ch 8 (cancers of the female reproductive tract)

_____ cancer is the second leading cause of cancer death. Females have a 1 in ___ lifetime chance of developing cancer and a 1 in ___ lifetime risk of dying from cancer. There is high cancer mortality rate among _____ females than ____ females.

A: breast, 3, 6, black, white

Social support has shown to be an effective method in empowering cancer patients so patients without a social support network may need a s____ w____ referral or may need to be guided toward s_____ groups to receive the emotional support they need.

A: social work, support

Risk factors for having cancer of the reproductive tract include: early m_____, late m_____, STIs, use of h_____ agents, and i______.

A: menarche, menopause, hormonal, infertility

A ___ test is used to diagnose cervical cancer and should be taken by all sexually active females.

A: pap

A ____ ____ is a screening for pelvic pathology to assist in diagnosing endometrial cancer, it allows measurement of endometrial t______ to determine if biopsy is needed for postmenopausal bleeding.

A: transvaginal ultrasound, thickness

What protein is found in the blood at higher levels in about 80% of people with ovarian cancer?

A: CA-125 (caner antigen 125)

In educating a patient on preventing reproductive tract cancer they should have a p____ e___ annually. They should also report any b_____ in a bowel movement, unusual vaginal d_____, persistent abdominal b_____ or c_____, pelvic p___, persistent low b______, bleeding after m________.

A: pelvic exam, blood, discharge, bloating or constipation, pain, backache

In educating a patient on reducing risk factors for reproductive tract cancer, teach them to not s____, drink ___ drink of alcohol a day, receive the ___ vaccine, avoid long term ____ exposure, have a pap smear every ___ - ____ years if sexually active, have cholesterol checked annually starting at age ___, and have blood pressure checked every 2 years.

A: smoke, 1, HPV, sun, 1 - 3, 45

_____cancer is a malignant neoplastic growth of the ovary. Those with this cancer are typically diagnosed in late stage since there is still no adequate screening test, however the 2 genes B__ and B____ are linked with breast and this type of cancer. Also what biological tumor marker is associated with this cancer?

A: ovarian, BRCA1 and BRCA2, CA-125

In ovarian cancer a L____ is done for diagnosis and staging.

A: laparoscopy

Match the stages of ovarian cancer with description:

1) Stage 1

2) Stage 2

3) Stage 3

4) Stage 4

Description; 1) cancer has metastasized to distant sites

2) cancer is limited to the ovaries

3) growth involves one or both ovaries with pelvic extension

4) cancer involves one or both ovaries and other organs or structures inside the abdominal cavity and outside the pelvis

A: 1) Stage 1 - cancer is limited to the ovaries

2) Stage 2 - growth involves one or both ovaries with pelvic extension

3) Stage 3 - cancer involves one or both ovaries and other organs or structures inside the abdominal cavity and outside the pelvis

4) Stage 4 - cancer has metastasized to distant sites

Surgical intervention remains the mainstay of management of ovarian cancer with it including surgical staging, c______ or d______ surgery, and adjunct chemotherapy. The second surgery involves resecting all visible tumors from the p____, taking biopsies, sampling lymph nodes, and removing all r_____ organs and the omentum.

A: cytoreduction or debulking, peritoneum, reproductive

The most common early symptom in ovarian cancer is abdominal b____, e____ satiety, difficulty eating, vague a_____ pain, and urinary f_____.

A: bloating, early, abdominal, frequency

Risk factors for ovarian cancer include: child birth ____ in life, obesity, smoking, family history, ethnic of E_____ E_____ or A_____ J______, positive BRCA1 and BRCA 2 mutation, history of b____ cancer, on HRT for more than ___ years.

A: later, eastern european or ashkenazi jew, breast, 10

In promoting early detection of ovarian cancer you should urge patients to have yearly p____ e____ and t_____ u_____- to allow identification of ovarian masses in early stages.

A: pelvic examination, transvaginal ultrasound

A small ovarian cyst found on ultrasound in a postmenopausal patient should arouse suspicion of ___ ____.

A: ovarian cancer

Reducing the risk of ovarian cancer includes p_____, use of o___ c_____, and b____, and eating a ______ ___ diet.

