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53 Cards in this Set
- Front
- Back
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What two genital prolapses are caused by an anterior vaginal wall weakness?
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cystocele, cystourethrocele
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What symptoms are seen in a cystocoele?
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pelvic pressure, bulge/mass in the vagina
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What 3 surgical treatments are done for a cystocoele?
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anterior colporrhaphy, paravaginal repair, colpocleisis
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What 3 prolapses are caused by a posterior compartment defect?
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rectocele, perineal deficiency, perineal descent
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What symptoms are present in a rectocele?
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difficulty evacuating stool, vaginal mass, fullness sensation
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What are the 2 major causes of a rectocele?
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childbirth, chronic constipation
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What is the surgical treatment for a rectocele?
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posterior colporrhaphy
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What are 3 prolapses caused by apical defects?
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uterine prolapse, vault prolapse, enterocele
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What symptoms are seen with a uterine prolapse?
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severe pelvic/abdominal pressure, bulge/mass, low back pain
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What is a complete uterovaginal prolapse called?
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procidentia
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What is the surgical treatment for a uterine prolapse?
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hysterectomy, vaginal cuff, apex suspension
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What hormone replacement is necessary after surgical repair of a uterine prolapse?
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estrogen replacement
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What type of prolapse is filled with bowel and is distended by abdominal pressure?
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pulsion enterocele
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What confirms the diagnosis of an enterocele?
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bowel peristalsis
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What are 6 risk factors promoting prolapse?
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erect posture, trauma of vaginal delivery, aging, estrogen deprivation, collagen abnormalities, chronic increase in intraabdominal pressure
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What percent of cervical cancers in the US occur in women who were never screened?
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50%
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When should the first pap smear be performed?
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3 yrs after sexual intercourse or by age 21
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How often should women up to 30 y.o. get a pap smear?
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yearly
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How often should women over 30 get a pap smear?
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yearly, every 2-3 years if 3 negative tests in a row
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Which patients should always be screened annually?
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immunocompromised, HIV, exposure to DES
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What was diethylstilbestrol used for?
-prevents miscarriages or premature deliveries -At what age can pap smears be discontinued? -65-70 years old -What are the most common strains of high risk HPV (what number)? -16 and 18 -What strains of HPV cause genital warts? -6 and 11 -A cervical smear includes 2 samples from what places? -portio, endocervix -What is necessary in order for the sample to be viable? -rapid fixation on slide -What area of cells in sampled in the portio? -squamocolumnar junction (transition zone) -What test improves the quality of the sample and displays the cells in an even layer? -thinprep pap test -What equipment is needed to perform the ThinPrep test in both locations? -plastic spatula for the portio -endocervical brush for the endocervix -What three categories of descriptive diagnoses are used in the bethseda system? -benign cellular changes- infection/reactive -epithelial cell abnormalities, squamous cell -glandular cells |
prevents miscarriages or premature deliveries
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At what age can pap smears be discontinued?
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65-70 years old
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What are the most common strains of high risk HPV (what number)?
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16 and 18
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What strains of HPV cause genital warts?
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6 and 11
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A cervical smear includes 2 samples from what places?
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portio, endocervix
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What is necessary in order for the sample to be viable?
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rapid fixation on slide
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What area of cells in sampled in the portio?
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squamocolumnar junction (transition zone)
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What test improves the quality of the sample and displays the cells in an even layer?
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thinprep pap test
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What equipment is needed to perform the ThinPrep test in both locations?
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plastic spatula for the portio
endocervical brush for the endocervix |
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What three categories of descriptive diagnoses are used in the bethseda system?
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-benign cellular changes- infection/reactive
-epithelial cell abnormalities, squamous cell -glandular cells |
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What are 2 causes of low grade squamous intraepithelial lesions?
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HPV, mild dysplasia/CIN 1
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What are 3 causes of high grade squamous intraepithelial lesions?
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moderate/severe dysplasia, CIN 2 and 3, squamous cell carcinoma insitu
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What is the method used to remove dysplastic tissue from the cervix?
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loop electrosurgical excision procedure (LEEP)
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What is the name of the HPV vaccine?
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gardasil
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Which age group can receive gardasil?
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women 9-26 y.o.
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How many doses of the quadrivalent HPV are given?
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3 doses starting at 11 y.o. (can be given as early as 9 yo)
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HPV vaccine is contraindicated in what pts?
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pregnancy
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The HPV vaccine can still protect pts if they have been exposed to HPV (true/false)?
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True
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What age group accounts for 50% of ovarian cancer pts?
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> 65 y.o.
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Carriers of what genes have a significant chance of ovarian cancer?
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BRCA1 and BRCA2
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What are the three types of ovarian cancer?
-epithelium, germ cells, stromal cells -What cells are the most common cause of ovarian cancer? -epithelial cells -What is the most common type of tumor in ovarian cancer? -serous tumors -What rare tumor in ovarian cancer presents with virilization? -sertoli-leydig cell tumor -What are 3 things that lower your risk of ovarian cancer? -pregnancies, breast feeding, oral contraceptives -What 3 medications are associated with an increased risk of ovarian cancer? -clomiphene citrate (for fertility), danazol (for endometriosis), estrogen/hormone replacement therapy -What are the clinical manifestations of ovarian cancer? -bloating sensation, abdominal swelling, chronic stomach pain, pelvic pressure, back ache, leg ache, anorexia, abnormal vag bleeding, ascites, pelvic mass -Pts with ovarian cancer may have elevated serum levels of what? -CA-125 -If a pelvic mass is noted what is the next step in staging? -laparotomy -What are the 4 stages of ovarian cancer? 1. disease limited to ovaries 2. cancer has spread but limited to pelvis 3. cancer has spread but limited to pelvis and abdominal cavity (not liver) 4. cancer has spread outside abdomen or to liver |
epithelium, germ cells, stromal cells
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What cells are the most common cause of ovarian cancer?
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epithelial cells
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What is the most common type of tumor in ovarian cancer?
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serous tumors
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What rare tumor in ovarian cancer presents with virilization?
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sertoli-leydig cell tumor
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What are 3 things that lower your risk of ovarian cancer?
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pregnancies, breast feeding, oral contraceptives
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What 3 medications are associated with an increased risk of ovarian cancer?
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clomiphene citrate (for fertility), danazol (for endometriosis), estrogen/hormone replacement therapy
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What are the clinical manifestations of ovarian cancer?
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bloating sensation, abdominal swelling, chronic stomach pain, pelvic pressure, back ache, leg ache, anorexia, abnormal vag bleeding, ascites, pelvic mass
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Pts with ovarian cancer may have elevated serum levels of what?
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CA-125
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If a pelvic mass is noted what is the next step in staging?
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laparotomy
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What are the 4 stages of ovarian cancer?
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1. disease limited to ovaries
2. cancer has spread but limited to pelvis 3. cancer has spread but limited to pelvis and abdominal cavity (not liver) 4. cancer has spread outside abdomen or to liver |
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What are 5 things that point to low risk of recurrence of ovarian cancer?
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grade 1 or 2 disease
no tumor on external surface of ovary negative peritoneal cytology no ascites tumor confined to ovaries |
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What is the standard for surgical care in ovarian cancer?
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cytoreductive or debulking surgical exploration
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What are 4 steps involved in staging for ovarian cancer?
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peritoneal cytology
multiple peritoneal biopsies omentectomy pelvic/para-aortic lymph node sampling |
