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5.3. Quiz:

Uterine cancer

1. Clinical symptoms of uterine tumors. 2. Diagnosis of uterine tumors. 3. Classification of tumors of the uterine body. 4. Question metastasis 5. Epidemiology of uterine tumors, morbidity and mortality, etiological factors and Precancer disease pathogenesis. 6. Principles and treatment in uterine tumors, and long-term results of treatment of uterine body cancer, diagnosis and treatment of recurrences and metastases. 7. Predisposing factors and precancerous conditions, prevention. 8. Examination of disability, prognosis, rehabilitation patients

Cervical Cancer

1. The frequency of cervical cancer.

2. Precancerous diseases and their treatment.

3. Morphological structure of tumors.

4. Classification of cervical cancer.

5. Clinic cervical cancer, diagnostics.

6. Method of and value colposcopy, cytological and histological examination of cervical cancer.

7. Choosing the best method of treatment of cervical cancer depending on the stage of the process.

8. Weather.

Ovarian Cancer

1. Clinical symptoms of cancer of the uterus. 2. Diagnosis of tumors of the uterus. 3. Classification of tumors of the uterus. 4. Question metastasis 5. Epidemiology of cancer of the uterus, morbidity and mortality, etiological factors and Precancer disease pathogenesis. 6. The principles and tactics of treatment of tumors of the uterus, and long-term results of treatment of cancer of the uterus, diagnosis and treatment of recurrences and metastases. 7. Predisposing factors and precancerous conditions, prevention. 8. Examination of disability, prognosis, rehabilitation patients

 

5.4. Final stage:

Control and correction of professional skills and knowledge held by solving situational and clinical tasks, tests for self-control. Assesses knowledge and skills students study each assessment.

The teacher has homework, recommended literature on the subject next class basic and additional.

VI. Materials for methods of classes

6.1.Materialy control baseline (rising levels) of students: test tasks (correct answers indicated *)

test tasks

Task 1. Woman '60 addressed the precinct n th gynecologist with complaints of spotting the external genital tract, which appeared two months ago. Obese III level, hypertension of II. Menopause 10 years. When rektovahinalnomu study uterus is not enlarged, epididymis involyutni. Infiltrates in the pelvis there. The cervix is not changed. What additional test method can offer the patient for further diagnosis? A. Diagnostic vyskoblennya uterus * V. pelvic ultrasound; S. hysterography; D. CT abdomen; E. Colposcopy.  

With avdannya 2. Woman '38 suffers menstrual cycle during the last year. When rectal examination and pelvic ultrasound uterus and ovaries are not enlarged. Infiltrates in the pelvis there. Done diagnostic vyskoblennya uterus, endometrial polyp elements derived from ozloyakisnennyam. What is the best treatment option? A. Chemotherapy; B. Hormone; S. supravaginal amputation of uterus with appendages; D. Bilateral ovariectomy; E. hysterectomy with appendages. *

With avdannya 3. Female 62 years old, who is in menopause for 12 years, complains of bloody vaginal discharge that appeared 5 months ago. When rektovahinalnomu study enlarged uterus to 7 weeks of pregnancy, tistuvata, mobile. Appendages not enlarged. Infiltrates in the pelvis there. When diagnostic vyskoblenni derived elements adenocarcinoma. What kind of treatment can offer this patient? A. Radiation therapy; V. supravaginal amputation of uterus with appendages; S. Duplex tubovariektomiya; D. Hysterectomy with appendages * E. Chemotherapy.

With avdannya 4. Female 56 years old, indicating intense acyclic month for the last 3 years, pain in the abdomen. In the history of two sorts, one abortion. When rektovahinalnomu study enlarged uterus before 12 weeks of pregnancy, represented by individual nodes to 3.5 cm in diameter, mobile. With ultrasound pelvic nodes in the uterus are subserous. Appendages not enlarged. What diagnosis can put this patient? A. Fibroids Fibroids * B. Glandular endometrial hyperplasia; S. Polyp endometrial D. Cervical erosion; E. uterine cancer.

