Hereditary CA Syndrome 1
Hereditary CA Syndrome 2
Uterine Inversion
Jada Refresher
100
What type of gene are BRCA genes?
Tumor suppressor genes
100
This is the most common origin site for ovarian cancer in BRCA1/2 mutations.
The fallopian tubes
100
These are possible uterine relaxation agents to give in the event of an inversion
nitroglycerin (50 to 500 mcg), a tocolytic agent (magnesium sulfate or β-mimetic), or a halogenated anesthetic. Also stop pitocin
100
This is the amount you should put in the Jada balloon (per manufacturer)
120 cc sterile water
200
This is the chromosome that BRCA1 and BRAC2 are found on.
Chromosome 17 (BRCA1) and 13 (BRCA2)
200
This BRCA mutation has a higher risk of ovarian cancer.
BRCA1 (39-46% vs 10-27 with BRCA2)
200
These are two risk factors for uterine inversion
uterine overdistention, fetal macrosomia, rapid labor, congenital uterine malformations, invasive placentation, short umbilical cord, use of uterine-relaxing agents, nulliparity, manual placental extraction, and Ehlers-Danlos syndrome.
200
This is the suction pressure the Jada should be set at
80
300
A 34 yo patient with BRCA1 mutation is not ready for risk-reducing BSO. These are the available screening procedures for the patient.
Measurement of CA-125 levels and transvaginal US. However, these have not been proved to decrease the mortality rate or increase the survival rate associated with ovarian cancer in high-risk populations
300
This is the surveillance for primary peritoneal CA in women with BRCA mutations who have undergone risk-reducing BSO.
There are none. The benefit of serum CA 125 measurement or imaging surveillance after risk-reducing salpingo-oophorectomy is not known because peritoneal cancer is relatively uncommon. Counsel about routine screening for age and symptom awareness.
300
Briefly describe the Huntington procedure
The Huntington procedure involves a laparotomy with serial clamping and upward traction of the round ligaments to restore the uterus to its proper position
300
This is the amount of blood held in the Jada tubing.
120 cc (10 cc per foot of tubing)
400
For women 25-29 with BRCA mutations, these are the breast cancer screening recommendations.
Clinical breast examination every 6–12 months and annual radiographic screening (preferably, magnetic resonance imaging [MRI] with contrast)
400
These are 4 criteria for genetic evaluation for hereditary breast and ovarian cancer.
Women affected with one or more of the following: epithelial ovarian, tubal, or peritoneal cancer, breast cancer at age <45 years, breast cancer and have a close relative with breast cancer at age 50 years or less or close relative with epithelial ovarian, tubal, or peritoneal cancer at any age, breast cancer at age <50 years with a limited or unknown family history, breast cancer and have 2+ close relatives with breast cancer at any age, breast cancer and have two or more close relatives with pancreatic cancer or aggressive prostate cancer, 2 breast cancer primaries with the first diagnosed <age 50 years, triple-negative breast cancer at age <60 years, breast cancer and Ashkenazi Jewish ancestry at any age, pancreatic cancer and have 2+ close relatives with breast cancer; ovarian, tubal, or peritoneal cancer; pancreatic cancer; or aggressive prostate cancer
Women unaffected with cancer, but with one or more of the following: A first-degree or several close relatives that meet one or more of the aforementioned criteria, a close relative carrying a known BRCA1 or BRCA2 mutation, a close relative with male breast cancer
400
The uterine fundus is visible just outside of the vaginal introitus. This is the degree of inversion.
Third degree inversion
400
Per the manufacturer, this the median time to control bleeding with the Jada
3 minutes