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  1. What cancer am I ?
       Most commoon in younger women
       Affects women of lower socioeconomic status
       Early sexual activity, multiple partners,
       multiple pelvic infections, smoking
  2. ___ cancer incidence is higher in wives of men with penile cancer
  3. Women whose mothers used DES during early months of pregnancy are more likely to develop ____ cancer
  4. Because of PAP smears _____ of cancers are diagnosised in non-invasive stages
  5. What Cancer am I?
       Has increased over the past few years
       Aging population
       high-calorie diet & high fat diets
       use of estrogen in the 60's & 70's
       peak age is 58
       Diabetes & hypertension
       Prolong estrogen use (HRT)
  6. Women who are 50lbs over weight have a ___ times increase in risk of developing ___ cancer
    • 9 times
    • endometrial
  7. ___ & ___ cancers are rare & occur in older women
    Vaginal & Vulva
  8. Vulva cancer is ___ times more common then vaginal & is associated with diabetes & STD's
  9. **NOTE**
    ****Vulva cancers are also associated with changes in normal vaginal lining, loss of hormone stimulation, and poor hygeine
    **** Vaginal cancer is also related to DES use while in utero.
  10. What cancer am I?
       occurs between ages 50 & 70
       Risk factors include:
         older age
         late or few pregnancies
         late menopause
         lack of oral contraceptives
         family history of ovarian cancer
         personal history of breast, colon, or endometrial cancer
         diets high in meat or animal fat
  11. What cancer am I?
    Slow progressive disease
    Presenting signs:
       poscoital bleeding
       increased menstrual bleeding
       discomfort with intercourse
       Maloderous discharge, pelvis pain, and urinary or rectal symtoms may accompany more advance disease
  12. List the lymph nodes involved in cervical cancer
    • They are normally in order:
    • para cervical (around the cervix)
    • para metrial (around the uterus)
    • pelvic
    • common iliac
    • para-aortic
    • and even SVC nodes
  13. Cervical cancer affects in Direct extension
    superior =
    inferior =
    anteriorly =
    posteriorly =
    • superior = uterus
    • inferior = vagina
    • anteriorly = bladder
    • posteriorly = rectum
  14. where does hematogenous spread of cervical cancer go?
    Lungs, bone  & liver
  15. In detecting & diagnosis what are the classes of PAP Smear
    Class I
    Class II
    Class III
    Class IV
    Class V
    • Class I - normal
    • Class II - atyical (not cancerous, but starting to change)
    • Class III - dyspalsia
    • Class IV - carcinoma in situ (starts cancer)
    • Class V - Invasive cacinoma
  16. What are some methods of detection & diagnosis of Cervical Cancer?
    H&P, including pellvic & rectal exams, CT, MRI, PET, cystoscopy and proctoscopy are used to assess metastatic disease.
  17. What is most common pathology of Cervical Cancer?
    Squamous Cell
  18. Most cervical lesions are in the ___ lip of the cervix
  19. What is the most common symptom of cervical Cancer?
  20. Describe Point A
    • 2cm superior of the external os
    • and
    • 2 cm lateral of the external os
  21. Describe Point B
    • 2 cm superior of the external os
    • and
    • 5cm lateral of the external os
  22. Point A is associated with dose to _____.
  23. Point B is assocaited with dose to ____.
    nodal areas
  24. Tamdum is inserted into the ____.
    Ovoids lie in the ____ ____ or each side of the cervix.
    • uterus;
    • lateral fornices
  25. Radiation fields for cervical Ca.
       Whole pelvis is treated with a:
    4 field box
  26. ___ cancer is the most deadliest of all GYN cancers and has few symtoms until it is widely disseminated.