A: pregnancy, oral contraceptives, breastfeeding, low fat

___ cancer is a malignant neoplastic growth of the uterine lining. Early symptoms of it include ___ ____

A: endometrial, abnormal bleeding

What diagnostic tool can be used to evaluate the thickness of the endometrial lining which would then determine if biopsy is needed to assess for endometrial cancer? How thick?

A: transvaginal ultrasound, 5mm or more (known as endometrial hyperplasia)

In a patient with postmenopausal bleeding and a thick endometrium, a s_________ can determine whether the endometrium is diffusely thick or has focal areas of thickening, with ___ thickness a biopsy is appropriate.

A: sonohysterogram, diffuse

In a endometrial biopsy, a endometrial s___ c____ is inserted through the cervix into the uterine cavity and a tissue sample is taken.

A: suction catheter

Match the stages of endometrial cancer with description: Stage 1 - 4 Description 1) it has spread to the connective tissue of the cervix but not outside the uterus

2) tumor is confined to the corpus and ovary

3) has spread locally and regionally

4) has invaded the bladder mucosa and bowel mucosa, lymph nodes, with distant metastases to the lungs, and bone

A: 1) Stage 1 - tumor is confined to the corpus and ovary

2) Stage 2 - it has spread to the connective tissue of the cervix but not outside the uterus

3) Stage 3 - has spread locally and regionally

4) Stage 4 - has invaded the bladder mucosa and bowel mucosa, lymph nodes, with distant metastases to the lungs, and bone

Surgery for endometrial cancer involves removal of uterus (______) and fallopian tube and ovaries removal (s______-________). Routine surveillance intervals for follow up are necessary since the majority of reoccurrences occur in first ___ years.

A: hysterectomy, salpingo-oophorectomy, 3

Risk factors for endometrial cancer include obesity, d_____, early m____, late onset of m____, and t____ use.

A: diabetes, menarche, menopause, tamoxifen

In preventing endometrial cancer you should have a ___ __ diet, b____ your baby, use combination of e___ and p___ pills for contraception, and report any signs of bleeding during s___, bleedings that's longer than a _____, reappearance of bleedings 6 months or more of no m____.

A: low fat, breastfeed, estrogen and progestin, week, menses

Cervical cancer is a malignancy located in uterine cervix and is mostly caused by ___.

A: HPV

What diagnostic used for cervical cancer?

A: pap smear

A conventional pap smear test can be wrong 20 - 30 % of time so there are 2 tests that can improve the sensitivity and specificity of pap test: match them

1) ThinPrep

2) Thin Prep imaging system

Description: 1) algorithm based decision making technology that identifies slides that should be rescreened by cytologists by selecting sample that exceed a certain threshold for likelihood of abnormal cells

2) liquid based technique, cervical specimen is placed into a vial of preservative solution rather than glass slide

A: 1) ThinPrep - liquid based technique, cervical specimen is placed into a vial of preservative solution rather than glass slide

2) Thin Prep imaging system - algorithm based decision making technology that identifies slides that should be rescreened by cytologists by selecting sample that exceed a certain threshold for likelihood of abnormal cells

Cervical cancer screening should begin at age ___ regardless of sexual history. Pap smears every __ years for ages 21 - 29, between 30 - 65 can choose pap every — years or HPV every ___ years, cervical caner screening can be stopped after ___ years old.

A: 21, 3, 5, 65

Suspect advanced ____ ____ in patients with pelvic, back, or leg pain, weight loss, anorexia, weakness, and fatigue, and fractures.

A: cervical cancer

Further diagnostic testing for cervical cancer includes a c_______, patient is placed in l_____ position and their cervix is cleansed with a_____ a___ solution, as this solution makes abnormal cells appear w____.

A: colonoscopy, lithotomy, acetic acid, white

______ __ is the vaccine currently approved by US FDA to protect children and adults from HPV from ages 9 - 45. It is a ___ vaccine in a 2 - 3 dose series with the younger the age getting it the ____ injection needed.

A: Gardasil 9, IM, fewer

Does the patient need any special preparation before a Pap test?

A: no (common misconception)

____ cancer is an uncommon malignant tissue growth arising in vagina. If cancer is localized then r_____, wide local i_____, l_____ surgery, or all may be used. If cancer has spread then radical surgery like h_____ or removal of upper vagina might be needed.

A: Vaginal, radiation, incision, laser, hysterectomy