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EOR - Women's Health > Neoplasms > Flashcards

Neoplasms Flashcards

1
Q

6 women’s health neoplasms to know

A

breast cancer
cervical carcinoma
cervical dysplasia
endometrial cancer
ovarian neoplasms
vaginal/vulvar neoplasms

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2
Q

mc malignancy in women

A

breast ca

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3
Q

4 rf for breast ca

A

menarch before 12 yo
advanced maternal age w. first full term pregnancy
nulliparity
menopause after 52 yo

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4
Q

describe a malignant breast mass (2)

A

irregular
immobile

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5
Q

3 PE findings of breast ca

A

immobile irregular mass
nipple retraction
bloody nipple d.c

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6
Q

4 types of breast ca to know

A

infiltrating intraductal carcinoma (IIC)
infiltrating lobular
paget’s dz of the nipple
inflammatory breast ca

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7
Q

mc type of breast ca

A

infiltrating intraductal carcinoma (ICC)

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8
Q

which type of breast ca is frequently bilateral

A

infiltrating lobular

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9
Q

which breast ca is characterized by chronic, eczematous itchy, scaling rash on the nipples and areola

A

paget’s dz of the nipple

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10
Q

which breast ca is characterized by red, swollen, warm and itchy breast; nipple retraction, and peau d’orange

A

inflammatory breast ca

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11
Q

which type of breast ca is not associated w. a mass

A

inflammatory breast ca

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12
Q

3 types of breast ca tumors (hormones)

A

-estrogen receptor positive (ER)
-progesterone receptor positive (PR)
-human epidermal growth factor receptor positive (HER2)

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13
Q

breast ca tumors from most to least common

A

ER
PR
HER2

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14
Q

tx for breast ca

A

-segmental mastectomy (lumpectomy) followed by xrt in all pt’s +/- chemo
-anti-estrogen tamoxifen
-aromatoase inhibitors (estrogen inhibitors)
-monoclonal abs

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15
Q

indications for chemo w. breast ca

A

positive nodes stage I and II w. tumors < 4 cm in diameter

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16
Q

what pharm tx is most effective for ER positive breast ca tumors

A

tamoxifen

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17
Q

moa for tamoxifen

A

binds/blocks estrogen receptors in breast tissue

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18
Q

what pharm tx is most effective for postmenopausal ER positive breast tumors

A

aromatase inhibitors (anastrozole)

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19
Q

moa for aromatase inhibitors

A

reduces estrogen production

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20
Q

what pharm tx is most effective for HER2 positive breast tumors

A

monoclonal abs

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21
Q

triad associated w. cervical ca extension into the pelvic wall

A

unilateral leg edema
sciatic pain
ureteral obstruction

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22
Q

cervical ca is the _ mc type of ca

A

third

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23
Q

80% of pt’s w. cervical ca present w.

