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FM II Women's Health > GYN ONCOLOGY > Flashcards

GYN ONCOLOGY Flashcards

(45 cards)

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1
Q

What is the MC GYN cancer?

A

Endometrial cancer (in postmenopausal women)

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2
Q

Endometrial cancer is what type of cancer?

A

Adenocarcinoma

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3
Q

What is the cardinal symptom of endometrial cancer?

A

Inappropriate uterine bleeding

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4
Q

How do we diagnose endometrial cancer?

A

In post menopausal bleeding do a Pap Smear, endocervical curettage, and endometrial biopsy.

 - Endometrial biopsy has an accuracy of 90-95%
 - Can also do D&C and transvaginal U/S
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5
Q

How do we treat endometrial cancer?

A

Total hysterectomy (bilateral salpingo-oophorectomy)

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6
Q

What type of GYN cancer is the second MC but the highest mortality rate?

A

Ovarian cancer

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7
Q

What are the risk factors for ovarian cancer?

A

Older women, nulliparous, white, and family Hx

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8
Q

What is thought to be protective against ovarian cancer?

A

Long-term OCP’s

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9
Q

What are the sxs of ovarian cancer?

A

Usually none :(

  • Palpable ovary in a postmenopausal woman is a PROBLEM
  • Otherwise ascites, abdominal distention, early satiety, changes in bowel habits, or a fixed mass
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10
Q

How do you diagnose ovarian CA?

A

Transvaginal U/S

- Genetics: BRCA1, CA-125, and mutations in P53

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11
Q

How do you treat ovarian cancer?

A

surgery + chemo and radiation

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12
Q

What is the MC cancer in women?

A

Breast Cancer

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13
Q

What genes are associated with breast cancer?

A

BRCA 1 and BRCA 2

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14
Q

What are some associated risk factors for breast cancer?

A

nulliparity, early menarche, late menopause, long-term estrogen use, radiation exposure, and delayed childbearing, and first degree relatives

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15
Q

How does breast cancer present?

A

lumps, bumps, skin changes, dimpling, red/hot, pain/no pain, regional node enlargement

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16
Q

When do we start mammograms?

A

Age 40 annually or every 2 years

Age 50 annually or every 2 years

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17
Q

if you have a post-menopausal woman with a new mass, discharge, or asymmetry what should you always think about?

A

Presumed cancerous until proven otherwise

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18
Q

What is the GOLD STANDARD of breast mass diagnosis?

A

Aspiration/biopsy = superior to imaging

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19
Q

What’s the most common type of breast cancer?

Study These Flashcards
A

Infiltrating ductal carcinoma = spreads

20
Q

What sxs make you think of infiltrating ductal carcinoma?

Study These Flashcards
A

redness, scaling, dimpling, thickening of the nipple

21
Q

How do you treat infiltrating ductal carcinoma?

Study These Flashcards
A

Lumpectomy (if <2cm) or mastectomy

Sentinel node biopsy

22
Q

What type of breast cancer does not metastasis but has a high incidence of recurrence?

Study These Flashcards
A

Ductal carcinoma insitu

23
Q

What are the systemic treatment options for breast CA?

Study These Flashcards
A

Chemo, hormonal therapy, estrogen receptor downregulators (Tamoxifen) for pre-menopausal

24
Q

If breast CA were to metastasize, where does it most likely go?

Study These Flashcards
A

obvi lymph nodes/muscle/fat/skin around the breast

But vertebral pedicles & ribs

25
What does the F/U involve after breast CA?
every 3-6 months x 3 years Every 6-12 months years 4 & 5 Every year after year 5 *Yearly mammogram + pelvic exams (some drugs can increase uterine cancer)
26
If a pt has itching, burning, pain, scales/thickening of the nipple – what should you think?
Not just eczema but possible breast CA! | Paget’s
27
What is cervical cancer associated with 99.7% of the time?
HPV
28
What are the risk factors for cervical cancer?
early onset sexual activity, multiple partners, high-risk, hx of STIs, smoking
29
What are the sxs associated with cervical cancer?
Early on = asymptomatic Irregular or heavy vaginal bleeding Postcoital bleeding
30
What would the cervix look like that would make you think cervical cancer? Dx?
lesions that are raised, red, and friable | Dx – based on histologic evaluation
31
Where does cervical cancer typically originate on the cervix?
transformational zone (SJC)
32
How do we manage cervical cancer?
early detection | - Radical hysterectomy, fertility sparing surgery, and radiation
33
When do we start paps?
Age 21
34
A 23y/o female has a pap result that shows ASCUS, how do you move forward?
repeat pap in 1 year - If repeat pap is NORMAL, or ASCUS or LSIL again – screen in 1 year - If repeat pap is ABNORMAL – colposcopy
35
A 26y/o female has a pap result that shows ASCUS, how do you move forward?
Reflex HPV testing - HPV Positive = colposcopy - HPV negative = repeat co-testing in 3 years
36
A 23y/o (21-24y/o) female has a pap result that shows LSIL, how do you move forward?
repeat pap in 1 year - If repeat pap is NORMAL, or ASCUS again – screen in 1 year - If repeat pap is ABNORMAL – colposcopy
37
A 28y/o female has a pap result that shows LSIL, how do you move forward?
HPV positive = colposcopy | HPV negative = repeat co-testing in ONE YEAR (not 3 like ASCUS)
38
A 22y/o female has a pap result of HSIL, how do you move forward?
Colposcopy FOR ALL, no matter the HPV status | *high risk of carcinoma, correlates with CIN II or III
39
A 27y/o has a pap result of ASC-H, how do you move forward?
colposcopy
40
What if you 35y/o has a pap result of ASC-H, what do you do?
Colposcopy PLUS endometrial sampling if 35 or older
41
What are the grades of CIN?
CIN I = mild dysplasia CIN II = moderate dysplasia CIN III = severe dysplasia to carcinoma in situ
42
How does a colposcopy work?
Magnify the cervix | - Staining to identify areas to be biopsied (acetic acid and iodine)
43
How do we treat the abnormal areas after biopsy via colposcopy?
LEEP | Ablation of T-zone with cryotherapy or laser
44
Tell me about vaginal cancer?
Rare, mostly SCC Diagnose via pap and biopsy Treat with chemo or radiation
45
If on the vulva you note red/white lesion that are itchy for the patient, dx? Tx?
Think Vulvar cancer - Biopsy - Surgery/chemo/radiation

FM II Women's Health (12 decks)

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