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Clin Med III exam III > Vulvar cancer > Flashcards

Vulvar cancer Flashcards

(58 cards)

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1
Q

Vulvar intraepithelial neoplasia is a ___ condition

A

premalignant

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2
Q

Three types of vulvar intraepithelial neoplasia

A
  • low grade
  • high grade
  • differentiated type
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3
Q

Low grade VIN is associated with ___

A

low oncogenic HPV tyes

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4
Q

High grade VIN is associated with ___

A

high oncogenic HPV types

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5
Q

Differentiated VIN is associated with ___

A

lichen sclerosus

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6
Q

Risk factors for high grade VIN

A
  • HPV
  • smoking
  • immunodeficiency
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7
Q

Clinical presentation of VIN

A
  • pruritus and discomfort

- vulvar lesion

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8
Q

Treatment of high grade VIN with a lesion

A
  • surgical excision
  • ablative therapy
  • topical imiquimod
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9
Q

Treatment of high grade VIN without a lesion

A

-ablative therapy

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10
Q

Treatment of differentiated VIN

A

surgical excision

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11
Q

What are the risk factors of recurrence of VIN after treatment

A
  • immunosuppression
  • multifocal/multicentric disease
  • positive margins
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12
Q

When do you follow with with a patient that had VIN after treatment

A

every 6 months for 5 years then anually

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13
Q

What population is vulvar carcinoma most frequently seen in

A

postmenopausal women

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14
Q

What are the risk factors for vulvar cancer

A
  • VIN/SIN
  • prior hx of cervial cancer
  • vulvar lichen sclerosus
  • smoking
  • immunodeficiency
  • northern european ancestry
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15
Q

What complaint is associated with most vulvar disorders

A

pruritus

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16
Q

Histologically what are most vulvar cancers? What else can they be?

A

most are squamous cell carcinomas

can also be melanoma

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17
Q

Treatment of vulvar cancer with no evidence of distant disease

A

surgery with adjuvent therapy

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18
Q

Treatment for vulvar cancer with locally advanced disease

A

chemo or radiation alone

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19
Q

Treatmetn of vulvar cancer with distant mets

A
  • chemo w/ carboplatin and paclitaxel

- restaging exams w/ CT of chest,abd, pelvis every 3 cycles

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20
Q

Origins of atypical glandular cells

A
  • enodcervial

- endometrial

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21
Q

Are atypical glandular cells associated with premalignant/malignant lesions

A

YES

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22
Q

relationship between risk of malignancy and age in women with AGC

A

risk of malignancy increases with age

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23
Q

How are atypical enodmetrial cells worked up

A

endometrial and endocervical sampling–> colposcopy if no endometrial pathology

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24
Q

How are all subcategories of AGC (except endometrial) worked up

Study These Flashcards
A

colposcopy with endocervial sampling and endometrial sampling

25
Adenocarcinoma in situ of the cervix is what
a premalignant condition
26
Adenocarcinoma in situ is the only precursor to what
adenocarcinoma
27
Cytology for adenocarcinoma in situ
atypical glandular cells resemble the same ones of cervical invasive adenocarcinoma
28
How does a patient with adenocarcinoma in situ present
- nearly always asymptomatic | - generally not visible on gross examination
29
How do you diagnose adenocarcinoma in situ
- colposcopy directed biopsy - endovervical curettage - conization
30
Preferred management for adenocarcinoma in situ
hysterectomy
31
Conservative management of adenocarcinoma in situ
if margins are negative after excision--> long term follow up if margins are involved or ECC +---> re-excision is recommended or re-evaluate at 6 months
32
What is endometrial hyperplasia
proliferation of endometrial glands
33
Endometrial hyperplasia is typically a result from what
unopposed chronic estrogen stimulation
34
WHO classification of endometrial hyperplasia
- hyperplasia without atypia | - atypical hyperplasia (enodmetrial intraepithelial neoplasm)
35
Risk factors for endometrial hyperplasia
- HPV - smoking - exposure to estrogen - Lych syndrome
36
Endometrial hyperplasia clinical presentation
- abnormal uterine bleeding | - same as endometrial carcimona
37
Diagnostic evaluation of endometrial hyperplasia
- pelvic sonography | - enodmetrial sampling
38
What are the two categories of endometrial carcinoma
- type I tumors | - type II tumors
39
Which endometrial carcinoma has the better prognosis
type I tumors
40
Which type of endometrial carcinoma is estrogen responsive
type I tumors
41
What may precede a type I endometrial carcinoma
intraepithelial neoplasm
42
Are type I or type II endometrial carcinoma tumors more common
type I
43
Cervical cytology findings with endometrial carcinoma
- adenocarcinoma - aytpical glandular cells - endometrial cells
44
Bleeding patterns in postmenopausal women that should make you think cancer. Age 45 to menopause. Younger the 45.
Postmenopausal: any bleeding 45 to menopause: any abnormal bleeding Younger than 45: abnormal and persistent uterine bleeding
45
If suspected endometrial cancer, what should be done?
- physical exam (size, mobility and axis of uterus) - urine HCG - pelvic sonography - endometrial sampling
46
Enodmetrial carcinoma is a ___ diagnosis based upon results of ____
histological diagnosis based on results of andometrial biopsy or hysterectomy
47
When is routine endometrial cancer screenings preformed
in women with lunch syndrome
48
Before treating someone for endometrial cancer what should be done
- evaluation for hereditary cancer syndromes - serum tumor marker CA 125 - contrast MRI
49
Standard treatment for women with low risk endometrial cancer
Surgical staging - total hysterectomy - bilateral salpingo-oophroectomy - lymph node evaluation
50
Standard treatment for women with recurrent of metastatic endometrial cancer
-if isolated to vaginal vault-->radiation if limited to pelvis--> surgery and/or radiation
51
The majority of ovarian malignancies are derived from ___
epithelial cells
52
Risk factors for ovarian cancer
- lynch syndrome - BRCA gene mutation - increasing age - hx of infertility - endometriosis - PCOS - smoking
53
What factors can reduce a womens risk for ovarian cancer
- previous pregnancy - use of OCP - breastfeeding
54
Acute presentation of ovarian cancer. Subacute presentation.
acute- pleural effusion, bowl obstruction subacute- adenxal mass, pelvic/abd pain, bloating, GI sx's
55
How does a patient with advanced ovarian cancer present
- abd distension - nausea - anorexia - early satiety d/t acites or bowel mets
56
When do you preform a surgical evaluation if ovarian cancer is suspected
if there is an adnexal mass is found
57
When to refer premenopausal women with a pelvic mass to gyn onc
- very elevated CA125 level - ascites - evidence of abdominal or distant mets
58
When to refer postmenopausal women with a pelvic mass to gyn onc
- elevated CA 125 - ascites - nodular or fixed pelvic mass - evidence of abdominal or fixed mets

Clin Med III exam III (10 decks)

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