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10 Cards in this Set
- Front
- Back
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1. Standard of care for diagnosing irregular bleeding?
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a. Endometrial biopsy (EMB).
b. If adequate biopsy cannot be done D%C (±hysteroscopy) should be done to sample the endometrium. c. A D&C should also be done if there are suspicious findings (atypical hyperplasia or necrosis) on EMB or if pt continues to have sx after a negative EMB. |
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2. In addition to endometrial sampling, what should the initial workup for a woman w/abnormal vaginal bleeding include?
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a. TSH
b. Prolactin level (if oligomenorrheic) c. Possibly an FSH (to distinguish if the pt is truly menopausal) d. CBC to r/o anaemia preoperatively. e. Similarly, a CA-125 is often drawn preoperatively. f. Up to date PAP should also be obtain. |
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3. Imaging tests for abnormal bleeding?
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a. Pelvic U/S to look for fibroids, adenomyosis, polyps, and endometrial hyperplasia.
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4. Endometrial stripe in postmenopausal woman?
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a. Due to oestrogen deficiency, it should be very thin <4-5 mm).
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5. HNPCC or Lunch II and risk of endometrial cancer?
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a. >50% of women w/HNPCC or Lynch II will develop endometrial and/or ovarian cancer before developing colon cancer.
b. They should undergo yearly endometrial biopsy beginning at 35 |
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6. Tx for all stages of Endometrial cancer?
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a. TAHBSO.
b. For pts w/>50% myometrial invasion (even if stage I or II) and those w/other poor prognostic factors such as large tumour mass (>2cm or filling the cavity, grade III (more than 50% of tumour is solid), papillary serous or clear cell histologic types, or enlarged lymph nodes, will also require pelvic and aortic lymph node dissection and radiation therapy even if the disease is confined to the uterus. |
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7. Approach to Stage II and IV endometrial carcinoma?
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a. Pelvic and aortic lymph node sampling should also be performed.
b. These pts will also require pelvic radiation therapy in addition to surgical tx. |
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8. First line tx for advanced or recurrent endometrial carcinoma?
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a. High-dose progestins.
b. Chemo may also be used in advanced or recurrent disease but the best regimen and duration have not been determined. |
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9. Prognosis of endometrial carcinoma?
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a. Bc most are stage I are diagnosis, the OVERALL 5-yr survival is 65%.
b. Stage I: 87% c. Stage II: 76% d. Stage II: 59% e. Stage IV: 18% |
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10. When are most Recurrence of endometrial carcinoma?
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a. 75% of recurrences are within the first 2 years.
b. 85-100% within first 3 years. c. Most (60%) are distance recurrences in upper abdomen or lungs. While 40% are local in vagina or pelvis. |
