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Reproduction > Cancer > Flashcards

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
Q

What is endometriosis?

A
  • endometrial glands and stroma outside the uterine body
26
Q

Risk of malignancy in endometriosis?

A
  • endometrioid carcinoma
27
Q

Commonest type of ovarian cancer?

A
  • epithelial (adenocarcinoma: serous, mutinous, endometriosis/clear cell)
28
Q

Endometrioid adenocarcinoma of the ovary is a associated with what condition?

A
  • endometriosis

- Lynch syndrome

29
Q

Types of ovarian tumours?

A
  • epithelial
  • germ cell
  • sex cord
  • metastatic
30
Q

Explain a Brenner tumour?

A
  • ovarian
  • usually benign
  • tumour of transitional type epithelium (bladder, urethra)
31
Q

Epithelial tumours of the ovary can be classed as what?

A
  • benign
  • borderline
  • malignant
32
Q

Commonest germ cell tumour of the ovary and its presentation?

A
  • mature teratoma

- sebum, hair, teeth

33
Q

3 main types of sex-cord tumours in the ovary?

A
  • fibroids
  • granulosa cell
  • sertoli-leydig
34
Q

Granulosa tumours of the ovaries are seen with what?

A
  • increased oestrogen
35
Q

Sertoli-leydig cells of the ovary cause what?

A
  • rare

- androgen production

36
Q

What staging is used for ovarian cancers and describe the rough outline?

A
  • 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
Q

What must be considered in bilateral ovarian cancer?

A
  • metastatic origin?
38
Q

Commonest site for an ectopic pregnancy?

A
  • Fallopian tubes
39
Q

What cell type is the ectocervix?

A
  • stratified squamous epithelium
40
Q

What cell type is the endocervix?

A
  • single layer of glandular columnar epithelium
41
Q

During a smear test what is sampled?

A
  • exfoliating cells from the transformation zone, between endocervix and ectocervix
42
Q

What is cervitis and its causes?

A
  • irritation of the cervix
  • chlamydia
  • HSV
43
Q

Risk factors for CIN?

A
  • Persistence of high risk HPV
  • Long term oral contraceptives
  • smoking
  • immunosuppression
44
Q

Koilocytosis is what?

A
  • virally infected cells on histology

- seen in Genital warts and CIN

45
Q

Timeline for the development of CIN?

A
  • 6mnths - 5yrs
46
Q

Timeline for development of cervical cancer?

A
  • 5-20yrs
47
Q

Whirls of keratin on histology of the cervical transformation zone, indicates?

A
  • cervical cancer
48
Q

Cervical intraepithelial neoplasia is what?

A
  • dysplasia at the transformation zone
49
Q

How will CIN appear on microscopy?

A
  • delay in maturation of cells
  • increased nucleus:cytoplasm
  • mitotic figures
50
Q

How is CIN staged?

A
  • CIN 1 = Less than 1/3
  • CIN 2 = 2/3
  • CIN 3 = full thickness (carcinoma in situ)
51
Q

Majority of cervical cancers develop from what?

A
  • pre-existing CIN
52
Q

How are cervical cancers staged?

A
  • FIGO
53
Q

Commonest cell type for a cervical cancer?

A
  • squamous cell
54
Q

Symptoms of CIN

A
  • Asymptomatic
55
Q

Symptoms of cervical cancer

A
  • abnormal bleeding
  • pelvic pain
  • haematuria
56
Q

Precurosor of adenocarcinoma of the cervix?

A
  • cervical glandular intraepithelial neoplasia (CGIN)
57
Q

Background history with someone with vulval intraepithelial neoplasia?

A
  • inflammatory dermatosis e.g. lichen sclerosis

- HPV

58
Q

Vulva intraepithelial neoplasia may develop into?

A
  • SCC
59
Q

Lichen sclerosis has a risk of what?

A
  • vulval scc
60
Q

Symptoms of Vulval padgets disease?

A
  • crusting rash

- painful

61
Q

Name HPV driven neoplasia?

A
  • cervical intraepithelial neoplasia
  • cervical glandular intraepithelial neoplasia
  • vulvar intraepithelial neoplasia
  • vaginal intraepithelial neoplasia
  • anal intraepithelial neoplasia

Reproduction (25 decks)

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