Female GU

Question 1

CIN

Answer 1

pre malignant transformation and dysplasia of the squamous cells on the surface of the cervix

Question 2

Presenting complaint cervical cancer

Answer 2

post coital bleeding

mucoid vaginal discharge

Question 3

Risk factors for cervical cancer

Answer 3

HPV (16 and 18)
Smoking
oral contraceptives
multiple pregnancies
early age of sexual intercourse
multiple sexual partners

Question 4

Clinical features of endometriosis

Answer 4

severe pain and dysmenorrhea
pain during intercourse
infertility
chronic fatigue

Question 5

Meig syndrome

Answer 5

benign ovarian fibroma
malignant ascites
pleural effusion

Question 6

Theories of endometriosis

Answer 6

retrograde menstruation
dissemination of endometrial cells
decreased cell mediated immune response

Question 7

Fibroids

Answer 7

benign leiomyomas

whorled pattern like silk

Question 8

HPV infection: Early genes E6 and 7

Answer 8

inactivate p53 and TSGs - allow amplification of the viral genome

Question 9

HPV late genes: L1 and 2

Answer 9

encode capsid proteins

Question 10

Ovarian stromal hyperplasia

Answer 10

non neoplastic proliferation of ovarian stream cells

Question 11

Sclerosing adenosis

Answer 11

benign proliferation of glandular tissue and stroma

multiple small lumps, microcalcification

Question 12

Radial scars

Answer 12

sclerosing duct hyperplasia

hyperplastic tissue cells and a central fibrous core
asoc with DCIS

Question 13

Lysozyme

Answer 13

enzyme in mucosal surfaces that can break down gram positive cell walls

Question 14

Lctoferrin

Answer 14

PROTEIN found at mucosal surfaces that chelates iron which inhibits bacterial growth

Question 15

3 function of antibodies

Answer 15

opsonise pathogens
activate complement
neutralise toxins

Question 16

function of Th1, Th2, Th17, T reg

Answer 16

Th1: IFN gamma secretion

Th2: allergic reactions

Th17: recruits neutrophils, host defence at mucosal surfaces

Treg: immunosuppressive - maintain tolerance

Question 17

Encapsulated organism

Answer 17

n. meningitidits
strep pneum
haemophilus influenzae

Question 18

Components of virchows triad (clotting)

Answer 18

hypercoaguable - pregnant, malignancy, oestrogen

vascular wall injury - atherosclerosis, trauma

circulatory stasis - AF, left vent dysfunction

Question 19

Three blood vessel changes in inflammation

Answer 19

Increased permeability
vasodilation
endothelial activation

Question 20

How is the immune response terminated

Answer 20

neutrophils short half life in tissues
short half life of inflammatory mediators
production of anti inflammatory cytokines eg. TGF beta
neural impulses inhibit TNF
cytokines released in cascades

Question 21

Activation of kinin system and function

Answer 21

factor XII

create proteins which sustain vasodilation

Question 22

C5a

Answer 22

chemotaxic for neutrophils
increased vascular permeability
release of histamine from mast cells

Question 23

C3b

Answer 23

opsonisation of bacteria

Question 24

Benefits and harm of acute inflammation

Answer 24

benefits: dilution of toxins, delivers immune cells and nutrients, fibrin traps micro-organisms, stimulation of immune response
detrimental: swelling of soft tissues, digestion of normal tissues and inappropriate response eg. hypersensitivity

Question 25

Definition of sepsis

Answer 25

The presence of a likely or confirmed infection, in addition to a life threatening organ dysfunction caused by a dysregulated host response to the infection

Question 26

qSOFA

Answer 26

bedside scoring system to assess end organ failure and determine if a patient has sepsis

BP < 100
GCS <15
Resp rate > 22

Question 27

characteristics of chronic inflammation

Answer 27

persistent and lacks resolution, inflammatory infiltrate and leads to some degree of organisation and scarring

Question 28

chronic granulomatous disease

Answer 28

defect in NADPH oxidase system within phagocytes

inability to kill organisms by respiratory burst