L70

Question 1

Does too much or too little E put you at risk for risk for endometrial cancer?

Answer 1

Excess E - endo prolif

• Tamoxifen
• Obesity
• Diabetes
• No preg/early periods/late menopause

Question 2

TESTQ: presenting symptom of endometrial cancer + follow up

Answer 2

Post-meno bleeding

Do biopsy, possible followed by D&C if need more tissue

Question 3

What are the 2 types of endometrial hyperplasia?

Answer 3

Non-atypical = benign
Atypical = pre-cancerous

Question 4

Is endometrial cancer surgically or clinically staged?

Answer 4

Surg

Question 5

What is an endometrioid cancer?

Answer 5

Endometrial hyperplasia that still resembles the tissue of origin

Question 6

Treat endometrial cancer for post-meno pt

Answer 6

Surgery - likely partial/full hysterectomy

Adj therapy of some kind

Question 7

Treat endometrial cancer for a woman who still wants to have kids

Answer 7

+ Progesterone (PO or IUD) - only for low grade/stage cancers

Question 8

What are some of the different types of uterine sarcomas?

Answer 8

MMMT = carcinosarcoma
Leio-myo-sarcoma
Overall sarcomas = rarer = more aggressive

Question 9

Anti-step: is grade of stage the most important prognostic factor for endometrial cancer?

Answer 9

Grade… lol its actually stage for step

Question 10

You know what strains of HPV go in the cervical cancer vaccine, but what part of the virus is used to make it?

Answer 10

Empty viral capsid - makes sense! You just need to recognize the outside

Question 11

What are the 2 parts of cervical cancer screening?

Answer 11

1. Pap smear

2. If see, ASC-US do HPV testing

Question 12

What are the next steps if an HPV test comes back positive?

Answer 12

Colposcopy determines abnormal areas for biopsy

Question 13

TESTQ: presentation of invasive cervical carcinoma

Answer 13

Bleeding after sex

Question 14

Most common types of invasive cervical cancer

Answer 14

SCC - from exocervix

Adenocarcinoma - from endocervix

Question 15

Is cervical cancer staged surgically or clinically?

Answer 15

Clinically

Look for LOCAL spread: involved the vagina? Pelvic side walls? Bladder/ureters?

Question 16

Treat cervical cancer

Answer 16

Based on stage

Surg + rad +/- chemo

Question 17

What are the 3 categories of endometrial cancers?

Answer 17

1. Epithelial cell cancer - most
2. Stromal cell cancer = granulosa or Leydig/Sertoli cells
3. Germ cell tumors

Question 18

How does ovulation play into your risk of ovarian cancer?

Answer 18

More ovulation cycles = higher risk

Preg, PO birth control, breast feeding all protective

Question 19

2 genetic risk factors for ovarian cancer

Answer 19

BRCA 1/2

HNPCC (Lynch syndrome)

Question 20

Ovarian cancer presenting symptoms

Answer 20

Non-specific!!!

Bloating + fuller ab size

Question 21

Marker for endometrial cancer that you can test for

Answer 21

CA-125 - not screening

For treatment response and recurrance

Question 22

What might ovarian mets look like

Answer 22

Seed the abdomen

1. Ascities
2. Omental caking = thickening of omental fat

Question 23

Is ovarian cancer staged clinically or surgically?

Answer 23

Surg - examine regional LN specimens

Question 24

Treat high vs low stage ovarian cancer

Answer 24

Low - surg only
High - surg + adj chemo
Chemo = intraperitoneal carboplatin/taxol

Question 25

Are you worried about ovarian cancer recurrence?

Answer 25

YEP - even if you go into remission, you'll relapse at some point

Question 26

Where does endo vs cervical vs ovarian cancer met

Answer 26

Endo to LNs Cervix locally Ovarian into peritoneum

Question 27

What is the tumor marker for a dysgerminoma? (ovarian germ cell tumor)

Answer 27

LDH

Question 28

What is the tumor marker for a yolk sac tumor? (ovarian germ cell tumor)

Answer 28

AFP

Question 29

What is the tumor marker for choriocarcinoma? (ovarian germ cell tumor)

Answer 29

HCG