Flashcards in Uwise - Gyn Onc Deck (18)
Complete vs partial mole - karyotype? HCG? Uterus size? Risk of chorioCA? Fetal parts?
46 X- vs 69 X--
Very high vs elevated
Larger vs normal
Higher vs lower
Risk factors for molar pregnancy?
Asian, extremes of age, frolic acid deficiency
do not need to acquire biopsy to confirm this cancer?
Pt with molar pregnancy - when to try to get pregnant again?
6 months after negative ß-HCG
Tx of vulvar CA?
excisional biopsy if <1mm invasion
Otherwise radial vulvectomy
Tx of vulvar Intraepithelial neoplasm grade 2? Grade 3? CA?
CO2 laser ablation (or skinning vulvectomy, but this is disfiguring)
Pt with history of warts – now presents with lesions. Type of lesions that would suggest dysplastic lesions from HPV related condition?
Multifocal, flat, white lesions on the labia bilaterally
Paget's disease of the vulva description? Typical pt?
Skin cancer with red velvety area with islands white tissue
PAP smear schedule in patients with HIV?
1. Twice in first year after diagnosis, and if normal, annual surveillance
2. any abnormal smear, undergo colposcopy and biopsy
Indications for cervical conization?
1. Unsatisfactory colposcopy
2. Inability to visualize squamocolumnar junction
3. Positive cervical curettage
4. Pap smear indicates adenocarcinoma in situ
5. Discrepancy between Pap smear biopsy results (ex HSIL on PAP and normal biopsy)
Risk factors for cervical cancer?
1. Anything that increases HPV exposure (early sexual activity, no partners, history of HPV, lack of regular PAP smears)
Treatment of a patient with ASCUS Pap smear?
1. It's under 20, repeat in one year
2. In older women, HPV DNA testing or repeat in 6-12 months or colposcopy
a. DNA negative, repeat in 12 months
b. If HPV positive, repeat in 6-12 months
3. If infection/inflammation, treat and repeat 4-6 weeks
1. Area other columnar epithelium that has not undergone squamous metaplasia – appears as reddish ring tissue surrounding external us
3. Blood vessels on their sides
4. Blood vessels on end
Major symptom of fibroids? Mechanism?
1. Increase in surface area – increase in endometrial sloughing
2. Obstruction of vasculature leads to venous congestion and hypermenorrhea
Treatment of fibroid in pregnancy?
Treatment of fibroids in perimenopause?
1. if irregular bleeding, endometrial biopsy
2. GnRH analogue to carry her into menopause
1. Perimenopausal women who does not ovulate regularly
2. Postmenopausal woman with bleeding
3. Menstruating woman with bleeding, pelvic pain, uterine enlargement
4. Postmenopausal women with bleeding, pelvic pain, uterine enlargement, vaginal discharge
5. Symmetrically enlarged boggy uterus with dysmenorrheaFindings to differentiate
1. Endometrial hyperplasia
2. Endometrial carcinoma
4. Uterine Leiomyosarcoma