Cancer

Question 1

where in the cervix does cervical cancer arise

Answer 1

in the transformation zone - this is where there is natural metaplasia of glandular epithelia from the endocervix to squamous epithelia found in the exocervix

Question 2

how does HPV cause cervical cancer

Answer 2

expresses the viral protein E6 and E7 which inhibit the tumour suppressor gene p53 and pRB - this means theres increased cell proliferation and less DNA repair

Question 3

which HPV strains are high risk for cervical cancer

Answer 3

16 and 18

Question 4

what are risk factors for cervical cancer

Answer 4

HPV 
immunodeficiency 
smoking 
multiple births 
multiple partners 
oral contraceptive pill

Question 5

what is a Pap test

Answer 5

where cells from the transformation zone of the cervix are scraped off, stained and examined

Question 6

what is colposcopy

Answer 6

where the is a visual examination of the cervix

Question 7

when does cervical screening start and how often is it repeated

Answer 7

at 25 and repeated every 5 years

Question 8

what are the advantages of the HPV vaccination to boys

Answer 8

prevents penile cancer

acts as herd immunity as penile cancer can also cause cervical cancer

Question 9

what is CIN

Answer 9

cervical intraepithelial neoplasm - where there is dysplasia of the squamous cells but it has not breached the basement membrane

Question 10

what levels of CIN may regress on its own

Answer 10

I and II

Question 11

what is CIN III

Answer 11

carcinoma in situ - lots of squamous dysplasia but just not breached the basement membrane yet

Question 12

what is the most common types of cervical carcinomas

Answer 12

80% = squamous cell carcinomas 
20% = adenocarcinomas

Question 13

what type of cancer are vulval tumours usually

Answer 13

squamous cell carcinomas

Question 14

what is the most common cause of vulval cancer in pre-menopausal women

Answer 14

HPV

Question 15

what are the most common causes of vulval cancer in post-menopausal women

Answer 15

vulval irritation/inflammation:

• squamous hyperplasia
• Lichen sclerosis

Question 16

what is Lichen sclerosis

Answer 16

fibrosis of the superficial dermis causing chronic irritation giving squamous abnormalities

Question 17

what is VIN

Answer 17

vulval intraepithelial neoplasm - abnormal squamous cells which havent invaded through the basement membrane - precursor to squamous cell carcinoma

Question 18

where do vulval carcinomas spread

Answer 18

inguinal, pelvic, iliac and para-aortic lymph nodes

Question 19

what are the risk factors of endometrial cancer

Answer 19

high oestrogen exposure causing hyperplasia:

• obesity
• exogenous oestrogen
• annovulation

Question 20

why can obesity increase the risk of endometrial hyperplasia

Answer 20

adipose tissue contains the enzyme aromatase which converts androgens to oestrogen so theres an increase in circulating oestrogen

Question 21

what type of cancer is endometrial cancer

Answer 21

adenocarcinomas

Question 22

what are the 2 types of endometrial adenocarcinomas

Answer 22

1. endometrioid endometrial adenocarcinomas

2. serous adenocarcinoma

Question 23

which type of endometrial adenocarcinoma gives a worse prognosis

Answer 23

serous adenocarcinoma - spreads more easily

Question 24

what type of cancer is found in the myometrium

Answer 24

leiomyomas (fibroids) - bengin, smooth muscle tumours

Question 25

what symptoms are seen with myometrial tumours

Answer 25

heavy/painful periods, urinary frequency, infertility

Question 26

what tumour markers are seen with testicular cancer

Answer 26

alpha fetoprotein and HCG

Question 27

what type of germ cell tumours are seen in males

Answer 27

seminomas or non-seminomatous

Question 28

what are non-seminomatous tumours usually made up of

Answer 28

a mixture of yolk sac tumour, choriocarcinomas, teratomas and embryonal tumours

Question 29

in what ages are teratomas in males benign/malignant

Answer 29

bengin in pre-puberty | malignant in post-puberty

Question 30

what are the most common types of sperm cord-stomal tumours in males

Answer 30

sertoli or leydig cell tumours

Question 31

what tumour marker is seen in ovarian cancer

Answer 31

CA-125

Question 32

how is the contraceptive pill protective of ovarian cancer

Answer 32

reduces ovulation so means theres less trauma and scarring/healing of the ovaries

Question 33

what are the 4 classifications of ovarian cancers

Answer 33

mullerian epithelium tumours germ cell tumours sperm cord-stroma tumours metasises

Question 34

what are the 3 types of mullerian epithelia tumours

Answer 34

serous mucinous endometrioid

Question 35

what are the types of germ cell cancer in the ovaries

Answer 35

teratomas, yolk sac tumour, embryonal, choriocarcinomas

Question 36

what are the 3 types of teratomas in females

Answer 36

bengin, malignant or monodermal

Question 37

what are monodermal teratomas

Answer 37

tumours composed of thyroid tissue so can cause hyperthyroidism if functional

Question 38

what are teratomas

Answer 38

tumours containing hair, sebaceous glands, teeth and a range of other tissue

Question 39

what are mucinous tumour like

Answer 39

cystic, benign and glandular

Question 40

where do serous tumour spread

Answer 40

to peritoneal surfaces causing ascites

Question 41

what are endometrioid tumours

Answer 41

tumours which resemble endometrial glandular tissue

Question 42

what is a kruckenberg tumour

Answer 42

tumour from the stomach which spreads to the ovaries

Question 43

what 2 types of sex cord-stroma tumours are seen in females

Answer 43

feminising - made up of granulose/theca cells | masculinising - made up of sertoli/Leydig cells