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Lawrd She got Cancer Flashcards

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1
Q

What percent of women diagnosed with cervical cancer never recieved cervical cytology?

A

50%

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2
Q

What percent of women had not be screened within 5yrs of being diagnosed with cervical cancer?

A

10%

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3
Q

What is dysplasia?

A

epithelium is replaced by cells showing atypia

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4
Q

How is cervical cancer staged?

A

Besthada- Cervical Intraepithelial Neoplasia

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5
Q

Reflects a recent HPV infection?

A

CIN 1

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6
Q

Large inter-observer variability?

A

CIN 2

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7
Q

Strong predicator of progression to cervical cancer

A

CIN 3

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8
Q

Since 1975 mortality due to cervical cancer has?

A

decreased

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9
Q

Where is cervical cancer much more common?

A

in countries without screening programs

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10
Q

What is the most common type of epi cell abnormalities?

A

undetermined significance (ASC-US)

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11
Q

Cervical cancer screening begins at ?

A

21 yrs

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12
Q

Age at which cervical cancer shouldn’t be screened regardless of age of sexual initiation or behavior related risk?

A

< 21 yr

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13
Q

How many cases of cervical cancer occur before age 20?

A

0.1% (1-2 cases out of 1,000,000)

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14
Q

What are 6 risk factors for cervical cancer?

A 
Young age at first coitus
multiple sexual partners
sexual partener w/ multiple partners
young age @ first preggo
low socioeconomic status
SMOKING!
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15
Q

What is not a risk factor related to cervical cancer??!

A

FAMILY HISTORY

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16
Q

Which strain of HPV has the highest carcinogenic potential?

A

HPV 16

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17
Q

Which strain of HPV has the 2nd highest carcinogenic potential?

A

HPV 18

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18
Q

How many HPV genotypes are associated with cervical cancer?

A

12

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19
Q

What accounts for 55-60% of cervical cancer?

A

HPV 16

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20
Q

What accounts for 10-15% of cervical cancer?

A

HPV 18

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21
Q

What are some known cofactors that increase the risk of HPV infection?

A

smoking
compromised immune system
HIV infection

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22
Q

Young women immune response usually clears the immune system on average of …

A

8 months

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23
Q

Young women immune response usually decreases the viral load to undetectable levels in….

A

8-24 months

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24
Q

Persistent HPV infection at 1 and 2yrs after infection strongly predicts what?

