• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/23

Click to flip

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;

23 Cards in this Set

  • Front
  • Back
Ovarian CA prev
2nd most common gym malig but highest mortality.
how mnay present at high stage?
75%
Majority of ovarian CAs are...
epithelial
Majority of ovarian ca in young girls are
germ cell tumors
Pathogen models (3)
Repeated ovulation/trauma/repair of ovarian epithelium - these people just plain ovulate a lot.

Excess gonadotropin secretion - some evidence that FSH or LH is mutagenic. Not widely supported

Origin is from fallopian tubes
Factors that put you at increased risk:
having ovaries, long ovulation hx, unexplained infertility, nulliparity, family hx
Factors that decrease your risk:
pregnancies, OCP use, bilateral tubal ligation, hysterectomy
Genetics
Sporadis causes are more common.

But the BRCA 1,2 and HNPCC have been implicated as major players.
Consider genetic counseling if woman presents with...
fam hx with 2 1st degree relatives with breast or ovarian CA, a relative with breast CA below age 30, bilat breast CA younger than 40 or male breast CA
With screning, must have...
an accurate, cost-effective test where early detection will improve outcomes.
CA-125
Produced by most epith cancers but most stage I won't be elevated.

PPV is 5% and 26% when combined with US
Ultrasound
More sensitive but not too specific

PPV is 9%
When treating ovarian CA...
you must remove all visible tumor, debulk and stage.

you debulk to minimize resistant cells, improve immune function and encourage the cell cycle.
Tx of ovarian CA
platinum and taxane based.

give combo of IV and intraperitoneal chemo. Pts must be debulked.
Preventative measures you can do
oral contraceptives or bilateral salpingo-oophorectomy.

BS-O is only 95% effective become some tumors can come from the retroperitoneum.
Clomiphene
induces ovulation for people who wanna get preggo.

causes more fsh and estradiol to get more ovulation but increases risk of ovarian CA
3 strategies for risk reduction
screening, chemoprevention, surgery.
is CA-125 good?
not really. decent if you already have high suspcion.
If US is abnormal...
repeat it later, because normal people have tons of weird changes in ovaries too.
Omental cake
when the omentum sucks up epithelial ovarian CA cells and it gets thick and rigid.
SEs of chemo
alopecia, myelosupp, neurotoxicity, anemia, nephrotoxicity, n/v, mucositis.
Standard of care today
staging, debulking, IP and IV therapy.
Conclusions
First-line therapy should incl adequate and complete staging and/or optimal cytoreduction if possible.

Current standard first-line chemo should contian platinum and a taxane.

Tx selection for recurrent ovarian CA should be based on pt specific variables with the goal of extending survival and maximizing quality of life.

All elig pts shoul dbe encouraged to enroll on clinical trials.