  27. Most common symptoms of cervical cancer is:
    abdominal/pelvic pain, ascites, abdominal distention, or GI symptoms (n/v, constipation, heartburn)
  28. Most common age for ovarian cancer
  29. ___ marker is a useful prognostic indicator
  30. In ovarian cancer blood spread is to the ____ & ____ and ovarian tumors can also seed into the abdomen.
    liver & lungs
  31. ***NOTE***
    Ovarian cancer does not have a huge role in radiation therapy. It is mainly for pallative treatment
  32. Pathology of ovarian cancer is 90% _____
  33. Treatment choice for ovarian cancer is
    surgury & chemotherapy
  34. Ovarian cancer overall 5 year survival is _____%
  35. What are the most common symptoms of endometrial (uterus) cancer the leads to early detection?
    vaginal bleeding & discharge
  36. What are some examples of poor prognosis of Endometrial Cancer?
    • higher grade
    • increased depth of invasion
    • lymph node involvement
    • cancer cells inthe peritonal fluid (abd fluid)
  37. Enndometrial cancer lymph spread is to the ___ & ____.
    Internal & external iliacs
  38. Endometrial cancer blood spread is to the ___ & ____
    lung & bone
  39. What is the most common histology of endometrial cancer?
  40. Overall 5 year survival for endometrial cancer is
  41. The "stop sign field" is used for ___ & ___ cancer
    cervical & endometrial
  42. What is the most common pathology for vulvar cancer
    squamous cell (below cervix)
  43. What is the overall 5 year survival rate for vulvar cancer?
  44. RT fields for vulvar cancer is
  45. _____ is a super rare female cancer
  46. ___ cancers accounts for cancers that have not reached the cervix or vulva
  47. what is the median age for vaginal cancer?
  48. What is the most common histology for vaginal cancer
    squamous cell carcinoma
  49. What is the most common location for vaginal cancer?
    upper 3rd of vagina
  50. ***NOTE***
    Vaginal primar is rare mostly we see a cervical that has grew into the vagina
  51. (Vaginal)
    Lymph drainage:
    inguinal, upper 3rd to the iliacs
  52. (vaginal)
    Direct extension:
    • along vaginal wall to cervix or vulva
    • It may also spread to the pelvic wall, bladder & rectum.
  53. (vaginal)
    Work up:
    Biopsy, H&P, blood & chemistry, urinalysis, chest x-ray, CT, and cystourethroscopy
  54. What is the treatment choice for vaginal cancer?
    Radiation Therapy (AP/PA fields)
  55. What are some side effects from Radiaiton Therapy?
    Fatigue, diarrhea, dermatitis, dysuria, n/v, anal irritation, menopause, vaginal fibrosis & dryness, bowel obstruction, dry & moist desquamation
  56. List the 3 categories of organs in the female reproductive system
    • primary
    • internal accessory
    • external parts
  57. What is an example of a primary organ in the famale reproductive system
  58. What is an example of internal accessorys in the female reproductive system?
    • uterine tubes
    • uterus
    • vagina
  59. What is an example of external parts in the female reproductive system?
    • labia majora,
    • labia minora,
    • clitoris,
    • vestibule,
    • and vestibular glands,
    • openings of the urethra, vagina & compose the vulva.
  60. What am I ?
    solid, oval structure about the size & shape of unshelled almonds.
    Located onthe laterla walls of the pelvic cavity.

    Lymphatic drainage goes almost exculvisely to the pperiaortic lymph nodes
  61. What is attached to the ovary to help hold it in place?
    broad ligament
  62. what is located in the upper end & it is a small fold of peritoeum & contains the ovarian blood vessels and nerves.
    suspensory ligament
  63. What helps hold up the uterian tubes?
    round ligament
  64. My function is to convey egg cells toward the uterus
    Uterine tubes

    AKA: fallopian tubes or oviducts
  65. What am I ?
    a funnel shaped that partially encircles the ovary and also has alot of irregular, branched extensions
    the infundibulum is the funnel shaped part and the fimbriae are the irregular, branched extensions
  66. What am I?
    does not directly touch the ovary & the fimbriae are connected directly to it
  67. ***NOTE***
    The egg moves from the ovary down the fallopian tube by cilia, which sweeps the egg toward the uterus and muscular contractions also help it until it has reached the uterus.
  68. What am I?
    Muscular shaped organ like an inverted pear. My function is to receive the embryo & to sustain life during development.
  69. What is the significance of the uterine pouch
    helps prevent the spread of uterine cancer to the rectum
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