Female GU Flashcards by Scott White

Breast cancer RFs

early menarche
later menopause
HRT
obesity
Alcohol

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BC SS

Lump (altered shape/size/feel)
pain
skin changes (puckering, dimpling, rash, redness)
nipple changes (tethering, inversion, discharge)

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BC Ix

Examination
Imaging
FNA
Biopsy

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BC Tx

Surgery (WLE)

radiotherapy

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What is BC grading based on

Nuclear pleomorphism
No of mitoses per mm
degree of gland formation

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Classes of BC

Invasive ductal carcinoma

Invasive lobular carcinoma

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What is tamoxifen

Oestrogen receptor antagonist (80% of BCs overexpress ERs)

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What is letrazole

Aromatase inhibitor (prevents conversion of androgens to oestrogen)

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What is the transformation zone

area of unstable differentiation where most cervical neoplasia develop

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What is cervical intraepithelial neoplasia (CIN)

replacement of normal squamous epi by neoplastic cells- precursor to invasive squamous carcinoma

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Features of CIN

hyperchromasia
pleomorphism
abnormal maturation/mitoses

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High risk types of HPV

Types 16 and 18

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Cervical screening schedule

smears taken every 3-5y from 25-64

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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

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What does cervical smear sample

Cells from TZ for changes assoc with HPV/CIN

If CIN 2/3 is detected: loop excision of tz

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Cervical cancer RFs

early age at 1st intercourse
high no of sexual partners
working class
HPV

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CC staging

1: cervix
2: beyond cervix
3: pelvic wall/ureters/ lower vagina
4: bladder/ rectum/ beyond pelvis

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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) ```