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Cancer Flashcards

1
Q

Causes of abnormal uterine bleeding?

A
  • endometritis
  • polyp
  • adenomyosis
  • leiomyoma
  • endometrial hyperplasia
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2
Q

What is endometrial hyperplasia? And what are the different types?

A
  • increase in the number of cells in an organ or tissue
  • simple
  • complex
  • atypical
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3
Q

Peak incidence for endometrial carcinoma?

A
  • age 50-60yrs
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4
Q

What must you consider in endometrial carcinoma in the young?

A
  • consider underlying predisposition
  • PCOS
  • Lynch syndrome
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5
Q

How is obesity linked to endometrial carcinoma?

A
  • Adiopocytes -> increased oestrogen

- insulin action altered -> proliferation

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6
Q

2 main types of endometrial carcinoma?

A
  • type 1 (endometroid carcinoma and mucinous)

- type 2 (serous carcinoma and clear cell)

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7
Q

Endometriod carcinoma precursor?

A
  • atypical hyperplasia
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8
Q

Causes of endometrioid carcinoma?

A
  • unopposed oestrogen excess
  • obesity
  • PTEN, KRAS mutation
  • Lynch syndrome
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9
Q

Symptoms of endometrial carcinoma?

A
  • abnormal bleeding
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10
Q

Typical spread of endometrial carcinoma?

A
  • direction -> myometrium
  • lymphatic
  • vascular
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11
Q

What is Lynch syndrome and what are its risks?

A
  • hereditary non-polyposis colorectal cancer syndrome

- risk: colorectal cancer, endometrial cancer

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12
Q

Explain type 2 endometrial cancer?

A
  • serous carcinoma
  • clear cell carcinoma
  • not associated with oestrogen excess
  • = TP53 mutation
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13
Q

Name 2 other endometrial carcinomas that aren’t type 1 or 2?

A
  • endometrial stromal sarcoma

- carcinosacroma

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14
Q

Name a benign abnormality of the myometrium?

A
  • leiomyoma

- aka. fibroids

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15
Q

Name a malignant smooth muscle tumour of the uterus?

A
  • leiomyosarcoma
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16
Q

Methods of hysterectomy?

A
  • open
  • laparoscopic
  • robotic
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17
Q

Benefits of minimal access surgery?

A
  • lesser risk of bleeding and infection
  • enchanted recovery
  • reduced VTE risk
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18
Q

Fertility preserving cervical cancer treatments?

A
  • LLETZ/Cone biopsy

- trachelectomy

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19
Q

Non-fertility sparing treatment of cervical cancer?

A
  • hysterectomy

- radical hysterectomy

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20
Q

What is a radical hysterectomy?

A
  • Hysterectomy + bilateral salpingo-oophorectomy +/- pelvic node dissection
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21
Q

What is the management of ovarian cancer?

A
  • CT
  • RMI score
  • staging lapotomy
  • radical debulking and pelvic clearance
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22
Q

What is radical debulking and pelvic clearance?

A
  • hysterectomy + bilateral salpingo-oophorectomy + infracolic omentectomy
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23
Q

Treatment of vulval cancer?

A
  • wide local excision

- 1cm free bargain

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24
Q

Commonest type of ovarian cyst?

A
  • follicular
  • seen in PCOS
  • Thin walled, lined by granulosa cells
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25
What is endometriosis?
- endometrial glands and stroma outside the uterine body
26
Risk of malignancy in endometriosis?
- endometrioid carcinoma
27
Commonest type of ovarian cancer?
- epithelial (adenocarcinoma: serous, mutinous, endometriosis/clear cell)
28
Endometrioid adenocarcinoma of the ovary is a associated with what condition?
- endometriosis | - Lynch syndrome
29
Types of ovarian tumours?
- epithelial - germ cell - sex cord - metastatic
30
Explain a Brenner tumour?
- ovarian - usually benign - tumour of transitional type epithelium (bladder, urethra)
31
Epithelial tumours of the ovary can be classed as what?
- benign - borderline - malignant
32
Commonest germ cell tumour of the ovary and its presentation?
- mature teratoma | - sebum, hair, teeth
33
3 main types of sex-cord tumours in the ovary?
- fibroids - granulosa cell - sertoli-leydig
34
Granulosa tumours of the ovaries are seen with what?
- increased oestrogen
35
Sertoli-leydig cells of the ovary cause what?
- rare | - androgen production
36
What staging is used for ovarian cancers and describe the rough outline?
- FIGO staging ``` 1 a = 1 ovary 1 b = both ovaries 1 c = ovary surface involvement 2 a = uterus or tubes involved 2 b = pelvic organ involvement 3 a = seeding outside true pelvis 3 b = gross outside pelvis = 2cm 3 c = gross outside pelvis > 2cm 4 = distant metastasis ```
37
What must be considered in bilateral ovarian cancer?
- metastatic origin?
38
Commonest site for an ectopic pregnancy?
- Fallopian tubes
39
What cell type is the ectocervix?
- stratified squamous epithelium
40
What cell type is the endocervix?
- single layer of glandular columnar epithelium
41
During a smear test what is sampled?
- exfoliating cells from the transformation zone, between endocervix and ectocervix
42
What is cervitis and its causes?
- irritation of the cervix - chlamydia - HSV
43
Risk factors for CIN?
- Persistence of high risk HPV - Long term oral contraceptives - smoking - immunosuppression
44
Koilocytosis is what?
- virally infected cells on histology | - seen in Genital warts and CIN
45
Timeline for the development of CIN?
- 6mnths - 5yrs
46
Timeline for development of cervical cancer?
- 5-20yrs
47
Whirls of keratin on histology of the cervical transformation zone, indicates?
- cervical cancer
48
Cervical intraepithelial neoplasia is what?
- dysplasia at the transformation zone
49
How will CIN appear on microscopy?
- delay in maturation of cells - increased nucleus:cytoplasm - mitotic figures
50
How is CIN staged?
- CIN 1 = Less than 1/3 - CIN 2 = 2/3 - CIN 3 = full thickness (carcinoma in situ)
51
Majority of cervical cancers develop from what?
- pre-existing CIN
52
How are cervical cancers staged?
- FIGO
53
Commonest cell type for a cervical cancer?
- squamous cell
54
Symptoms of CIN
- Asymptomatic
55
Symptoms of cervical cancer
- abnormal bleeding - pelvic pain - haematuria
56
Precurosor of adenocarcinoma of the cervix?
- cervical glandular intraepithelial neoplasia (CGIN)
57
Background history with someone with vulval intraepithelial neoplasia?
- inflammatory dermatosis e.g. lichen sclerosis | - HPV
58
Vulva intraepithelial neoplasia may develop into?
- SCC
59
Lichen sclerosis has a risk of what?
- vulval scc
60
Symptoms of Vulval padgets disease?
- crusting rash | - painful
61
Name HPV driven neoplasia?
- cervical intraepithelial neoplasia - cervical glandular intraepithelial neoplasia - vulvar intraepithelial neoplasia - vaginal intraepithelial neoplasia - anal intraepithelial neoplasia

Reproduction (25 decks)

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