GYN Neoplasms Flashcards
(45 cards)
What is a uterine Leiomyoma?
Benign smooth muscle tumor
What is the course of a uterine Leiomyoma? Why?
They may be symptomatic until menopause and then they will shrink and be asymptomatic because they are hormone sensitive
What are some possible symptoms of uterine Leiomyomata?
- Heavier bleeding
- Pelvic pressure
- Constipation/Urinary retention
How will the uterus feel on examination with uterine Leiomyomata? What diagnostic can you obtain?
Irregularly enlarged uterus
–> TVUS
What medications and surgeries can you try for symptomatic uterine leiomyomas?
Medications:
- OCPs/Medroxyprogesterone and NSAIDs
Surgeries:
- Myomectomy or Hysterectomy
What is the malignant form of a uterine fibroid?
Leiomyosarcoma
Type 1 and Type 2 Endometrial cancers are what?
Type 1 = Endometrioid
Type 2 = Serous/Mucinous
How does Type 1 Endometrial cancer arise usually?
Type 1 = Endometrioid
–> UNOPPOSED ESTROGEN
What are some protective factors against Endometrial Cancer type 1?
OCPs
Multiparity
Progestins
Breast feeding
What mutations are often present with Type 2 Endometrial cancer?
Type 2 = Serous/Mucinous
=> P53, PTEN, BRCA genes
How will Endometrial cancer present?
Post-menopausal bleeding or intermenstrual/heavier bleeding in premenopausal women
What 2 diagnostics should be obtained if you are concerned about Endometrial cancer?
TVUS – most often if premenopausal
Biopsy – especially if postmenopausal
An endometrial stripe > ____ mm is concerning for Endometrial hyperplasia/cancer
> 4 mm
What medication can be used for Endometrial Hyperplasia?
Progestins
What cells are normally found at the Endocervix? Ectocervix?
Endocervix = Columnar cells
Ectocervix = Squamous cells
What are some risk factors for Cervical cancer?
HPV 16/18
Tobacco use, HIV, STDs
Multiparity
How will Cervical cancer present?
Post-coital bleeding +/- heavier and IMB
HPV infection is often the cause of Cervical cancer. What cells may be present and what do they look like?
Koilocytes = bilobed nucleus + perinuclear halo
With a majority of abnormal pap smears, what is often done next?
Colposcopy +/- biopsy/endocervical curretage
If a patients pap result is ASC-US with a history of normal paps and (-) HPV, what is the workup?
Repeat pap in 1 year
If a patients pap result is ASC-US with a history of that on prior paps or they are HPV (+), what is the workup?
Colposcopy
If a patients pap result is ASC-Glandular, what is the workup?
Colposcopy + Endocervical curretage + Endometrial biopsy
If a patients pap result is ASC-H, LSIL, HSIL, what is the workup?
Colposcopy
What pap result is CIN1?
LSIL
