| Them Genes Though | #NeverForget | The dreaded intraop pimp | chemo, radiation, surgery is the new GTL | But theres an app for that! |
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What disease is characterized by the overexpression of PTEN?
Cowden
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This score determines what chemotherapy you get, single agent versus a ton ton more.
below 6 single agent, 7 or more multi
MTX vs, act-D EMACO |
Describe the path of the ureter.
Enters the pelvis at the bifurcation of the common iliac and runs under the IP ligament.
Runs retroperitoneally along pelvic side wall and goes under the uterine artery and enters the paracervical tunnel. Distance from cervix to ureter is about 2cm. |
Taking out a 30 cm ovary when you accidentally pop it soaking yourself with what appears to be high-grade cancer juice. Stage if otherwise NED and what you do after, besides change your scrubs.
Stage IC1, need chemotherapy for high grade cancer subtype.
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That family med patient referral of a 21 y/o with HGSIL. But then you do a colpo and its CIN2 but gyn onc declined your referral...so, uh, what now?
Repeat colpo and pap in 6-month intervals for 12 months
if CIN2 persists for >2 years, progresses to CIN3, or inadequate then LEEP. |
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The five most commonly affected genes in this syndrome causes an increased risk for colon, endometrial and ovarian cancer.
MLH1, MSH2, PMS1, PMS2, and MSH6
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Breast Mass, the most common is this. For benign and for cancer.
Fibroadenoma in benign
Invasive ductal carcinoma for cancer |
Good, you found it. But how are you going to injure it during a BSO, during a laparoscopic hysterectomy, and during a vaginal hysterectomy? Options are endless
BSO: When taking down the IP
Laspy hyst: when taking down the uterine Vaginal: near the trigone |
1A vs. 1B-III vulvar cancer. Didn't realize there was a difference in treatment to be honest...
1A <2cm and <1mm DOI, excision OUT withOUT LND
1B - III radical excision WITH LND, if within 1cm need bilateral |
Things go bump in the night when you get this consult for a patient with a fungating mass and a bump in her creatinine. What stage and treatment?
Stage IIIb
Chemo RT |
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This syndrome known for soft tissue sarcomas, leukemia, adrenal corticoid cancers, breast, and brain cancers is caused by a mutation in this infamously notorious gene.
TP53
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Just trying to live your life with dense breasts, you'll likely need one of these 4 screening modalities.
Ultrasound, MRI, Digital Mammography, and Film mammography
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When you are retracting in a hysterectomy but the attending is getting on your last nerve so you accidentally injure this one.
Femoral nerve L2-L4
Sensory change to anteromedial thigh motor weakness with hip flexion and knee extension |
Most common cancer in pregnancy? Most commonly diagnosed cancer in pregnancy?
Breast and cervical
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Not sure what AIS but my 28 y/o patient has it and it extends into the deep margin. She's not sure if she's done having kids though.
re-excision via CKC if margins are negative then pap, colpo, ECC with testing every 6 months vs. rad hyst if childbearing is complete.
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Presence of 2/3 of the following symptoms needed to diagnose this autosomal dominant syndrome: hamartomas of the GI tract, mucocutaneous pigmentation, family history of cancers.
Putz-Jegher's Syndrome
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But I have breast cancer, can't you conserve my breast? But why not?
Multifocal disease
Diffuse calcifications on imaging history of radiation therapy to the chest wall Positive margins on re-excision Large tumor size in relation to the breast |
Sharp burning pain over the suprapubic area, labia, and inner thigh. Girl what did you do and how did you do it?
Ilioinguinal, iliohypogastric nerve injury
Transverse incision or trocar |
1B EC, G1, -LVSI, -LND in 70 y/o, adj tx?
Why is all of obgyn a bunch of letters?
HIR features, recommend adjuvant RT.
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In endless onc clinic you stand there having a mini panic attack as your stage IIB SCC of cervix patient tells you she is peeing blood. Why is she peeing blood?!
Radiation cystitis
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When you have BRCA but need a mammogram. Age matters!
Breast MRI with screening mammogram alternating every 6 months starting at the age of 30 for patients younger 25-29 clinical breast exam every 6-12 months and annual MRI.
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The treatment for this cancer, where the histology is characterized by the proliferation of intermediate trophoblastic cells is a hysterectomy because of chemotherapy resistance.
Placental site trophoblastic tumor
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Get liggy with it. Ligate this during a uterine artery pedicle bleed that you just can't Tisseel over it.
Hypogastric artery ligation
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When you feel supraclavicular nodes in this type of cancer, you know it's end game or stage 4B.
Cervical cancer
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When you're back in Ob clinic, your happy place, until your 32 y/o 10+4 patient's pap smear comes back as HGSIL HPV Positive. What is her CIN3 risk?
64% CIN3+ risk
ECC, EMB and treatment w/o bx are not acceptable in pregnancy. A diagnostic excisional procedure or repeat bx is recommended only if cancer is suspected. |
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