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65 Cards in this Set

  • Front
  • Back
How are endometrial polyps diagnosed?
Sonohysteroscopy: inject saline into uterine cavivy & do US
Where are most endometrial polyps found?
can be found anywhere, but mainly endometrial cavity.
What is the tx or endometrial polps?
hysteroscopy to remove polyps or D & C
What is the most common sx of an endometrial polyp?
irregular bleeding
What is adenomyosis?
invasion of endometrial gland into stroma of uterus. So where ever there are glands you get hypertrophy of the muscle.
Is adenomyosis a symptomatic condition? How would they be treated?
70% of women are symptomatic and get worse-->many get hysterectomy post child birth. Amt of pain correlates to depth of penetration. May get severe anemia b/c of heavy bleeding
Are ovarian cysts in repro age mostly benign or malignant?
do the functional or follicular cysts go away on their own?
yes, in about 60 days. most are asymptomatic & are just found on PE.
In which condition would a functional cyst cause a problme?
If you get torsion of ovary or blood supply & if its severe enough for you to get an infarct and its painful
Which cysts are filled w/ blood, are a functional type of cyst, 3-11 cm in size and will delay menstrual cycle?
corpus luteum cyst.
Which ovarian cysts are benign, cause an inc in hCG, are bilateral and can result from fertility meds?
Thecal luteal cysts.
Will thecal luteal cysts go away? Would you remove them if they didn't go away on their own?
Yes, they go away spontanesouly when you stop fertility drug; yes, you should remove them in case of molar or choriocarcinoma.
What are the 'chocolate cycts, filled w/ old blood, 6-8 cm and DON"T resolve on their own?
Describe the sx's of polycystic ovarian syndrome?
secondary amenorrhea, infertility, hirsuitism, 70% are obese. Assoc w/ insulin resistance.
What do the ovaries look like in polycystic ovarian syndrome?
bilateral enlargement of ovaries; ovaries have thick cortical surface & a lot of retained cysts.
When can a luteoma of pregnancy be found? does go away?
Rare but you can see at time of c-section. Ovaries enlarged, can get to 5-20 cm, cause no problem, & resolve by end of pregnancy.
How would you tx an ovarian cyst in general?
-need to evaluate if benign. Preferred method is to excise once you diagnose. Fxn'al cyst will go away in 1-2 cycles so need to eval further. Use US to evaluate if its simple cyst, papillary or if its got fluid.
What is the most common neoplasm of the ovary?
epithelial tumors.
The majority (30%) of epithelial tumors of the ovary are what?
Which of the epithelial tumors are the largest, are benign, and produce mucin?
What is a Brenner tumors?
an adenofibroma, always benign.
What are some rare tumors diagnosed after surgery?
sex-cord tumors, thecomas, fibromas, hilus cell tumors.
Describe the characteristics of a mature teratoma.
40-50% of all benign tumors of ovary. Have all germ line cells. One type can produce thyroid tissue and thus thyroid hormone. Have teeth, hair, sebum.
Are almost all ovarian neoplasms benign or malignant?
VIN is (in vulvar disease) is also known as what?
Bowen's dz.
Vulvar dz has a strong association w/ what?
What % of VIN are positive for HPV?
For vulvar diseases lesions of the young and elderly, what are the causes?
young-->viral etiology
How does one diagnose vulvar disease?
inspection, colpo, and biopsy suspected areas.
What is the tx for vulvar dz?
topical 5-FU, Imiquimod, excision, laser (CO2)
Is vulvar CA mostly pre or post menopausal?
What are the sx's of vulvar CA?
pruritis, blood discharge, may appear like pre-malignant or massive lesions (huge, fungating mass)
How is vulvar CA diagnosed?
What is the main type of vulvar CA?
90% are squamous cell (melanoma is 15%? and basal cell is 2%)
What is the tx for vulvar CA?
surgical removal (vulvectomy & lymph node dissection, hard for pts to heal)
What is the prognosis of vulvar CA dependent on?
node status, look elsewhere for upper tract neoplasia.
Pre-invasive dz of vagina is probably related to what virus?
HPV b/c its probably releated to CIN of cervix since 2/3 have had 2/3 of cervical or vulvar lesions.
What is teh tx for Pre-invasive dz of vagina?
excision, CO2 laser, topical 5-FU
In the early phases of vaginal CA and pre-invasive dz of vagina, is it symptomatic?
No, diagnosis is mainly based on cytology
What are the early and late sx's of vaginal CA?
early-painless bleeding; late-bleeding, pain, weight loss.
The majority of vaginal cancer is what types of cells?
85% is squamous cell CA.
Clear cell adenoCA of the vagina is related to exposure to what?
DES (they used to think it would help maintain the pregnancy)
What is the tx for vaginal cancer?
surgery or combo external & internal radiation
In Pre-Invasive & Invasive dz of cervix, what would examination show?
Dx of CIN, Most cervix appear nl. HPV is present, Pap is abnl. Colpo & Bx confirm.
Is cervical cancer symptomatic?
Early dz is asymptomatic; abnl bleeding & discharge are common later in dz.Do bx to confirm.
What is the 2nd most common tumor in developing world w/ 370,000 cases/yr & 50% mortality?
Cervical CA
75% of cervical cancers are what types of cells?
squamous cells
What is the tx for cervical CA?
radical hysterectomy w/ lymphadenopathy, followed by radiation.
What are the risk factors for premalignant & malignant diseases of the uterus?
Hyperestrogenism, metabolic syndrome, nulliparity, age.
How do you confirm diagnosis of a premalignant or malignant dz of uterus?
Emb, Sono
What is the most common pelvic genital CA?
endometrial CA
What is the age of pt for endometrial CA?
peaks in 7th decade, but 25% are premenopausal.
What is the tx for endometrial CA?
-most dx early, require TAH/BSO, w/ lymph node sampling for stage.
-primary radiation for poor Surgical candidates
-Post op radiation for advanced stage.
-Px depends on stage, grade & nodal spread
If a 40 yr old woman comes in w/ a rapidly growing mass (uterus), pelvic pain, what would you suspect?
Uterine sarcoma
Is a uterine sarcoma malignant? Where does it spread to? How would you tx it?
highly malignant, aggressive w/ early spread to abdomen, liver, lungs; Tx: surgery followed by radiation & chemo.
What is the prognosis for a uterine sarcoma?
-tumor outside uterus-10% survive 2 yrs
-tumor inside 10-50%--5yrs.
-low malignancy variants have better survival, up to 100%
What is the peak age for ovarian CA?
What are some protective factors for ovarian CA?
multiparity, BCP use, breast feeding
60% of ovarian tumors are of what type?
epithelial tumors (90% of malignant tumors)
What seems to be the cause of ovarian CA?
incessant ovulation
What is the best way to evaluate an ovarian tumor?
What is ALWAYS the method of therapy for any cell type of ovarian cancer?
surgery (can do frozen section & staging during surgery). Chemo for all pts except stage 1.
What is the prognosis for ovarian CA?
-Px depends on stage & grade: 95% for stage 1 and 5% for stage 3
What are the sx's of ovarian cancer?
produce no sx's until dz is widespread; nonspecific GI complains, P, inc abdominal girth.
What is the least common genital CA?
fallopian tube CA (similar to epithelial cell ovarian in presentation & behavior)