VIN, Cervical Cancer, Uterine Cancer, Ovarian Cancer – Flashcards
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Most type of vulvar/vaginal tumors are?
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Squamous cell carcinomas
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Examples of non-neoplastic epithelial disorders
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Lichen sclerosus, squamous hyperplasia
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Two types of intraepithelial neoplasias
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Squamous VIN and Non-squamous
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Types of Squamous VIN
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I, II, III
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Types of Non-squamous intraepithelial neoplasias
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Extramammary Paget's disease, tumors of melanocytes
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Treatment for VIN II
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Laser ablation
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Treatment for VIN III
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Excisional biopsy and vulvectomy to rule out carcinoma; then laser ablation and referral to oncologist
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How to diagnose VIN
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Colposcopy - add toluidene blue and rinse with acetic acid, if blue --> biopsy
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Can you use cryosurgery on the vagina?
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NO
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Rare, slow-growing, non-invasive, non-squamous carcinoma
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Extramammary Paget's disease (EMPD)
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What does Extramammary Paget's disease resemble?
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Eczema
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How to diagnose Extramammary Paget's disease
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Biopsy
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Types of Paget's disease of the vulva
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Primary or secondary (associated with adenocarcinoma from Bartholin gland, urethra, or rectum)
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Initiating even in cervical cancer
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HPV 16,18
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Risk factors for cervical cancer
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Young age at first intercourse, multiple partners, cigarette smoking, race, high parity
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Colposcopy findings for cervical cancer
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Abnormal blood vessels, irregular surface contour, yellow-orange color
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Why do you do a cervical conization for cervical cancer?
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To assess depth of microinvasion ( 3 mm - positive pelvic lymph nodes)
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Most common malignancy of the female genital tract
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Uterine cancer
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Two types of uterine cancer
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Too much estrogen (hyperplastic endometrium); No estrogen (atrophic endometrium)
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Risk factors for uterine cancer
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Nulliparity, late menopause, obesity, DM, too much estrogen, Tamoxifen, endometrial hyperplasia
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Presentation for uterine cancer patient
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Bleeding, pelvic pressure
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How to diagnose uterine cancer
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Biopsy, transvaginal US (determine endometrial thickness)
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MC type of uterine cancer
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Endometrioid
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Types of endometrial carcinomas
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SCEMP - Squamous, Clear cell, Endometrioid, Mucinous, Papillary serous
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A patient has psammoma bodies. What type of cancer does this pt have?
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Papillary serous endometrial cancer
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Most fatal gynecologic malignancy
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Ovarian cancer
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Account for 90% of ovarian cancers
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Epithelial ovarian tumors
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Types of epithelial ovarian tumors
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SCEMB - Serous, Clear cell, Endometrioid, Mucinous, Brenner
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Large epithelial ovarian tumors
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Mucinous
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Can cause pseudomyxoma peritonei
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Mucinous epithelial ovarian tumors
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Cells associated with serous epithelial ovarian tumors
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Endosalpingeal cells
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Cells associated with mucinous epithelial ovarian tumors
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Endocervical cells
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Cells associated with clear cell epithelial ovarian tumors
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Hobnail, clear cells
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Cells associated with Brenner epithelial ovarian tumors
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Transitional cells
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Treatment for Brenner tumors
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Surgical removal
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Identical to cancers in pts exposed to diethylstilbestrol in utero
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Clear cell tumors
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Mullerian tumors
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Clear cell tumors
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Tumors that do not invade the stroma
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Brenner tumors
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Increases risk of ovarian cancer
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Early menarche, late menopause
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These decrease risk of ovarian cancer
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OCPs, oophorectomy, having more kids
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What markers can you check in a pt with ovarian cancer?
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CA 125, OVX1
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Symptoms of ovarian cancer
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Ascites, pelvic mass, bloating, constipation, nausea
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How to diagnose ovarian cancer
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CA 125, Ultrasound (cystic mass > 8 cm)
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Treatment for ovarian cancer
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TAH BSO ( and chemo if high grade)
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What age do non-epithelial ovarian cancers develop in?
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Young patients
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Germ cell cancers
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Non-epithelial ovarian cancers
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Characterizes squamous endometrial cancer
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Pyometria, inflammation, cervical stenosis
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What can Tamoxifen cause?
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Uterine cancer
