Flashcards in Gyn Onc Deck (31)
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1
Point A for Radiotherapy for carcinoma of the cervix. How much Rads for local advanced disease?
2 cm above level of external os and 2cm lateral to the midline (point of crossover of artery over ureter)
2
Point B for Radiotherapy for carcinoma of the cervix. How much Rads?
3 cm lateral to point A (position of obturator nodes) Aim to deliver 5500 to 6500. Rads to Point B depending on the extent of parametrial/sidewall disease
3
High risk HPV subtypes
16, 18, 31, 33, 35, 45
4
Describe the histological architecture of Endometrial Intraepithelial Neoplasia (EIN)
Increased glandular density w/ atypia
5
Risk of malignancy w/ Endometrial Intraepithelial Neoplasia (EIN)
formerly simple/complex hyperplasia w/ atypia (formerly 10/30%)
30-50%
6
Types of Endometrial Cancer
Type I- Endometriod, 75% of endometrial cancer, global process, unopposed estrogen, better prognosis
Type II- Clear Cell, Papillary Serous. High grade, poorer prognosis, more focal in origination
7
How is staging for uterine cancer performed?
Surgical staging-remove uterus, cvx, adnexa, pelvic and para aortic nodes and pelvic washings
8
One of most important prognostic factors for endometrial carcinoma?
Presence of extra uterine disease
9
What percent of patients w/ surgery for an atypical endometrial hyperplasia will have an endometrial cancer at final pathology?
40% of patients
10
Criteria for patient selection for Medical Management of Endometrial Carcinoma?
1. Pre-menopausal w/ strong desire to preserve uterus for fertility
2. Poor candidate for major operation due to medical co-morbidities
11
Medical Management of Endometrial Cancer
1. Medroxyprogesterone or Megestrol
2. Progesterone-containing IUD
Should be prescribed by Gyn Onc
12
Differential Dx of Solid Ovarian Tumor
Fibroid
Thecoma
Fibroma
Fibrothecoma
Brenner
Granulosa Cell Tumor
Dysgerminoma
13
Differential Dx of Cystic Tumors
Fx Cysts
Serous Cysts
Mucinous Cysts
Mature cystic teratoma
14
Bilaterality of Germ cell tumors
5-10% (teratoma)
Exception=gonadoblastoma (40%)
15
Bilaterality of Fibroma
10%
16
B/L of Serous carcinoma
66%
17
B/L of Mucinous carcinoma
20%
18
B/L of Krukenburg
100% ( from GI tract )
19
B/l of Mucinous adenoma
0% (virtually)
20
B/l of Serous adenoma
10%
21
CA-125
Serous epithelial tumors
22
False + CA-125
Appendicitis
Cholecystitis
PID
Fiborids
Endometriosis
Diverticulosis
23
CEA
Mucinous epithelial tumors
24
AFP
Endodermal sinus tumors
Embryonal tumors
Germ Cell Tumors
25
HCG
Choriocarcinoma
Embryonal Sinus tumor
Germ cell tumors
26
Estrogens
Granulosa Cell tumor
27
Androgens
Thecoma
Fibroma
Sertoli-Leydig cell tumor
28
Inhibin
Granulosa cell tumor
29
LDH
Dysgerminoma
30
Criteria for borderline tumors
Epithelial stratification
Papillations
Nuclear atypia
No stromal invasion
31