A

abnormal vaginal bleeding

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24
Q

mc age group for cervical ca

A

postmenopausal

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25
besides abnormal vaginal bleeding, 3 less common sx of cervical ca
postcoital bleeding vaginal d.c pain
26
mc type of cervical ca _ mc arises from _
squamous cell arise from squamocolumnar junction/ectocervix (transformational zone)
27
5 rf for cervical ca
multiple sex partners early age of intercourse early first pregnancy HPV smoking
28
99% of cervical ca is due to
HPV
29
which types of HPV are associated w. cervical ca
**16** **18** 31 33
30
PE finding of cervical ca
friable, bleeding cervical lesion
31
gs dx for cervical ca (2)
bx of gross lesions colposcopically directed bx
32
tx for cervical ca stages 1 and 2
stage 1: conservative, simple, or radical **hysterectomy** stage 2: chemo +/- xrt
33
what age shold pt's receive first pap regardles of sexual activity
21 yo
34
indications for pap earlier than 21 yo
at the time of intercourse for women who are: -HIV (+) -chronic immunosuppression (SLE, post organ transplant)
35
cervical ca screening guidelines for women 21-29
cytology only q 3 yaers
36
cervical ca screening guidelines for women 30 yo and older
q 5 years: cytology PLUS HPV testing
37
4 indications for annual cervical ca screening
HIV (+) immunosuppression in utero DES exposure past tx for cervical ca
38
guidelines for d.c of pap smears
-total hysterectomy if for benign condition -65 yo if 3 negative cytology tests OR 2 consecutive negative HPV/pap co-tests 10 years before stopping w most recent test w.in 5 years
39
pap pathology: asc-us: lsil: hsil:
asc-us: atypical squamous cells of undetermined significance lsil: low grade squamous intraepithelial lesion -> mild dysplasia (CIN I) hsil: high grade squamous intraepithelial lesion -> mod-sev dysplasia (CIN II-III, carcinoma in situ)
40
management of pt w. negative pap cytology but hpv positive
repeat both tests in 12 mo
41
management of ASC-US, LSIL, and CIN-1
reflex HPV testing: if negative or < 25 yo -> retest in 12 mo if positive and >/= 25 yo -> colposcopy
42
management of HSIL, CIN-2, CIS
**colposcopy:**: outside cervix -> LEEP vs cryotherapy inside cervix: cone bx
43
gardasil 9 guidelines
-females and males 11-12 yo (as early as 9 yo) -catch up: females 13-26 yo, msm 22-26 yo, immunocompromised -27-45 yo: shared decision making
44
dosing of gardasil 9
<15 yo: 2 doses 6 months apart >15 yo and immunocompromised: three doses at 0, 1-2mo, and 6 mo
45
mc gyn malignancy
endometrial ca
46
cardinal sx of endometrial ca
postmenopausal vaginal bleeding
47
bleeding in postmenopausal women is _ until proven otherwise
endometrial ca
48
mc type of endometrial ca
adenocarcinoma
49
9 rf for endometrial ca
obesity nulliparity early menarche late menopause unopposed estrogen therapy HTN gallbladder dz DM prior ovarian/endometrial/breast ca
50
50% of women w. endometrial ca will have an
abnormal pap
51
dx for endometrial ca
endometrial bx
52
all women w. postmenopausal vaginal bleeding should get a
endometrial bx
53
tx for endometrial ca
1.total hysterectomy w. bilateral salpingoophorectomy 2. pelvic xrt +/- chemo
54
2nd mc type of gyn ca
ovarian
55
age range for ovarian ca
40-60
56
if a woman has _ ovarian ca is the most likely tumor to be found
ascites
57
2 sx associated w. ovarian ca at advanced age
ascites abd pain
58
3 protective factors against ovarian ca
multiparity OCP breast feeding
59
5 rf for ovarian ca
nulligravidity infertility early menarche late menopause endometriosis
60
mc type of ovarian ca
epithelial
61
dx for ovarian ca
1. transvaginal US 2. bx
62
serum tumor marker for ovarian ca
ca-125
63
what gene is associated w. ovarian ca
BRCA1
64
tx for ovarian ca stages 1-2
hysterectomy w. bilateral salpingoophorectomy
65
tx for ovarian ca stages III-IV
1. hysterectomy w. bilateral salpingoophorectomy 2. chemo + xrt
66
what is used to monitor tx of ovarian ca
ca-125
67
4 rf for vulvar/vaginal carcinoma
hpv smoking cervical carcinoma in utero des exposure
68
vaginal ca is rare and is usually caused by
other gyn cancer
69
peak age of vaginal ca
60-65 yo
70
mc type of vaginal ca
squamous cell
71
squamous cell vaginal ca is associated w. what rf: adenocarcinoma vaginal ca is associated w. what rf:
sqamous cell: hpv adenocarcinoma: in utero DES exposure
72
mc location of vaginal carcinoma
upper one-third of posterior vaginal wall
73
2 mc presenting sx of vaginal carcinoma
abnormal vaginal bleeding changes in menstruation
74
tx for vaginal carcionma
xrt
75
peak incidince of vulvar ca
50 yo
76
mc presenting sx of vulvar ca
vaginal pruritis
77
what 2 types of vulvar ca represent 90% of cases
squamous cell melanoma
78
rf for vulvar ca
hpv 16, 18, 31
79
PE finding of vulvar ca
pruritic black lesions -> hpv
80
dx for vulvar ca
bx
81
what guides bx location for vulvar ca
toludine blue OR acetic acid staining
82
tx for vulvar ca
vulvectomy PLUS lymph node dissection
83
what do pruritic red lesions on the vulva make you think
paget's dz

EOR - Women's Health (15 decks)

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