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TC Oral boards > Gyn Onc > Flashcards

Gyn Onc Flashcards

1
Q

Types of ovarian cancer

A 
Epithelial (59%)
Serous cystadenoma- bilat, psammoma bodies
Mucinous 
Undifferentiated 
Endometrioid 
Clear cell
Brenners
Squamous
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2
Q

Tumor markers

A 
CEA-elevated in mucinous tumors
HE4- epithelial ovarian ca
AFP- endodermal sinus/yolk sac tumor
HCG- choriocarcinoma
LDH- dusgerminoma
Inhibin- granules a cell tumor
Sertoli Leydig- testosterone
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3
Q

Types of germ cell tumors

A

Immature teratomas
Dysgerminoma can be associated with Gonadoblastoma
Endodermal sinus (Schiller Duvall bodies)
Mature teratoma /(malignant potential 1% SCC)
Choriocarcinoma

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4
Q

Sex cord stromal tumors

A

Granulosa cell tumors- call exner bodies, coffee bean nuclei.
Often associated with endometrial hyperplasia
Inhibin

Sertoli-stromal cell tumors- virilizing, Reinke crystals

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5
Q

Adjuvant breast cancer therapies

Use in?
Menopausal status?
Risks

tamoxifen
Raloxifene
AI

A

ER+/unknown
Both
VTE

ER+
Post
VTE

ER+/unknown
Post
Bone loss

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6
Q

Stage 1 cervical cancer

A

1A: <5 mm
1B: Greater than or equal to 5 mm

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7
Q

Stage 2 cervical cancer

A

Beyond uterus, upper 2/3 of vagina but not to pelvic sidewall

2A1: clinical lesions<4cm in greatest dimension
2A2: > or = 4cm
2B: extension to parametrium

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8
Q

Stage 3 cervical ca

A

3A: lower 1/3 vagina, not pelvic sidewalk
3B: to pelvic SW, hydronephrosis
3C1: pelvic LNs
3C2: paraaortic Lns

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9
Q

Cervical cancer stage 4

A

4A: spread to adjacent pelvic organs

4B: spread to distant organs

*cervical cancer staging is clinical**

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10
Q

Treatment for cervical cancer

A

1A1: cone or simple hysterectomy
1A2: rad hyst + nodes
1B-2A: surgery, nodes OR radiation + cis platinum
2B and up: radiation and cis platinum

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11
Q

High risk/oncogenic HPV subtypes

A

16,18,31,33,35,45,52,58

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12
Q

Ovarian cancer staging

Stage 1

A

Confined to ovary, tube
1A limited to 1 ovary/tube, capsule intact
1B limited to both ovaries/tubes, capsule intact
1C: 1A or 1B with:

1C1: surgical spill
1C2: capsule ruptured or tumor on surface
1C3: positive washings

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13
Q

Ovarian cancer

Stage 2

A

Spread to pelvis

2A: uterus
2B: other pelvic intraperitonral tissues

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14
Q

Ovarian cancer stage 3

A

Peritoneal implants outside the pelvis or positive nodes

3A: positive retroperitoneal nodes and/or microscopic spread outside the pelvis
3B: peritoneal spread <2 cm +or- nodes
3C: peritoneal spread >2cm +or- nodes

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15
Q

Ovarian cancer stage 4

A

4A: pleural effusion +cytology
4B: parenchyma disease or extra-abdominal disease

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16
Q

DDX FOR solid tumors

A 
Fibrous
Thecoma
Fibroid
Granulosa cell tumor
Dysgerminoma
Brenner tumor
17
Q

Cystic tumors

A

Functional cysts
Serous and mucinous tumors
Mature teratoma

18
Q

Endometrial cancer

Stage 1
Stage 2

A

Stage 1A: <1/2 myometrial invasion
Stage 1B: >1/2 myometrial invasion

Stage 2: cervical stroma

19
Q

Endometrial cancer
Stage 3

Stage 4

A

3A: serosal or adnexal involvement
3B: vaginal involvement
3C: positive pelvic or para-aortic LNs

4A: bladder and/or rectum
4B: distant metS

20
Q

Complete vs partial mole

A 
Complete 
46XX or 46 XY
No fetus
Theca lutein cysts
15% GTN

Partial
69XXX OR 69XXY
fetus present
3% GTN

21
Q

Bad prognostic factors for GTN

A 
>4 mo since pregnancy
Pretreatment HCG >40000
Mets to liver and brain
Preceded by term pregnancy instead of ab 
Previous therapy failed
22
Q

Treatment for GTN

A

Single agent MtX vs actinomycin D for low risk dz

EMA CO for high risk dz (etoposide, MTX, actinomycin D, cyclophosphamide and vincristine

23
Q

Causes of cancer death in US women

A 
Lung
Breast
Colon 
Pancreas
Ovary
24
Q 
Histopathology
Ovarian tumors
1. Brenner
2. 
Dysgerminoma
3. Struma ovarii 
4. Granulosa cell tumor
5. Krukenburg tumor
6. Endodermal sinus/yolk sac tumor
7. Serous tumors, low malignant potential tumors
A
  1. Coffee bean nuclei, island of transitional epithelium
  2. Lymphocytes
  3. Single germ cell layer containing thyroid tissue
  4. Call Exner bodies (Starry sky appearance), coffee bean nuclei
  5. Signet ring cells
  6. Schiller Duvall bodies
  7. Psammoma bodies
25
Q

Subtypes of epithelial ovarian cancer

A

Serous High grade or a low-grade
Clear cell
Endometrioid
Mucinous

26
Q

Risk of breast and ovarian cancer in BRCA1

BRCA2

A

BRCA 1
Breast 60%
Ovarian 40%

BRCA 2
Breast 50%
Ovarian 15%

27
Q

Which genes warrant risk reducing BSO?

A

BRCA 1&2
Lynch syndrome
BRIP1
RAD 51C&D

28
Q

Screening for BRCA carriers age 25-29

>30

A

Clinical breast exam q6mo
Breast MRI annually

Annual mammo and annual breast MRI staggered q6mo

29
Q

Chemoprohylaxis in breast cancer

A

Tamoxifen for BRCA2. Doesn’t work for a BRCA1 (likely because of negative receptor status)

30
Q

Side effects of tamoxifen

Raloxifene

A

VMS
vaginal dryness
VTE
endometrial cancer

VTE
LEG cramps
Dyspareunia
Weight gain

31
Q

Type 2 endometrial cancers

A

Clear cell

Papillary serous

32
Q

Risk factors for endometrial cancer

A

DM
OBESITY
HTN
Smoking increases risk for type 2 only

33
Q

Pelvic LNs

Para-aortic LNs

A

Removal of nodal tissue from distal half of common iliac

Distal IVC from level of IMA to right common iliac artery

TC Oral boards (38 decks)

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