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Old 11-23-2012
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Arrow Billy Step 1 Questions # 94

62-year-old childless woman noticed a blood-tinged vaginal discharge twice during the past month. Her last menstrual period was 14 years ago. Bimanual pelvic examination shows that the uterus is normal in size, with no palpable adnexal masses. There are no cervical erosions or masses. Her body mass index is 33. Her medical history indicates that for the past 30 years she has had hypertension and type 2 diabetes mellitus. An endometrial biopsy specimen is most likely to show which of the following?


□ (A) Adenomyosis
□ (B) Leiomyosarcoma
□ (C) Adenocarcinoma
□ (D) Squamous cell carcinoma
□ (E) Choriocarcinoma
□ (F) Malignant mixed müllerian tumor
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  #2  
Old 11-23-2012
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Default my answer :)

(C) Adenocarcinoma
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Old 11-23-2012
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□ (C) Adenocarcinoma aka endometrial carcinoma
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Old 11-23-2012
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C) Adenocarcinoma
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Old 11-23-2012
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Quote:
Originally Posted by billy View Post
62-year-old childless woman noticed a blood-tinged vaginal discharge twice during the past month. Her last menstrual period was 14 years ago. Bimanual pelvic examination shows that the uterus is normal in size, with no palpable adnexal masses. There are no cervical erosions or masses. Her body mass index is 33. Her medical history indicates that for the past 30 years she has had hypertension and type 2 diabetes mellitus. An endometrial biopsy specimen is most likely to show which of the following?


□ (A) Adenomyosis
□ (B) Leiomyosarcoma
□ (C) Adenocarcinoma
□ (D) Squamous cell carcinoma
□ (E) Choriocarcinoma
□ (F) Malignant mixed müllerian tumor
All the leading clue in the above question reveals risk factors associated with endeometrial caricinoma.
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Old 11-23-2012
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C. Adenocarcinoma. The risk factors point towards the diagnosis. Her BMI is 33, when will increase peripheral conversion of androgens to estrogens by aromatase enzyme.
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Old 11-24-2012
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Correct Answer C is correct

Postmenopausal vaginal bleeding is a “red flag” for endometrial carcinoma. Such carcinomas often arise in the setting of endometrial hyperplasia. Increased estrogenic stimulation is thought to drive this process, and risk factors include obesity, type 2 diabetes mellitus, hypertension, and infertility. Adenomyosis is an extension of endometrial glands and stroma into the myometrium, generally resulting in symmetric uterine enlargement. A submucosal leiomyosarcoma could produce vaginal bleeding, but the uterus would be enlarged because leiomyosarcomas tend to be large masses. Squamous carcinomas of the endometrium are rare. Choriocarcinomas are gestational in origin. Malignant mixed müllerian tumors are much less common than endometrial carcinomas, but they could produce similar findings.
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Old 11-26-2012
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Hi billy!
Do you make these questions yourself or do you get them from somewhere?
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Old 11-26-2012
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postmenopausal women with pv bleeding is endometrial ca..n common is adenoca
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