Principles 5

Question 1

Sheehan’s syndrome: is a partial or complete ______________ due to
________________________ of the ___________________ in women with severe __________ and hypotension during delivery

Answer 1

pituitary insufficiency

postpartum necrosis

anterior pituitary gland

blood loss

Question 2

Sheehan’s syndrome

Clinical manifestations
- Failure to _________
- Breast and ________ and __________
- Loss of _______ and ____________
- Oligomenorrhea or amenorrhea
- Loss of _______
- Pale skin with premature wrinkling
Fatigue, weight loss, postural hypotension
- Hyponatremia, hypoglycemia and anemia

Answer 2

lactate

involution ; atrophy

pubic ; axillary hair

libido

Question 3

Ovarian cancer is the __________ most common gynecological cancer;

commonest being _________

Answer 3

second; cervical

Question 4

Ovarian Cancer: Classification

_________ Ovarian Tumor (80%)

_____________ Tumor (10%)

__________ Tumor (10%)

______________

Answer 4

Epithelial

Sex cord Stromal

Germ Cell; Metastatic

Question 5

Epithelial ovarian tumor

List 5

Answer 5

• Serous
• Mucinous
• Endometriod
• Clear cell
• Undifferentiated

Question 6

Ovarian cancer

Sex cord Stromal Tumor (10%)

List 3

Answer 6

• Granulosa Cell
• Sertoli-Leydig
• Gynandroblastoma

Question 7

Ovarian cancer

Germ Cell Tumor (10%)

List 5

Answer 7

Dysgerminoma
Endodermal sinus (Yolk Sac)
Teratoma
Choriocarcinoma
Mixed

Question 8

Example of a metastatic ovarian cancer

Answer 8

Krukenberg

Question 9

Ovarian cancer

Risk factors??

List all

Answer 9

Nulliparity
Intrauterine device
Cigarette smoking
Obesity
Family history
Early menarche
Endometriosis
Late menopause

Question 10

Ovarian cancer

Protective factors??

List all

Answer 10

Multiparty
COCP
Tubal ligation
Hysterectomy
Breastfeeding

Question 11

Staging of ovarian cancer

I Tumor confined to ______
II Tumor confined to ________
III Tumor confined to _____________ or __________________ nodes
IV Tumor involving ______________ with ___________________ (if pleural effusion is present, cytology must be positive; liver parenchyma metastasis equals stage IV)

Answer 11

ovaries

pelvis

abdominal peritoneum; inguinal lymph

one or both ovaries; distant metastases

Question 12

______________ Accounts for about 80% of all primary ovarian cancers

Answer 12

Epithelial ovarian cancer (EOC)

Question 13

Clinical features of ovarian cancer

Persistent pelvic and abdominal ______
Increased __________ or __________
Anorexia and ____________
Change in ___________
__________ symptoms
Back ache
_________ ___________
Fatigue
Endometrial cancer (in about 10%)

Answer 13

pain

abdominal size or bloating

early satiety; bowel habit

Urinary; Irregular bleeding

Question 14

Endometrial cancer arises from the _________ tissue within the uterine lining

Answer 14

glandular

Question 15

Endometrial cancer

More common in (whites or blacks?) than in (whites or blacks?)

Answer 15

whites

Blacks

Question 16

Risk factor for endometrial cancer

List 9

Answer 16

Nulliparity
Obesity
Diabetes mellitus
Family history of colorectal, ovarian or breast cancer
Unopposed estrogen therapy
Estrogen producing ovarian tumor
Late menopause (>52 yrs)
Tamoxifen therapy
Hormone replacement therapy

Question 17

Clinical feature of endometrial cancer
_____________
____________
_________________________ bleeding
________-stained, ______-smelling vaginal discharge
Low abdominal _______
Low abdominal _______
_________________

Answer 17

Menorrhagia
Metrorrhagia
Post-menopausal

Blood; foul

swelling; pain

Dyspareunia

Question 18

_________ cancer is the commonest malignancy of the female genital tract

Answer 18

Cervical

Question 19

Cervical cancer Occurs between _____ and______ decades.

Average age: ______ years

Etiology: _________________________ ; others: 31, 33, 35, 45, 56

Answer 19

5th and 6th

51

Human papillomavirus (HPV) 16 and 18

Question 20

Risk Factors for cervical cancer
•_______________ (16 yrs)
-_________ male sexual partner
-Male sexual partner with multiple sexual partner
-_______ age at first birth
-_______parity
• Smoking
-_____ socioeconomic s t a t u s
- Previous history of ________________
- Previous history of ________________
• Long term use of _________
•_______________ state e.g. HIV infection

Answer 20

Early coitarche; Multiple

Early; Multiparity

Low; sexually transmitted disease (STD)

pelvic inflammatory disease

COCP; Immunosuppressed

Question 21

condoms are not as protective against HPV as it is against other STDs due to ________________ contact

Answer 21

labio-scrotal

Question 22

Staging of cervical cancer

I) Tumor is ______________
II)Tumor ______________ but not to ___________ or __________
III) Tumor ____________________ and/or ______________ and/or causes ______________ or associated with non-functional kidney
IV) Tumor involves the __________________ and/or extends _____________

Answer 22

confined to the cervix

extend beyond the uterus

lower third of vagina ; pelvic side wall

extends to lower third of vagina

pelvic side wall ; hydronephrosis

mucosa of bladder or rectum; beyond the true pelvis

Question 23

Cervical cancer

Stage II

A1:_______; A2:__________
B:___________

Answer 23

Without parametrial invasion, Lesion ≤4 cm
Without parametrial invasion, Lesion >4 cm

With parametrial invasion,

Question 24

Cervical cancer

Stage III

A
B
C

Answer 24

lower third of vagina, no pelvic wall involvement

Extends to pelvic wall and/or hydronephrosis/non-functioning kidney

Positive lymph nodes

Question 25

Cervical cancer Stage IV A B

Answer 25

Invades adjacent pelvic organs Distant metastasis

Question 26

Treatment In cervical cancer Simple hysterectomy is for which stages?

Answer 26

1A1 and 1A2