With avdannya 5. After morphological verification of diagnosis "Endometrial cancer" patient '55 performed hysterectomy with appendages. Postoperative period equal. Histological examination of the removed product revealed highly differentiated adenocarcinoma, prorstayucha in myometrium. What additional therapies to offer this patient? A. Symptomatic therapy; B. Chemotherapy; S. Immunochemotherapy; D. Immunotherapy; E. Radiation therapy to a small bowl. *

With avdannya 6 Patient, '48, who works as a teacher, 2 months ago, the treatment of tumors of the endometrium. How to evaluate the performance of the patient? A. Not broken * B. Temporarily lost C. Steadily lost D. It can not work with children E. Requires the reduction of working time

With avdannya 7 Woman '55 appealed to the district gynecologist with complaints of spotting the external genital tract, which appeared two months ago. Obese III level, hypertension of II. Menopause 5 years. When rektovahinalnomu study uterus is not enlarged, epididymis involyutni. Infiltrates in the pelvis there. At cervix ulcer with protruding edges and yellow bottom. What additional test method can offer the patient for further diagnosis? A. Diagnostic vyskoblennya uterus; B. CT abdomen; C. Hysterography; D. Ultrasound of the pelvic E. Colposcopy, biopsy of the cervix. *  

With avdannya 8 Patient K., 52 years old, turned out to be a water occurrence within their last 3 months of contact bleeding from the genital tract. Examination revealed Ca in situ of the cervix. What is the best treatment option? A. Chemotherapy; B. Hormone; S. Diatermoelektroekstsyziya cervical D. Bilateral ovariectomy; E. hysterectomy with appendages. *

With avdannya 9 Patient B., 28 years embarked on account of pregnancy at 24 weeks of life. In the study revealed cervical cancer and stage. What is the treatment in this patient? A. Abortion, surgery and radiotherapy Wertheim B. Cesarean section, surgery and radiotherapy Wertheim C. Prolongation of pregnancy up to 36 weeks, cesarean section, Wertheim operation and radiotherapy * D. Cesarean section, radiotherapy E. Treatment after the independent labor

With avdannya 10 Female 50 years indicates intense acyclic month for the last 3 years, pain in the abdomen. In the history of two sorts, one abortion. When rektovahinalnomu study enlarged uterus and 6 weeks pregnant, represented by individual nodes to 0.5 cm in diameter, mobile. With ultrasound pelvic nodes in the uterus are subserous. Appendages not enlarged. When viewed in the mirrors on the cervix area congestion of the internal os 1.5 cm in diameter. What preliminary diagnosis can put this patient? A. Fibroids uterine cervical erosion * B. Glandular endometrial hyperplasia; S. Polyp endometrial D. Uterine cancer, cervical erosion; E. uterine cancer.

With avdannya 11 Patient '66 morphologically verified diagnosis "Cervical cancer stage II." What is the treatment strategy? A. Symptomatic therapy; B. Chemotherapy; S. Immunochemotherapy; D. Combined radiotherapy; E. Surgical treatment and radiation therapy *

With avdannya 12 Patient, '48, who works as a teacher, 2 months ago about the treatment of ovarian tumors. How to evaluate the performance of the patient? A. Not broken * B. Temporarily lost C. Steadily lost D. It can not work with children E. Requires the reduction of working time

Target 13 Patient B., 62 years with severe ascites, after celiocentesis (deleted to 8 liters of fluid) was determined by the limited mobile, painless swelling in the right iliac area. When ultrasound determined tumor of the right ovary 15h13 cm, homogeneous structure, with clear contours. Cytology in ascitic fluid - puhlynovydni cells were not found. What research should be done to clarify the diagnosis? A. Fibergastroduodenoscopy; B. Diagnostic laparotomy; C. Laparoscopy * D. Fibrokolonoskopiyu; E. Urine for Bence-Jones protein.

With avdannya 14 Patient A., 57 years, menopause 4 years, complains of weakness, lack of appetite, discomfort in the lower abdomen. During bimanual examination: the uterus of normal size in anteflexio, to the right of it in the zone right appendages palpable tumor formation to 15 cm in diameter, painless, movable. What research should be done to diagnose? A. Puncture rear construction; B. Plain radiographs of the abdomen; C. Sample Roberha; D. Fibrokolonoskopiyu; E. Ultrasonography of the pelvis. *

With avdannya 15 Patient G., 58 years appealed to the doctor about the rapid increase in the volume of the abdomen, pain in his lower divisions, dyspnea on exertion, pastoznost leg weakness. Located on the records about coronary heart disease. As most correct to interpret the symptoms described? A. Chronic intestinal obstruction; B. Ascites obscure origin * C. Decompensated heart failure; D. Fibroids of the uterus; E. Ascitic form of ovarian cancer.

