C ratio
• Prominent nucleoli
• irreg clumped chromatin

Question 9

Premalignant

Answer 9

Atypical hyperplasia (complex)

Question 10

Vaginal discharge
Abd pain
Intermenstrual bleeding
HMB

Answer 10

Endo hyperplasia

Question 11

Percent endo hyperplasia to endoCA

Answer 11

1.6%

Question 12

Mgmt of endo hyperplasia

Answer 12

Hysterectomy

Question 13

Atypical hyperplasia versus carcinoma

Answer 13

No invasion of connective tissue

Question 14

Atypical hyperplasia to CA

Answer 14

22%

Question 15

Risk of progression to endo CA

Answer 15

Simple
1%
8%
Complex
3%
6%
29%
adenomatous
9%

Question 16

Diagnosis of endo hyperplasia

Answer 16

Fractional curettage

• choice
• endocervix and endometrium
• 30 and above

Endo sampling, brushing, biopsy or vacuum curettage

• 74-97% accurate for endo CA
• 32-70% endo hyperplasia

Question 17

Pap smear endo CA accuracy

Answer 17

<50%

Question 18

Endo hyperplasia

Young women desiring fertility

Answer 18

3-6 mos progestin therapy oral or IUD then repeat sampling

Question 19

Peri and postmenopausal who have hyperplasia w/o atypia

Answer 19

3-6 mos progestin then repeat sampling

Question 20

Complex atypical hyperplasia treatment

Answer 20

Hysterectomy

Question 21

Postmenopausal bleeding or irregular menses

Answer 21

Endo CA

Question 22

Median age endo CA

Range

Answer 22

61

50-59

Question 23

Risk factors for endo CA

Answer 23

Early menarche (<12)
Late menopause (>52)
Functioning ovarian tumor
Anovulation/PCOS
Infertility
Ovesity
Tamoxifen
Comorbidities
Radiation

Question 24

Syndrome associated with endo CA

Answer 24

Lynch II syndrome
Auto dominant
Endo CA is 2nd most common

Question 25

Dec risk endo CA

Answer 25

``` High parity (cervical CA) OCPs ```

Question 26

Most common histologic type of endo CA

Answer 26

Endometrioid CA

Question 27

AdenoCA coexisting with benign squamous | malignant squamous

Answer 27

Adenoacanthoma | Adenosquamous

Question 28

2 causes of endo CA

Answer 28

- Excess endogenous estrogen | - absence of hyperestrogenism

Question 29

Endo CA with endo hyperplasia

Answer 29

Excess endogenous estrogen - well or mod differentiated - myometrial invasion is superficial - good prognosis

Question 30

Endo CA with atrophic endometrium

Answer 30

Absence of hyperestrogenism - poor differentiated - aggressive

Question 31

Histologic grade of endo CA

Answer 31

Well - 95% glandular Mod - 5-50% solid Poor - >50% solid

Question 32

Histologic grade of endo CA correlates with

Answer 32

- myometrial invasion - pelvic and paraaortic nodes - survival

Question 33

Endo CA ancillaries

Answer 33

Peritoneal washings DNA ploudy analyzer (aneuploid poor prognosis) Biochemical assay (more reliable)

Question 34

Endo CA treatment

Answer 34

Surgery | Explore lap, TAHBSO, peritoneal fluid cytology, lymph node dissection

Question 35

Endo CA | given post-op to patients with more than stage 1B

Answer 35

Radiotherapy

Question 36

Endometrial polyp diagnosis | Procedure

Answer 36

Vaginal utz Hyperechoic <2cm Hysteroscopy and biopsy Excise thru hysteroscope with D&C