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65 Cards in this Set
- Front
- Back
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How are endometrial polyps diagnosed?
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Sonohysteroscopy: inject saline into uterine cavivy & do US
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Where are most endometrial polyps found?
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can be found anywhere, but mainly endometrial cavity.
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What is the tx or endometrial polps?
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hysteroscopy to remove polyps or D & C
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What is the most common sx of an endometrial polyp?
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irregular bleeding
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What is adenomyosis?
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invasion of endometrial gland into stroma of uterus. So where ever there are glands you get hypertrophy of the muscle.
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Is adenomyosis a symptomatic condition? How would they be treated?
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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
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Are ovarian cysts in repro age mostly benign or malignant?
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benign.
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do the functional or follicular cysts go away on their own?
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yes, in about 60 days. most are asymptomatic & are just found on PE.
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In which condition would a functional cyst cause a problme?
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If you get torsion of ovary or blood supply & if its severe enough for you to get an infarct and its painful
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Which cysts are filled w/ blood, are a functional type of cyst, 3-11 cm in size and will delay menstrual cycle?
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corpus luteum cyst.
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Which ovarian cysts are benign, cause an inc in hCG, are bilateral and can result from fertility meds?
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Thecal luteal cysts.
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Will thecal luteal cysts go away? Would you remove them if they didn't go away on their own?
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Yes, they go away spontanesouly when you stop fertility drug; yes, you should remove them in case of molar or choriocarcinoma.
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What are the 'chocolate cycts, filled w/ old blood, 6-8 cm and DON"T resolve on their own?
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Endometrioma.
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Describe the sx's of polycystic ovarian syndrome?
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secondary amenorrhea, infertility, hirsuitism, 70% are obese. Assoc w/ insulin resistance.
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What do the ovaries look like in polycystic ovarian syndrome?
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bilateral enlargement of ovaries; ovaries have thick cortical surface & a lot of retained cysts.
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When can a luteoma of pregnancy be found? does go away?
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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.
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How would you tx an ovarian cyst in general?
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-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.
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What is the most common neoplasm of the ovary?
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epithelial tumors.
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The majority (30%) of epithelial tumors of the ovary are what?
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serous
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Which of the epithelial tumors are the largest, are benign, and produce mucin?
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Mucinous
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What is a Brenner tumors?
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an adenofibroma, always benign.
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What are some rare tumors diagnosed after surgery?
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sex-cord tumors, thecomas, fibromas, hilus cell tumors.
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Describe the characteristics of a mature teratoma.
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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.
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Are almost all ovarian neoplasms benign or malignant?
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BENIGN.
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VIN is (in vulvar disease) is also known as what?
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Bowen's dz.
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Vulvar dz has a strong association w/ what?
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STDs
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What % of VIN are positive for HPV?
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80%
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For vulvar diseases lesions of the young and elderly, what are the causes?
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young-->viral etiology
old-->non-viral |
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How does one diagnose vulvar disease?
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inspection, colpo, and biopsy suspected areas.
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What is the tx for vulvar dz?
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topical 5-FU, Imiquimod, excision, laser (CO2)
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Is vulvar CA mostly pre or post menopausal?
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Post
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What are the sx's of vulvar CA?
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pruritis, blood discharge, may appear like pre-malignant or massive lesions (huge, fungating mass)
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How is vulvar CA diagnosed?
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biopsy
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What is the main type of vulvar CA?
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90% are squamous cell (melanoma is 15%? and basal cell is 2%)
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What is the tx for vulvar CA?
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surgical removal (vulvectomy & lymph node dissection, hard for pts to heal)
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What is the prognosis of vulvar CA dependent on?
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node status, look elsewhere for upper tract neoplasia.
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Pre-invasive dz of vagina is probably related to what virus?
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HPV b/c its probably releated to CIN of cervix since 2/3 have had 2/3 of cervical or vulvar lesions.
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What is teh tx for Pre-invasive dz of vagina?
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excision, CO2 laser, topical 5-FU
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In the early phases of vaginal CA and pre-invasive dz of vagina, is it symptomatic?
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No, diagnosis is mainly based on cytology
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What are the early and late sx's of vaginal CA?
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early-painless bleeding; late-bleeding, pain, weight loss.
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The majority of vaginal cancer is what types of cells?
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85% is squamous cell CA.
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Clear cell adenoCA of the vagina is related to exposure to what?
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DES (they used to think it would help maintain the pregnancy)
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What is the tx for vaginal cancer?
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surgery or combo external & internal radiation
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In Pre-Invasive & Invasive dz of cervix, what would examination show?
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Dx of CIN, Most cervix appear nl. HPV is present, Pap is abnl. Colpo & Bx confirm.
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Is cervical cancer symptomatic?
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Early dz is asymptomatic; abnl bleeding & discharge are common later in dz.Do bx to confirm.
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What is the 2nd most common tumor in developing world w/ 370,000 cases/yr & 50% mortality?
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Cervical CA
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75% of cervical cancers are what types of cells?
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squamous cells
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What is the tx for cervical CA?
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radical hysterectomy w/ lymphadenopathy, followed by radiation.
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What are the risk factors for premalignant & malignant diseases of the uterus?
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Hyperestrogenism, metabolic syndrome, nulliparity, age.
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How do you confirm diagnosis of a premalignant or malignant dz of uterus?
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Emb, Sono
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What is the most common pelvic genital CA?
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endometrial CA
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What is the age of pt for endometrial CA?
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peaks in 7th decade, but 25% are premenopausal.
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What is the tx for endometrial CA?
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-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 |
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If a 40 yr old woman comes in w/ a rapidly growing mass (uterus), pelvic pain, what would you suspect?
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Uterine sarcoma
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Is a uterine sarcoma malignant? Where does it spread to? How would you tx it?
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highly malignant, aggressive w/ early spread to abdomen, liver, lungs; Tx: surgery followed by radiation & chemo.
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What is the prognosis for a uterine sarcoma?
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-tumor outside uterus-10% survive 2 yrs
-tumor inside 10-50%--5yrs. -low malignancy variants have better survival, up to 100% |
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What is the peak age for ovarian CA?
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65-74
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What are some protective factors for ovarian CA?
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multiparity, BCP use, breast feeding
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60% of ovarian tumors are of what type?
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epithelial tumors (90% of malignant tumors)
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What seems to be the cause of ovarian CA?
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incessant ovulation
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What is the best way to evaluate an ovarian tumor?
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sonogram;
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What is ALWAYS the method of therapy for any cell type of ovarian cancer?
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surgery (can do frozen section & staging during surgery). Chemo for all pts except stage 1.
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What is the prognosis for ovarian CA?
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-Px depends on stage & grade: 95% for stage 1 and 5% for stage 3
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What are the sx's of ovarian cancer?
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produce no sx's until dz is widespread; nonspecific GI complains, P, inc abdominal girth.
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What is the least common genital CA?
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fallopian tube CA (similar to epithelial cell ovarian in presentation & behavior)
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