  With avdannya 16 Patient B., 59 years old approached in hospitals by place of residence with complaints of increased abdominal in volume. He considers himself a patient for the past two months, when the weakness, poor appetite, stomach began to grow rapidly. The examination revealed that the supine form of belly does not change, although clearly marked ballot. How to interpret given the symptoms? A. Chronic intestinal obstruction; B. Giant cystoma * C. Ascites obscure origins; D. Tubal pregnancy; E. Fibroids of the uterus.

With avdannya 17 Patient L., 69 years with severe obesity complains of a feeling of heaviness in the abdomen, constipation. During bimanual examination clearly defined tumor of the uterus is impossible. These ultrasound - localization of the ovaries and determining their size is difficult because of pronounced obesity and flatulence. What diagnostic study to be done to clarify the diagnosis? A. Laparotomy; B. Laparoscopy; C. Plain radiographs of the abdomen; D. Enema * E. Built with a rear puncture cytology obtained material.

6.2. Materials for the methods of the main stage classes H Abir radiographs, tables, owner of anticancer chemotherapy, hospital records and medical history of patients, findings of morphological studies of biopsies (if possible micropreparations) medicines.

6.3. Materials for the final stage of the study: clinical case studies

Final Test (Correct answers indicated *)

Test number 1 Female 55 years indicates intense acyclic month for the past 2 years, pain in the abdomen. History in two genera, one abortion. When rektovahinalnomu study enlarged uterus before 13 weeks of pregnancy, represented by individual nodes to 3.5 cm in diameter, mobile. With ultrasound and CT pelvic nodes in the uterus are subserous. Appendages not enlarged. What diagnosis can put this patient? A. Cervical erosion; B. Glandular endometrial hyperplasia; C. Polyp endometrial D. Cancer of the uterus and bodies. E. Fibroids Fibroids *

Test number 2 PATIENTS '53 performed hysterectomy with appendages about uterine cancer. Postoperative period equal. Histological examination of the removed product revealed highly differentiated adenocarcinoma, germinating in the myometrium. What additional therapies to offer this patient? A. Immunotherapy; B. Immunochemotherapy; C. Radiation therapy to the bed of the uterus. * D. Symptoms cal therapy; E. Chemotherapy;

Test number 3 Female 60 years old, who is in menopause 10 years, complains of bloody vaginal discharge that appeared 6 months ago. When rektovahinalnomu study enlarged uterus to 7 weeks of pregnancy, tistuvata, mobile. Appendages not enlarged. Infiltrates in the pelvis there. When diagnostic vyskoblenni derived elements adenocarcinoma. What kind of treatment can offer this patient? A. Bilateral tubovariektomiya; B. Hysterectomy with appendages; C. Supravaginal amputation of uterus with appendages * D. Radiotherapy; E. Chemotherapy.

Test number 4 An examination of women in '56, with complaints krov'yanisti discharge pyhvy, the doctor suspects endometrial cancer. What is needed diagnostic method? A. Radionuclide B. Ultrasound C. Trial endometrial curettage * D. Metro salpinhohrafiya E. Colposcopy

Test number 5 Woman in '38 diagnosed with endometrial cancer. Which treatment to choose? A. Surgical B. Drug C. Ray D. Combined * E. Ymunoterapevtychnyy

Test number 6 Woman '60 addressed the precinct gynecologist with complaints of spotting the external genital tract, which appeared two months ago. Obese III level, hypertension of II. Menopause 10 years. When rektovahinalnomu study uterus is not enlarged, epididymis involyutni. Infiltrates in the pelvis there. The cervix is eroded. What additional test method can offer the patient for further diagnosis? A. Diagnostic vyskoblennya uterus; V. pelvic ultrasound; S. hysterography; D. Tion CT belly cavity; E. Colposcopy. *

Test number 7 Female 55 years indicates intense acyclic month for the past 2 years, pain in the abdomen. History in two genera, one abortion. When rektovahinalnomu study enlarged uterus before 13 weeks of pregnancy, represented by individual nodes to 3.5 cm in diameter, mobile. With ultrasound and CT pelvic nodes in the uterus are subserous. Appendages not enlarged. What preliminary diagnosis can put this patient? A. Cervical erosion; B. Glandular endometrial hyperplasia; C. Polyp endometrial D. Cancer t Ila uterus. E. Fibroids Fibroids *

Test number 8 Patient D., 67 years old in the survey revealed elevated levels of tumor-associated surface antigen CA-125 levels. Can this analysis argued that patient with cervical cancer? A. Further additional examination of the patient; B. Yes; C. No * D. Need to re-study of CA-125 in the dynamics; E. Necessary research CEA, alfafetoproteyinu (AFP).

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