Female GUS

Question 1

What would you see in the endometrium during pregnancy?

Answer 1

Decidualisation

Hypersecretory

Question 2

What would you see in the endometrium during and post menopause?

Answer 2

Atrophy

Inactive

Question 3

What is endometrial hyperplasia associated with?

Answer 3

abnormal bleeding, increased gland: stroma ratio, malignancy potential, prolonged/unopposed oestrogen, PTEN tumour suppressor inactivation, microsatellite instability

Question 4

Two types of endometrial hyperplasia?

Answer 4

Endometrial hyperplasia without atypia (1-3% progress)

Endometrial hyperplasia with atypia (25-30% progress)

Question 5

What is the most common cancer of the female genital tract?

Answer 5

Endometrial Carcinoma

Question 6

Risk factors for endometrial carcinoma?

Answer 6

post-menopause, obesity, DM, infertility, oestrogen excess, microsatellite instability, hypermethylation MLH 1 gene promoter, Lynch syndrome

Question 7

What causes type 1 endometrial carcinoma?

Answer 7

prolonged oestrogen stimulation and hyperplasia

Question 8

What mutation is associated with type 2 endometrial carcinoma?

Answer 8

p53 mutation

Question 9

Most common tumour of female genital tract?

Answer 9

Fibroids/Leiomyomas

smooth muscle

Question 10

Risk factors for cervical carcinoma?

Answer 10

early age at first intercourse
multiple sexual partners
increased parity (no. of pregnancies)
HPV
OCP
smoking
genital infections

Question 11

How are cervical intraepithelial neoplasia detected?

Answer 11

Smear tests (shedding of atypical cells)

Question 12

What are the 3 gradings of CIN?

Answer 12

CIN 1 - mild dysplasia (low grade SIL)
CIN 2- moderate dysplasia (high grade SIL)
CIN 3- severe dysplasia (high grade SIL)

Question 13

Age for cervical cancer?

Answer 13

40-45 yrs

Question 14

What is the most common form of cervical cancer?

Answer 14

SCC (80%)

Question 15

Non-neoplastic cysts of ovary?

Answer 15

follicle cyst
corpus luteal cyst of pregnancy
endometriotic ‘chocolate’ cyst

Question 16

What is endometriosis?

Answer 16

endometrial glands/stroma in sites other than the uterine corpus
causes pelvic inflammation/infertility/pain

Question 17

Surface epithelial tumours of the ovaries?

Answer 17

Serous
Mucinous
Endometroid
Clear Cell
Brenner
Seromucinous

Question 18

Features of serous tumours?

Answer 18

cystic

frequently bilateral

Question 19

Serous tumours benign/borderline/malignant?

Answer 19

Benign- 60%
Borderline- 15%
Serous Carcinoma- 5%

Question 20

Why is there a disproportionate number of deaths caused by serous carcinoma?

Answer 20

normally non-specific symptoms -> in advanced stage in 75% at diagnosis

Question 21

What percentage of serous carcinoma is hereditary and which genes cause it?

Answer 21

15%
BRCA1, BRCA2
p53 mutation

Question 22

Where does serous tubal intraepithelial carcinoma arise?

Answer 22

Fallopian tubes

Question 23

Features of mucinous tumours?

Answer 23

Majority benign
Large and Cystic
Bilateral uncommon, ?mets

Question 24

Which carcinomas are associated with endometriosis?

Answer 24

Endometroid carcinoma

Clear Cell carcinoma

Question 25

Mature teratoma features?

Answer 25

3 germ cell layers
benign cystic
young women
often bilateral
1% malignant transformation

Question 26

Immature teratoma features?

Answer 26

Clinical concern

foetal/embryonic tissue

Question 27

What is a major cause of tubal pregnancy?

Answer 27

Chronic salpingitis (35-50%)

Question 28

What is Kruckenberg tumour?

Answer 28

metastic malignancy of the ovary (usually gastric in origin), mucin-containing signet rings