Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
41 Cards in this Set
- Front
- Back
|
What is the most common genital tract malignancy in the US?
|
endometrial hyperplasia and carcinoma
|
|
|
Endeometrial cancer is most often found in who?
|
women who are postmenopausal
|
|
|
What are some causes of post menopausal bleeding?
|
-atrophy
-HRT -endometrial cancer -polyps -hyperplasia |
|
|
Estrogen dependent hyperplasia may be a precursor to what?
|
carcinoma
|
|
|
Estorgen dependent hyperplasia and carcinoma generally occurs in what women?
|
women in hyperestrogenic state with unopposed estrogen
|
|
|
What are some endogenous glandular causes of estrogen dependent hyperplasia and carcinoma?
|
-PCOS
-granulosa cell tumor of the ovary |
|
|
What are some endogenous extraglandular causes of estrogen dependent hyperplasia and carcinoma?
|
fat (estrone via conversion of androstenedione)
|
|
|
What are the four clasiffications of hyperplasia?
|
-simple hyperplasia
-complex hyperplasia -hyperplasia with atypia -hyperplasia without atypia |
|
|
Simple hyperplasia is overgrowth of what?
|
glandular and stromal elements
|
|
|
Simple hyperplasia rarely progresses to carcinoma unless it is accompanied by what?
|
atypia
|
|
|
Complex hyperplasia is proliferation of what?
|
glandular rather than stromal elements
|
|
|
How does complex hyperplasia appear on slides?
|
more crowded
|
|
|
Complex hyperplasia with atypia is associated with a ________ risk of progression to cancer.
|
20-30%
|
|
|
What are some risk factors for estrogen dependent hyperplasia and carcinoma?
( the main 6 risk factors) |
-late menopause
-unopposed ERT -nulliparity -obsesity -Tamoxifen -DM |
|
|
What are some other risk factors for estrogen dependent hyperplasia and carcinoma?
|
-high fat diet
-early menarche -hereditary nonpolyposis colorectal carcinoma syndrome |
|
|
Estrogen independent carcinoma is seen in who?
|
older postmenopausal women wiht atrophic endometrium and no apparent risks
|
|
|
Estrogen independent carcinoma carries a worse or better prognosis than estrogen dependent?
|
worse
|
|
|
Simple and complex hyperplasia wiht out atypia carries a lower risk of what?
|
developing into cancer
|
|
|
What is the tx for simple and complex hyperplasia withOUT atypia?
|
Progesterone therapy
-10-20 mg daily for 10-14 days to mimic normal cycle for 3 months, allows for sloughing of endometrium -Megase 20-40 mg daily for 3 months |
|
|
When do you want to recheck endometrial biopsy after you start progesterone treatment for simple and complex hyperplasia without atypia?
|
4-6 months
|
|
|
What is the tx for simple and complex hyperplasia with atypia?
|
-Trans abdominal hyersterectomy (TAH)
-trans vaginal hysterectomy (TVH) |
|
|
What is the tx for simple and complex hyperplasia with atypia if the pt is not done child bearing?
|
Megase and high doses of progestrone indicated iwth periodic resampling via endometrial biopsy
|
|
|
Endometrial polyps are mainly seen via what?
|
US especially transvaginal US
|
|
|
Endometrial polyps can also be detected on what?
|
endometrial biposy histologic specimen
|
|
|
What percent of endometiral polyps show malignant changes?
|
less than 5%
|
|
|
What is the tx for endometrial polyps?
|
hysteroscopic polypectomy
|
|
|
Endometrial carcinoma is usually seen in who?
|
postmenopausal women
|
|
|
Most people with endometrial cancer present with what?
|
bleeding
|
|
|
How does metastasis spread in endometrial cancer?
|
spreads first by local invasion through myometrium, enodcervical canal, then through lymphatics and then hemotogenous spread
|
|
|
Myometrial invasion in encometrial cancer of more than 1/3 of uterine wall is consistent with what?
|
lymphatic dissemination
|
|
|
WHat is the main hystological type of endometrial cancer?
|
endometrioid
|
|
|
What are some other types of endometrial cancer?
|
-mucinious
-papillary serous -clear cell -squamous -mixed |
|
|
What is the main prognostic factor for endometrial cancer?
|
histologic grade
|
|
|
What is another prognostic factor for endometrial cancer besides histologic grade?
|
depth of invasion of myometrium
|
|
|
What does each of the following histological grades mean?
1- 2- 3- |
1-highly differentiated, good prognosis
2-moederately differentiated 3-poorly differentiated, poor prognosis |
|
|
What is the primary tx for endometrial carcinoma?
|
surgery
|
|
|
Tell me about the sx for endometrial carcinoma.
|
-peritoneal washings
-exploration of abdominal and pelvic cavity -TAHBSO or LHBSO, TVH in early disease |
|
|
In a simple hysterectomy for the tx of endometrial carcinoma there is a 5-10% incidence of reccurence where?
|
at vaginal apex
|
|
|
Most pts who undergo tx for endometrial cancer often get what as well?
|
-lymph node sampling
-preop/post op XRT, chemo |
|
|
What is the treatment recurrernt endometrial carcinoma?
|
-excision
-chemotherapy |
|
|
Is HRT recommened in the tx for reccurent endometrial carcinoma?
|
NO
HRT is only indicated for relief of postmenopausal hot flashes |
