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52 Cards in this Set

  • Front
  • Back
what is the most common genital tract malignancy in the US?

-ovarian CA
-uterine CA
-endometrial CA
-adenexal CA
endometrial CA
when do most women develop endometrial carcinoma ? (according to the book, pg. 456)

-A & C
A & C
if a 37 y.o. female presents with irregular menses may need what?

-endometrial biopsy
-pelvic ultrasound
endometrial biopsy
what is the most common cause of post menopausal bleeding?

-endometrial CA
endometrial CA

these are in order of occurance
what is an abnormal thickening of the uterine lining?
hyperplasia may be a precursor to?

estrogen dependent hyperplasia and carcinoma is generally found in women in __ state with unopposed estrogen.

what is the basic problem with estrogen dependent hyperplasia and carcinoma?
estrogen without progesterone

estrogen is unopposed
what is the cause of exogenous, estrogen dependent hyperplasia and CA?

exogenous is ERT, hormone replacement therapy
what are endogenous causes of estrogen dependent hyperplasia and CA?

-a and c
-b and c
glandular and extraglandular
what are the classifications of hyperplasia?
simple hyperplasia
complex hyperplasia

with or without atypia
if either a simple or complex hyperplasia returns with atypia, what do you do?
TAH this is precancerous
what type of endometrial carcinoma is more common in younger perimenopausal women with a histroy of unopposed endogenous or exogenous estrogen stimulation?

-estrogen dependent
-estrogen independent
estrogen dependent
what type of endometrial carcinoma occurs spontaneously, characteristically in thin, oler postmenopausal women without unopposed estrogen excess, arising in an atrophic endometrium rather than a hyperplastic one.

-estrogen dependent
-estrogen independent
estrogen independent
if a woman has simple hyperplasia without atypia, what does this mean ?
not CA
extraglandular unapposed estrogen comes from what peripheral estrogen source (within the body)?

-liver oxidation
fat (estrone via conversion of androstenedione)
what is described as "overgrowth of glandular and stromal elements, that rarely progresses to carcinoma unless accompanies by atypia"

-simple hyperplasia
-complex hyperplasia
simple hyperplasia
what hyperplasia is at the greatest risk of CA?

-simple hyperplasia with atypia
-complex hyperplasia w/o atypia
-complex hyperplasia w/ atypia
-simple hyperplasia w/o atypia
complex hyperplasia with atypia
what process is described as "proliferation of glandular rather than stromal elements, appear more crowded on histologic slide" is what?

-simple hyperplasia
-complex hyperplasia
complex hyperplasia
what are common risk factors for estrogen dependent hyperplasia and carcinoma?
late menopause
unopposed ERT
of the risk factors for estrogen dependent hyperplasia and carcinoma...which is the highest?

-late menopause
-unopposed ERT
obesity r/t unopposed estrogen from fat cells
which of the following is not a risk factor for estrogen dependent hyperplasia and CA?

-late menopause
not raloxifen
what are other risk factors for estrogen dependent hyperplasia and carcinoma?
high fat diet
early menarche
HNPCC-hereditary nonpolyposis colorectal carcinoma syndrome
what condition is seen in ..."older postmenopausal women with atrophic endometrium and no apparent risks, it is poorly differentiated, and has a poorer prognosis"

-estrogen independent carcinoma
-estrogen dependent carcinoma
-hyperplasia with atypia
estrogen independent carcinoma
if a pt. > age 35 presents with DUB/AUB what is the first test of choice?

-endometrial biopsy
-pap smear
endometrial biopsy
what is the first diagnostic test you do when evaluating a woman for AUB?
a pregnancy test
what is the gold standard test for AUB?

-endometrial biopsy
-D & C
-pelvic laparoscopy
endometrial biopsy
if the office EB is not possible or it's findings are inadequate for evaluation, what is the next step?
D & C and hyteroscopy
if the EB in a postmenopausal woman is insufficient for adequate evaluation, what do you do?
nothing, as apparently this is good news "since there was nothing to biopsy (atrophic)"
what is a more useful diagnostic tool in the evaluation of AUB in the postmenopausal woman?

-D & C/hysteroscopy
-pelvic ultrasound/transvaginal
-pap smear
pelvic u/s with transvaginal probe
pelvic ultrasound w/transvag probe helps in the evaluation of ???

-ovarian cancer
-b & c
-all of the above
b & c

pap smear is not reliable in detectin endometrial pathology, however endometrial cells, especially atypical type warrart further evaluation
at what point if a woman is on tamoxifen is it appropriate to do a EB?
only if she is bleeding
what is the management of simple and complex hyperplasia without atypia?
low risk of CA progression so give progesterone therapy
-provera or prometria
what is the MOA of progesterone therapy in the treatment of hyperplasia w/o atypia?
-mimic normal cycle for 3 months, allows sloughing of endocmtrium (chemicl D & C)
decreases estrogen receptors and changes enzyme pathways that convert estradiol to weaker estrogens
-f/u w/ EB in 4-6 months
what is the management of hyperplasia with atypia?
if contraindicated due to poor surgical candidate or not finished w/ child bearing, give high doses of progesterone w/ periodic resampling via EB
how are many endometrial polyps best seen?

many seen by U/S est. pransvaginal
can be detected on EB hisologic specimen
what percent of endometrial polyps are malignant?

what is the treatment of endometrial polyps?
hysteroscopic polypectomy
this is the epidemiology of what condition?
-usually seen in postmenopausal women
-15-20% perimenopausal
-5-10% premenopausal
-80-90% of women w/ this condition present with bleeding

-endometrial ca
-ovarian ca
-cervical ca
endometrial ca
__ is "spreads first by local invation through myometrium, endocervical canl, then through lymphatics and then hematogenous spread.
endometrial cancer
__ invasion of more than 1/3 of uterine wall is consistent with lymphatic dissemination.

mucinous papillary serous
clear cell
mixed are all the __ types of endometrial cancer.
what is the most common histological type of endometrial cancer?

-papillary serous
what is the most important prognostic factor?

-depth of invasion of myometrium
-histologic grade
histologic grade
of the histologic grading system, what are they?
1-highly differentiated, good prognosis
2-moderately differentiated
3-poorly differentiated, poor prognosis
what is the primary treatment of endometrial carcinoma?

what surgery is done in the treatment of endometrial CA?
TAHBSO or LHBSO, or TVH in early disease
what is the incidence of recurrence at the vaginal apex after a simple hysterectomy?

most patients get lymph node sampling now...of what ?
pelvic and periaortic
what is the tx of recurrent endometrial carcinoma?
treated with excision
is hormone replacement therapy indicated in the tx of endometrial ca?
no-only indicated for use of postmenopausal hot flashes