PLENO TUTORIAL 4

DOWN SYNDROME
Kelompok 3
Eileen Euides
Handry Baso P.M.
Nofyanti Tangkudung
Putu Wahyu
Linda Mutiah
Amelia Tiro
Nurul Syafitrah
Fandy P.Andilolo
Angriana Himran
Tirza Glady R.
Ita Indah Agustini
Main
Map

Scenario
Unfamiliar
Terms
Problems
Learning
Objectives

Questio
Reference
n

Menstrual Bleeding in Old Woman

Mrs.Agusta is a 53 years old woman whose

last menstrual period was approximately three
years ago. She presents to her family
practitioner complaining of uterine bleeding
similiar to a period. She has no history of prior
oral contraceptive use of hormone therapy.
On pelvic examination, no blood is found in
her vagina vault. A pap smear is perfomed.
On the bimanual examination, her uterus is
slightly enlarged and no adnexal masses are
palpated, although her examination is difficult
due to body habitus.

The family practitioner is suspicious for

endometrial cancer and refers the patient to a
gynecologist, who performs an endometrial
biopsy and endocervical curretage. A large
amount of heterogenous tissue is obtained
during the endometrial biopsy. A pathologic
review of the biopsy demonstrates the presence
of endometriod, adenocarcinoma grade 2, and
a negative endocervical curretage. When the
pap smear is review, abnormal glandular cells
are identified.

Unfamiliar Terms
No.

Unfamiliar
Terms

Roots,Word

Prefix

Suffix Meaning

1.

Pelvic
examination

W: Pelvic,
examination

Pelvic=wide curved set

of bones at the bottom
of the body that legs
and spine are
connected to
Examination = test to
build diagnostic
= test to build
diagnostic on pelvic

2.

Biopsy

R: Bi/o

opsy

Bio = life
Opsy = process of
viewing
= take sample
microscopic from life
tissue for ensure
diagnostic

No.

Unfamiliar
Terms

Roots,Word Prefix

Suffix Meaning

3.

Uterine Bleeding

W: Uterine,
bleeding

Uterine = pertaining to
womb
Bleeding = exisiting blood
= exisiting blood from
womb

4.

Oral

R: Oral

Oral = month

5.

Adnexall masses

W: adnexal

Adnexal = pertaining to
part of pelvic
Masses mass (plural)
= adding mass on
adnexal

6.

Uterus

W: Uterus

Uterus = womb

7.

Pap Smear

W: Pap
Smear

Pap = abbreviation from

Papinocelau
= screening test to
determine condition
woman organ genital

8.

Curretage

W:Curretage -

Curretage = cleening
surface of disease from

No.

Unfamiliar
Terms

Roots,Word Prefix

Suffix Meaning

9.

Endometrial

R: metri/o

endo

al

10.

Adenocarcinoma

R: aden/o

carcin/o oma

Aden/o= gland
carcin/o= cancerous
oma = tumor
= cancerous gland tumor

11.

Endocervical

R : cervic

endo

al

Cervic = neck of womb

Endo = within
al = pertaining to
= pertaining to within
neck of womb

12.

Glandular

R : Gland

Glandular = plural form

gland

13.

Practitioner

W:
Practitioner

Practitioner = man that

fulfill to be doctor and
involved in medical
practice

metri/o= womb
Endo = within
al = pertaining to
= pertaining to within of
womb

No.

Unfamiliar
Terms

Roots,Word Prefix

Suffix Meaning

14.

Heterogenous

R : gen/o

Hetero

ous

Gen/o = producer
Hetero = various
Ous = pertaining to
= various in composition,
quality and structure

15.

Gynecologist

R: Gynec/o

Logos

Ist

Gynec/o= woman/female
Logos = knowledge
Ist = one who specialist in
= one who specialist in
reproductive organ of
female

16.

Vagina vault

W: Vagina
W : Vault

Vagina = the outer female

reproductive organ
Vault = room with thick
walls

17.

Obtained not
Medical
terminology

Obtained = to produce

No.

