Female GU Flashcards
Breast cancer RFs
early menarche later menopause HRT obesity Alcohol
BC SS
Lump (altered shape/size/feel)
pain
skin changes (puckering, dimpling, rash, redness)
nipple changes (tethering, inversion, discharge)
BC Ix
Examination
Imaging
FNA
Biopsy
BC Tx
Surgery (WLE)
radiotherapy
What is BC grading based on
Nuclear pleomorphism
No of mitoses per mm
degree of gland formation
Classes of BC
Invasive ductal carcinoma
Invasive lobular carcinoma
What is tamoxifen
Oestrogen receptor antagonist (80% of BCs overexpress ERs)
What is letrazole
Aromatase inhibitor (prevents conversion of androgens to oestrogen)
What is the transformation zone
area of unstable differentiation where most cervical neoplasia develop
What is cervical intraepithelial neoplasia (CIN)
replacement of normal squamous epi by neoplastic cells- precursor to invasive squamous carcinoma
Features of CIN
hyperchromasia
pleomorphism
abnormal maturation/mitoses
High risk types of HPV
Types 16 and 18
Cervical screening schedule
smears taken every 3-5y from 25-64
Smear reporting
-ve: repeat in 3y
Borderline: repeat 6m (3 borderlines: refer colposcopy)
mild/moderate/severe dyskaryosis: refer colposcopy
Invasive features: urgent referall to colposcopy
What does cervical smear sample
Cells from TZ for changes assoc with HPV/CIN
If CIN 2/3 is detected: loop excision of tz
Cervical cancer RFs
early age at 1st intercourse
high no of sexual partners
working class
HPV
CC staging
1: cervix
2: beyond cervix
3: pelvic wall/ureters/ lower vagina
4: bladder/ rectum/ beyond pelvis
3 vaginal infections
thrush
trichomoniasis
bacterial vaginosis
5 diseases of the vulva
skin tags melanocytic naevi benign cysts lichen planus extra-mammary pagets
Dysfunctional uterine bleeding definition
menstruation irregularity e.g. intermenstrual bleeding/ menorrhagia
Endometriosis def
endometrial glands and stroma present outside uterus
causes inflammation, cysts, scars
Adenomyosis def
extension of basal endometrium into myometrium
Stages of endometrial carcinoma
1a: confined to myometrium (inner half)
1b: outer half
2: involves cervical stroma
3A: involves serosa
B: involves vagin
C: involves pelvic/para-aortic nodes
4A: involves bladder/bowel mucosa
B: distant metastases
Endometrial carcinoma tx
low rx: salpino-oophorectomy
high rx: lymphadenectomy
chemo/radio
Leiomyoma def
benign smc tumour of uterus
can cause dysmenorrhoea, menorrhagia
What is malignant form of leiomyoma
Leiomyosarcoma
can cause haem/necrosis, metastases
Salpingitis def and SS
inflammation of ovarian tube
fever, pelvic pain, pelvic masses
Types of ovarian neoplasm
Surface epithelial
Germ cell
Stromal/sex cord
RFs for ovarian cancer
Fhx (BRCA1, HER2, KRAS)
nulliparity
Classes of surface epi tumour
benign: cystic, may have solid stromal component
Borderline: limited invasive potential
Malignant
What are psammoma bodies
calcified concretions present in papillae of serous tumours
What are germ cell tumours usually
mature cystic teratomas (95%) with hair, skin, teeth etc
Types of stromal tumour
Granulosa
theca cell
Meigs syndrome
ovarian fibroma
ascites
pleural effusion
Brenner tumour def
mixed surface epi and stromal tumours
Types of surface epi tumour
High grade serous Low grade serous endometroid clear-cell mucinous
Types of benign breast condition
Developmental Stromal Inflammatory Fibrocystic Neoplasms
2 examples of developmental breast conditions
ectopic tissue (usually on milk line between axilla and groin) Breast hypoplasia
3 examples of stromal breast conditions
juvenile hypertrophy (overgrowth during puberty) diabetic fibrous mastopathy (assoc with T1DM) Pseudo-angiomatous stromal hyperplasia (over-proliferation of myofibroblasts)
Examples of inflammatory breast conditions
Acute mastitis (cellulitis assoc with feeding) Inflammatory BC foreign body infections (implants) periductal mastitis sub areolar abscess
Examples of fibrocystic breast condition
cysts (can be multifocal, bilateral)
apocrine metaplasia
papilloma (benign tumour of epi lining mammary ducts)
Classification of breast cysts
non-proliferative (no risk of BC)
proliferative without atypia (2x risk of BC)
proliferative with atypia (5x risk of BC)
Fibroadenoma definition
benign overgrowth of epi and stroma
Phyllodes tumour
Phases of endometrium
Proliferative (small tubular glands in stroma; mitotic figures) Secretory (vascular stroma; spiral glandular structures) Menstrual phase (large amount of blood, fragmented tissue)
