Gynecologic malignancies - aa Flashcards Preview

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Flashcards in Gynecologic malignancies - aa Deck (29)
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1
Q

Shockingly, the USPSTF and ACS/ASCCP/ACOG basically agree on cervical cancer screening. What are their recommendations?

A

~Under 21: don’t screen
~21-29: cytology every 3 years
~30-65: cytology every 3 years or cytology + HPV cotest every 5 years
~65+: if negative cytology for an adequate prior period, can stop screening. Do not restart, even if new sexual partners.
~hysterectomy with cervix removed: don’t screen
~HPV vaccinated: has no effect on screening recommendations

2
Q

What are the recommendations for endometrial cancer screening?

A

Don’t do it.

3
Q

What are the recommendations for ovarian cancer screening?

A

~USPSTF recommends against screening for ovarian cancer
~ACOG: For women at high risk of epithelial ovarian cancer, such as women with BRCA1/BRCA2, periodic tests to check for ovarian cancer may be recommended. These tests include transvaginal ultrasound and measurement of CA125 levels.

4
Q

What are the recommendations for vulvar cancer screening?

A

~ACS: There is no standard screening for this disease other than routine physical examinations.

5
Q

70% of vaginal cancers and 90% of vulvar cancers are of this type.

A

squamous cell carcinoma

6
Q

Vulvar cancer typically appears in what demographic?

A

postmenopausal women who have had infrequent medical exams

7
Q

Vulvar cancer just appears out of the blue, unfortunately.

T/F

A

False.

Long history of vulvar irritation with pruritus, local discomfort, and bloody discharge.

8
Q

HPV is strongly associated with vulvar cancer in ____ women, whereas in ____ women, vulvar dystrophy and chronic inflammation are the carcinogenic pathways.

A

younger, older

9
Q

What is the treatment for vulvar cancer?

A

excision or vulvectomy

10
Q

What are the symptoms of vaginal cancer?

A

~Often asymptomatic

~Postmenopausal vaginal and/or postcoital bleeding are the most common presenting symptoms

11
Q

If you see signs of vaginal cancer in the vagina, you can diagnose primary vaginal cancer.
T/F

A

False. Could be primary or metastasis.

~A diagnosis of primary cancer of the vagina cannot be established unless metastasis from another source is eliminated.

12
Q

What is the treatment for vaginal cancer?

A

~surgery

~radiotherapy with brachytherapy

13
Q

What are the most and least common gynecologic cancers?

A

most common: endometrial

least common: vaginal

14
Q

What are the presenting s/s of endometrial cancer?

A

~Abnormal uterine bleeding: menorrhagia, metrorrhagia, or postmenopausal bleeding

15
Q

What are the risk factors for endometrial cancer?

A

~Risk factors: hyperestrogenism—long-term exposure to unopposed estrogens (PCOS, chronic anovulation, late menopause, exogenous estrogens); metabolic syndrome including diabetes, hypertension, and obesity; nulliparity; increasing age; history of breast cancer; genetic predisposition

16
Q

How is endometrial cancer diagnosed?

A

endometrial sampling, ultrasonography

17
Q

How is endometrial cancer treated?

A

The mainstay of treatment is surgery, including a total hysterectomy with bilateral salpingo-oophorectomy and staging with pelvic and periaortic lymphadenectomy.

18
Q

Unlike cervical cancer, endometrial carcinoma is not related to sexual history.
T/F

A

True

19
Q

What is the most common gestational trophoblastic disease? Is it benign or malignant?

A

Hydatidiform mole is the most common form of gestational trophoblastic disease and is benign in nature.

20
Q

In what demographics is hydatidiform mole more common?

A

~under 20 and over 40
~nulliparous
~lower socioeconomic status
~diet deficient in protein, folic acid, and carotene

21
Q

What unique and characteristic tumor marker is associated with gestational trophoblastic tumors?

A

hCG

22
Q

From what is hydatidiform mole thought to arise?

A

extraembryonic trophoblasts

23
Q

Choriocarcinoma may accompany or follow any type of pregnancy.
T/F

A

True

24
Q

50% of choriocarcinomas are preceded by hydatidiform mole.

T/F

A

True

25
Q

What is the only way to prevent the occurrence of gestational trophoblastic diseases?

A

sexual abstinence

26
Q

What is the most common presenting symptom of molar pregnancy?

A

Abnormal uterine bleeding in the first trimester

27
Q

What sign has been said to be pathognomonic for a molar pregnancy?

A

Preeclampsia in the first trimester

28
Q

What is the treatment for molar pregnancy?

A

~suction curettage

~hysterectomy if not desirous of future pregnancy

29
Q

What should be closely monitored (weekly) following evacuation of molar pregnancy?

A

hCG levels