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CP > Breast & Gynaecology Pathology > Flashcards

Breast & Gynaecology Pathology Flashcards

1
Q

What are the types of intraepithelial neoplasia?

A 
Cervical intraepithelial neoplasia
Cervical glandular intraepithelial neoplasia
Vulval intraepithelial neoplasia 
Vaginal intraepithelial neoplasia
Anal intraepithelial neoplasia
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2
Q

What happens if dysplasia is removed?

A

It is curative but if it is left, there is a chance of developing an invasive malignancy

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3
Q

HPV is what type of virus?

A

Double stranded DNA

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4
Q

What are the low risk HPVs?

A

6 and 11

40, 42, 43, 44, 53

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5
Q

What are the high risk HPVs?

A

16 and 18

31, 33, 35, 39, 58, 59

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6
Q

What are low risk and high risk HPVs associated with?

A

low risk= genital warts

high risk= pre-invasive and invasive diseases

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7
Q

What is a condylomata? What HPV is it associated with?

A

benign squamous neoplasm

6 and 11

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8
Q

Which HPVs are protected against in Gardasil?

A

6, 11, 16 and 18

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9
Q

Which HPVs are protected against in Cervarix?

A

16 and 18

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10
Q

What do high risk HPVs do in the cell?

A

upregulate E6 and E7 expression

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11
Q

What does E6 do? What does E7 do?

A

E6 inactivates p53

E7 binds to RB1 gene products

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12
Q

what does p53 do?

What does RB1 do?

A

p53 mediates apoptosis

RB1 is a tumour suppressor gene

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13
Q

What is the transformation zone?

A

An area of squamous metaplasia

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14
Q

Where is a CIN likely to develop?

A

Transformation zone

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15
Q

What is different about the transformation zone in post-menopausal women?

A

It is not easily excised via LLETZ

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16
Q

What is the pre-inasive stage of cervical SCC?

A

Cervical intraepithelial neoplasia

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17
Q

What is the aim of the cervical screening programme?

A

detection of CIN

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18
Q

When are women first invited for cervical screening?

A

25

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19
Q

Who is screened every 3 years and 5 years for cervical cancer?

A

3 years= 25-49

5 years= 50-64

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20
Q

What are the risk factors for cervical squamous cell carcinoma?

A 
high risk HPVs
multiple sexual partners 
young age at first intercourse
low socioeconomic groups 
smoking 
immunosuppression
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21
Q

What is the precursor for cervical adenocarcinoma?

A

CGIN

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22
Q

How is cervical carcinoma staged?

A

FIGO

I- confined to cervix
II- invades uterus wall
III- extends to pelvic wall
IV- invades bladder or rectum

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23
Q

How deep are Stage IA2 tumours?

A

3-5mm

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24
Q

What types of vulvular intraepithelial neoplasia occurs in older women?

A

Differentiated

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25
Q

Is warty/basaloid VIN associated with HPV?

A

Yes

It is graded from 1-3

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26
Q

Lichen sclerosus is associated with

A

inflammatory dermatoses in those over 70 and there is a 15% chance of malignancy risk

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27
Q

Extra-mammary Paget’s disease is

A

an in situ adenocarcinoma of squamous mucosa

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28
Q

The most important prognostic factor in malignant melanoma is

A

Breslow thickness

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29
Q

How does malignant melanoma frequently spread?

A

via the urethra

30
Q

What is endometriosis?

A

Ectopic endometrium around the body

31
Q

How is endometriosis treated?

A

OCP
GnRH agonists
Progesterone antagonist
Ablation

32
Q

Endometritis presents as

A

abdo pain
pyrexia
discharge
dysuria

33
Q

What can cause endometritis?

A

Pelvic Inflammatory Disease

Endometrial TB

34
Q

What are polypoid estradiol-dependent uterine overgrowths?

A

Endometrial polyps

35
Q

How do endometrial polyps present?

A

Menorrhoagia

Dysmenorrhoea

36
Q

What are leiomyomas?

A

Uterine fibroids

benign myometrial tumours

37
Q

What are risk factors for uterine fibroids?

A

Genetics
Obesity
PCOS
HTN

38
Q

What can uterine fibroids present as?

A

Menometorrhagia (Fe deficient anaemia)

Subfertility

39
Q

The risk factors for endometrial hyperplasia are

A 
obesity
exogenous estradiol
PCOS
Tamoxifen 
HNPCC
40
Q

What is a histological presentation of endometrial adenocarcinoma?

A

Invasion into the myometrium

41
Q

What is the most common cancer of the female genital tract?

A

Endometrial carcinoma

42
Q

What type of endometrical carcinoma presents in post-menopausal women?

A

Serous

43
Q

What is the Rotterdam criteria?

A

Used to diagnose PCOS and requires 2/3 of:

polycystic ovaries on US
hyperandrogenism
irregular periods (>35 days)
44
Q

How do you treat PCOS?

A

Weight loss
Metformin, OCP
Ovarian drilling

45
Q

What does primary failure of gonads cause?

A

Hypergonadotropic hypogonadism

46
Q

Hypergonadotropic hypogonadism can be caused by

A

Turner syndrome, Klinefelter’s syndrome

Infection, surgery and toxins

47
Q

Secondary failure of the gonads is caused by

A

Hypothalamic/Pituitary failure

48
Q

What does hypogonadotropic hypogonadism cause?

A

Sheehan syndrome
Pituitary tumours
Brain injury

49
Q

How does gonadal failure present?

A

Amenorrhoea and absent menarche

50
Q

Teratomas and yolk sac tumours are examples of

A

Germ cell tumours of the ovary

51
Q

Sertoli-Leydig cell and thecomas are examples of

A

Sex-cord stromal tumours

52
Q

CA125 is a marker for

A

ovarian cancer

53
Q

What is Meig’s syndrome?

A

Ovarian tumour, right sided hydrothorax and ascites

54
Q

What are protective factors for ovarian cancer?

A

OCP, breastfeeding and hysterectomy

55
Q

Mullerian tumours of the ovary are commonly associated with

A

the uterus, fallopian tube, pelvic peritoneum and contralateral ovary

56
Q

Which women are eligble for breast screening?

A

50-70

occurs every 3 years

57
Q

What is the breast triple assessment?

A

Clinical examination
Radiological examination
Pathological examination

58
Q

Fibrocytic changes normally affect

A

pre-menopausal women

59
Q

What group are fibroadenomas most common in?

A

Afro-Caribbean women

60
Q

What is a risk factor for breast cancer?

A

Oestrogens

61
Q

What is commonly seen as microcalcifications on screening?

A

DCIS

62
Q

How is breast cancer assessed?

A

Nottingham Grading System

63
Q

What is the most common type of breast cancer?

A

Ductal

64
Q

Trastuzumab targets

A

HER2

65
Q

Tamoxifen is a

A

hormonally targeted therapy

66
Q

What are the TORCH organisms?

A 
Toxoplasmosis
Other (syphilis, varicella-zoster, parvovirus B19)
Rubella
Cytomegalovirus (CMV)
Herpes infections

They are some of the most common infections associated with congenital anomalies.

67
Q

What are risk factors for puerperal endometritis?

A

C section
prolonged labour
multiple vaginal examinations

68
Q

Pertussis is caused by

A

Bordatella pertussis

69
Q

Impetigo can be caused by what organisms in childhood

A

S. aureus

S. pyogenes

70
Q

Scarlet fever can be caused by

A

Group A beta-haemolytic streptococcus

CP (12 decks)

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