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Gyn onc Flashcards

(55 cards)

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1
Q

Most common type of cervical cancer

A

Squamous cell carcinoma, 70-75%
Favorable prognosis with early detection and treatment

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2
Q

Second most common cervical cancer

A

Adenocarcinoma, 25%
Favorable prognosis with early detection and treatment
Mostly associated with HPV16 (more oncogenic)

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3
Q

Type 2 endometrial CA

A

10-20% of EC
- Clear cell/papillary serous, high grade with poor prognosis
- risk factors: smoking, non-white, age, underweight
- arises in atrophic endometrium

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4
Q

Stage IA-B uterine sarcoma

A

Limited to uterus
A: 5 cm or less in diameter
B: >5 cm

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5
Q

Stage IIA-B uterine sarcoma

A

Extends beyond uterus within pelvis
A: adnexa
B: other pelvic tissues

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6
Q

Stage IIIA-C uterine sarcoma

A

Infiltrates abdominal tissues
A: one site
B: more than one site
C: Regional lymph node mets (para-aortic/pelvic)

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7
Q

Stage IVA-B uterine sarcoma

A

Tumor spreads to distant sites
A: bladder/rectum
B: distant mets

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8
Q

BRCA1 cancers, chromosome

A

Chromosome 17 (DNA repair)
breast, ovarian, prostate

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9
Q

BRCA2 cancers, chromosome

A

Chromosome 13 (DNA repair)
breast, ovarian, prostate, melanoma, pancreas

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10
Q

Lynch genes and cancers

A

MLH1, MSH2/6, PMS2, EPCAM (DNA mismatch repair)
Ovarian, endometrial, colon, gastric, ureteral, biliary, pancreatic, glioblastoma, renal pelvic

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11
Q

Li-Fraumeni

A

TP53, breast and colon CA
tumor suppressor

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12
Q

Cowden

A

PTEN
Breast, endometrial, colon, GI hamartomas

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13
Q

Indication for radical hyst

A

Stage 1B1-1B2 (sometimes 1B3 and IIA1)
Type C1 = nerve sparing, C2 = not nerve sparing
Uterine artery divided at medial aspect of internal iliac

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14
Q

Psammoma bodies

A

Papillary serous CA
Concentric rings of calcifications
- Serous cystadenoCA of ovary, serous endometrial CA (10% of endometrial CA, type 2)

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15
Q

Hobnail cells

A

Clear cell endometrial CA (similar to ovarian clear cell), 5% of endometrial CA, type 2

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16
Q

Type 1 endometrial CA genes

A

PTEN, KRAS, Lynch, ER+
5y survival with type 1 endometrial CA up to 85%

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17
Q

Type 2 endometrial CA genes

A

p53

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18
Q

Choriocarcinoma tumor marker

A

hCG

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19
Q

Dysgerminoma tumor marker

A

LDH, hCG

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20
Q

Embryonal tumor marker

A

hCG, AFP

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21
Q

Endodermal sinus/yolk sac tumor marker

A

AFP

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22
Q

Epithelial tumor marker

A

CA125

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23
Q

Granulosa tumor marker

24
Q

Mucinous tumor marker

25
Sertoli-Leydig cell tumor symptoms/findings
Sex cord stromal tumor that secretes testosterone - 75-85% of pts report the following: oligo/amenorrhea, breast atrophy, acne, hirsutism, clitoromegaly, deep voice, receding hairline
26
Choriocarcinoma tumor marker
hCG
27
Immature teratoma tumor marker
AFP, LDH, CA125
28
Schiller Duval bodies
Endodermal sinus tumor
29
Call Exner bodies
Granulosa cell tumor
30
Reinke crystals
Leydig cell tumors
31
Hobnail cells
Clear cell CA
32
Psammoma bodies
Serous cystadenoma
33
Signet ring cells
Krukenberg tumors
34
Stage 1A-B ovarian CA staging
1A: one ovary or tube 1B: both ovaries or tubes
35
Stage 1C1-3 ovarian CA staging
Cancer in one or both ovaries/tubes, can now be found on surface 1C = chemo 1C1: surgical spill 1C2: capsule rupture before surgery 1C3: found in ascites washings after surgery
36
Stage 2A-B ovarian CA staging
2A: spread to uterus 2B: spread to sigmoid/rectum/bladder
37
Stage 3A-C ovarian CA staging
3A1: primary peritoneal or spread to pelvic/para-aortic nodes 3A2: spread above pelvic brim 3B: spread to abdominal organs, up to 2 cm lesions 3C: capsule of liver/spleen, >2cm
38
Stage 4A-B ovarian CA staging
4A: pleural effusion 4B: organs outside abdomen/pelvis
39
Stage 1A-B endometrial CA
Confined in uterus 1A: <50% of myometrial thickness 1B: >50% myometrial thickness
40
Stage 2 endometrial CA
Spread to cervix but still confined within uterus
41
Stage 3A-C endometrial CA
Spread outside uterus but not to rectum/bladder 3A: ovary/uterine serosa 3B: vagina/parametrium 3C1: pelvic nodes 3C2: para-aortic nodes
42
Stage 4A-B endometrial CA
4A: bladder/rectum/bowel mets 4B: mets to other organs
43
Stage 1A1-2 cervical CA
Microscopic invasion confined to cervix 1A1: 3mm or less 1A2: >3-5 mm 1A1 managed with cone or simple hyst 1A2 managed with modified radical or radical hyst
44
Stage 1B1-3 cervical CA
Deeper invasion than 5mm but confined to cervix 1B1: >5 mm up to 2 cm 1B2: >2 cm up to 4 cm 1B3: >4 cm Managed with radical hyst (above this managed with chemoradiation)
45
Stage 2A-B cervical CA
Growth outside cervix/uterus but not pelvis or lower vagina 2A: upper 2/3 vagina 2B: parametrium Managed with cisplatin and radiation (stage 2-4A)
46
Stage 3A-C cervical CA
Spread to lower vagina or pelvic sidewall 3A: lower 1/3 vagina 3B: pelvic sidewall/hydronephrosis 3C: involves pelvic (3C1)/paraaortic nodes (3C2)
47
Stage 4A-B cervical CA
Spread to bladder, rectum, distant organs 4A: rectal/bladder mucosa, can still be managed with chemoradiation 4B: further mets, managed with palliative chemoradiation
48
Vulvar CA prognostic factors
Most important is lymph node involvement - Node negative: 70-93% 5y survival - Node positive: 25-41% 5y survival
49
Stage I vaginal CA
Limited to vaginal wall
50
Stage II vaginal CA
Invades paravaginal tissue, not pelvic sidewall
51
Stage III vaginal CA
Extends to pelvic sidewall, does not invade other pelvic organs
52
Stage IVA-B vaginal CA
Extends beyond true pelvis or involves bladder/rectum mucosa A: bladder/rectum or direct extension beyond pelvis B: distant organs
53
Lynch syndrome screening recommendations
- Colonoscopies starting at 20-25y q1-2y, or 2-5y before earliest cancer diagnosis in family - breast: age 25-30 MRI q6mos, exam q6 mos. >30 MRI and mammo alternating q6mos, exam q6mos - EMB starting at 30-35y q1-2y - Ovarian: >30 can consider annual US with CA125
54
Amsterdam criteria
Used to diagnose Lynch syndrome - 3+ relatives with Lynch-associated cancer - Involves at least 1 first degree relative and two successive generations - At least one diagnosed <50yo - Exclude FAP (familial adenomatous polyposis)
55
BRCA carrier prophylactic BSO timing
BRCA1: 35-40yo BRCA2: 40-45yo

ABOG written boards (5 decks)

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