A

risk of CIN 3 or cancer

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25
What is the best HPV vaccination to receive?
9-valent
26
When can the HPV vaccine be given?
9 to age 26 (now extended to 45)
27
HPV screening for 21-29yr?
pap smear every 3 years
28
HPV screening for 30-65yr?
HPV and pap smear every 5 yrs or Pap smear w/ cytology every 3 years
29
HPV screening for >65?
NO SCREENING
30
HPV screening for women who underwent total hysterectomy AND never had CIN 2 or higher?
NO SCREENING
31
HPV Screening for women who underwent total hysterectomy AND have a history of CIN 2 or higher in the past 20 yrs or cervical cancer
SCREEN
32
What 4 women need to be screened more often for cervical cancer?
Women HIV infected Immunocompromised women Women exposed to DES in utero Women previously txt for CIN2,3, or cancer
33
Abnormal pap smear what's next?
colposcopy
34
Treatment for CIN 2-3?
Cryotherapy LEEP (Loop Electrical Excision Procedure) Cold Knife Cone
35
A visible lesion seeing during pelvic exam needs what?
a biopsy for diagnosing NOT A SCREENING PAP
36
Who created the pap test?
Georgios Papanikolaou
37
90% of cases of genital warts are cause by what genotypes?
6 and 11
38
What is the dosing for HPV?
3 dose 2nd is given at least 1-2mo after 1st 3rd is @ least 6mo after 1st
39
T/F Vaccine is less effective in previous infected individuals?
TRUE
40
4TH most common cancer in women?
uterine cancer
41
4th and 5th leading cause of cancer death?
ovarian and endometrial cancer
42
3rd most common cancer among and women and 2nd most frequent cause of related death worldwide
cervical cancer
43
??? cancer is a sexually transmitted disease
cervical cancer
44
high risk HPV genotypes
16, 18, 31, 33, 35, 39 45, 51,52, 58
45
Low risk HPV genotypes
6, 11, 40, 42, 43, 44, 54
46
90% of anogenital warts
HPV 6, 11
47
50% of vaginal and vulvar cancer?
HPV 16, 18
48
95% of cervical HPV infection
Squamous Cell Carcinoma
49
30% of cervical HPV infection
Adenocarcinoma
50
Symptoms of cervical cancer?
irregular of heavy vaginal bleeding Postcoital bleeding Vaginal Discharge
51
HPV screening in HIV +
screening X2 in 1st yr after diagnosis | then ANNUALLY
52
What is done at a HIV + initial evaluation
Colposcopy
53
HPV Screening for immunosuppressive pt?
started after one yr of sex activity or by age 21
54
HPV Screening for Immunosuppressive <30yr
screen w/ yearly PAP test for 3 yrs
55
HPV Screening for Immunosuppressive normal results for 3 yrs?
move to screening every 3 years (NEVER 5)
56
ASCUS
atypical squamous cells of undetermined significance
57
Stage I cervical cancer
confined to cervix
58
Stage II cervical cancer
disease beyond cervix but not to pelvic wall or lower 1/3 of vagina
59
Stage III cervical cancer
disease to pelvic wall or lower 1/3 vagina
60
Stage IV cervical cancer
invades bladder rectum or metastasis
61
What can prevent almost all cervical cancers
vaccination and regular screening
62
If over >15 what HPV vaccine dose is recommended?
3 dose
63
Gardasil 9 is not approved for whom?
27-45yr
64
Potential allergic reaction to HPV?
previous dose, yeast, amorphous aluminum hydroxyphosphate sulfate or polysorbate 80
65
Most common GYN malignancy in U.S.
Endometrial cancer
66
What the two phenotypes for endometrial cancer?
Type I and Type II
67
Where does Type I endometrial cancer arise from?
estrogen stimulation
68
Where does Type II endometrial cancer arise from?
NOT associated w/ estrogen stimulation
69
Grade I and 2
Type I
70
Grade 3
Type II
71
Presentation of endometrial cancer?
``` Abnormal vaginal bleeding Postmenopausal bleeding (90%) Abnormal discharge ```
72
Diagnosis of endometrial cancer?
Endometrial biospy
73
Endometrial stripe thickness <4mm
low risk
74
Endometrial stripe thickness > 4mm
high risk.. proceed w/ biospy
75
Gold standard diagnosis for endometrial cancer?
fractional curettage +/- hysteroscopy
76
What is used to check endometrial thickness
transvaginal U/S
77
What stage of endometrial cancer has the highest 5 yr survival rate
Ia (91%)
78
What stage of endometrial cancer has the lowest 5 yr survival rate
IVb (20%)
79
Largest number in GYN deaths
ovarian cancer
80
cancer rises with age, peak at 54-64yr
ovarian cancer
81
3 risk factors for ovarian cancer?
- BRCA 1 mutation (35-46%) - BRCA 2 (13-23%) - Lynch Syndrome (3-14%)
82
What are two red flags for hereditary breast and ovarian cancer?
breast cancer before 50 | ovarian cancer any age
83
Two common presenting symptoms in ovarian cancer?
``` abdominal discomfort (50%) Vaginal bleeding (15%) ```
84
When should a postmenopausal woman be referred to GYN Onc?
``` w/ pelvic mass and 1: CA-125 above normal Ascites Fixed or nodular mass evidence of mets Family hx of >1 1st degree relatives ```
85
When should a premenopausal woman be referred to GYN Onc?
CA-125 > 200u/ml Ascites Evidence distant mets Family hx or >1 1st degree relatives
86
Surgery plan for ovarian cancer?
TAH, BSO complete staging and tumor debulking
87
Chemotherapy for ovarian cancer?
Carboplatin and Paclitaxel
88
Peak age for vulvar neoplasm
70yr
89
Peak age for vaginal neoplasm
50yr
90
Treatment for vaginal neoplasm
radiation therapy
91
Treatment for vulvar neoplasm
surgical excision, radiation therapy, chemotherapy
92
Risk factor vulvar neoplasm
HPV

Women's Health (11 decks)

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