Unfamiliar
Terms

Roots,Word

Prefi
x

Suffix Meaning

18.

Contraceptive

W:
Contraceptive

Contraceptive = reduce
possibility forming or
prevent conception

19.

Hormoen therapy

R : Hormone
Therapy

Hormon therapy =
medical treatment by
giving hormone

20.

Blood

W: Blood

Blood = red liquid that

flows through your body

21.

Oral
contraceptive

W : Oral
Contraceptive

Oral = month
Contraceptive = reduce
possibility forming or
prevent conseption
= hormonal compound
orally for reduce
conception

Problems
1. What cause old woman being bleeding?
2. What is the difference between pelvic
examination and bimanual examination?
3. Why on pelvic examination, no blood in her
vagina vault?
4. What is the definition endometrium cancer?
5. How about the management of this scenario?
6. How about the preventif of this scenario?
7. How about the prognosis of this scenario?
8. How long thickness of endometriod being
categorized carcinoma?
9. Whats the function of paps smear?

Learning objectives
Number 1-10

Main Map
Definition

Prevention

Etiology

Endometrial Cancer

Diagnosis

Management

Prognosis

Defenition
Endometrial cancer is disease in which malignant
(cancer) cells form in the tissues of the
endometrium, especially in postmenopausal women
primarily caused changes in hormne levels and the
main symptom is abnormal bleeding. According to,
Transvaginal USG, the thickness of endometriod
more than 5 mm should be investigated more to
make sure categorized endometrial cancer or not.

1. What cause old women being bleeding?

5. What is endometrium cancer?

Diagnosis
On pelvic examination, there are some ways: such
as:
Bimanual examination
examination by inserting two fingers into vagina
vault, and the other hand is placed over the
abdomen

2. What is the difference between

pelvic examination and bimanual
examination?

Pap smear is a screening test with

microscopic examination of cells taken from
the walls of cervical smears
sitohormonal evaluation, determine a
woman's hormonal status, presence or
absence of hormonal disorders,
inflammatory diagnosis and identification of
microorganisms that cause inflation, early
detection of pre-cancerous

9. Whats the function of

paps smear?

Biopsy
Endometrial biopsy is a procedure in
which a tissue sample is taken from
the lining of the uterus (endometrium),
and is checked under a microscope for
any abnormal cells or signs of cancer.

Management
Management for carcinoma endometriod is given
based on the stadium of that.
Stadium I, surgery (total abdominal hysterectomy and
bilateral oophorectomy),radiotherapy,chemotherapy
Stadium II, surgery (radical hysterectomy)

5. How about the management

of this scenario?

Stadium III, radiotherapy, hormon

therapy,chemoteraphy
Stadium IV, Internal and external radiaton therapy,
chemotherapy.

Prognosis
Prognosis of carcinoma endometriod
running well,cause the 80-85%,
carcinoma was find at stadium I.
Prognosis in the 5 years later, see in
following:
Stadium I : 75-90%
Stadium II : 50-60%
Stadium III : 20-30%
Stadium IV : 5-10%
7. How about the prognosis of
this scenario?

Preventio
n

- Straighten up the intake pattern, avoid instant food that cock

of cancer, routine to drink milk, general check up pap smear,
do exercise, avoid smoke, keep the reproductive organ health

6. How about the preventif of this scenario?

Reference:
Books:
Kumala Poppy, Kamus Kedokteran Ed.25, EGC, Jakarta.
Jones & Derek Llewellyn, 2002, Dasar-Dasar Obstetri&
Ginekologi Ed.6, Penerbit Hippokrates, Jakarta.
Norwitz & Schorge, 2006, Obstetrics&G ynaecology at a
Glance Sec Ed, Blackwell Publisher, USA.
Parisaei & Shailendra, 2008,Obstetrics&Gynaelogy,
Mosby Elsevier, UK.
Website:
http://www.oncolink.org/types/section.cfm?c=6&s=18,
accesed on 30th November 2011

Question
1.
2.
3.

THANK YOU