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MD3002 WEEK 11 - K > Female Reproductive Pathology 2 > Flashcards

Female Reproductive Pathology 2 Flashcards

1
Q

What are the most common cause of congenital uterine abnormalities?

A

Mullerian malformations

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2
Q

What are mullerian malformations associated with?

A

Abnormalities or renal and axial skeleton systems

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3
Q

What is the most common type of vulval cancer?

A

Squamous cell carcinoma which develops at edges of labia majora/minora

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4
Q

What do most vulval cancers develop from?

A

Vulvar intraepithelial neoplasia

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5
Q

What are the 2 types of squamous cell vulvar cancer?

A

HPV associated - seen in young people

Vulvar dystrophy (e.g. lichen sclerosus) associated - seen in older women

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6
Q

What are the features of vulval squamous hyperplasia?

A

Hyperkeratosis
Irregular thickening of ridges
Some neoplastic potential

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7
Q

What are the characteristics of Lichen Sclerosis?

A 
Hyperkeratosis and flattening of ridges 
Oedema in connective tissue 
White patches - 'leukoplakia'
Pruitis
Some neoplastic potential
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8
Q

What are the two types of endometrial adenocarcinoma?

A

Endometriod

Non-endometriod

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9
Q

What are the features of endometriod endometrial adenocarcinoma?

A

Related to unopposed oestrogen

Associated with atypical hyperplasia and polycystic ovary syndrome

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10
Q

What are the features of non-endometriod endometrial adenocarcinoma?

A

Affects elderly, post-menopausal women

p53 often mutated

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11
Q

What are some rarer types of endometrial tumour?

A

Endometrial stromal sarcoma

Malignant mixed Mullein tumour

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12
Q

What is adenomyosis?

A

Benign disease of the uterus due to the presence of ectopic endometrial glands and stroma within the myometrial hyperplasia

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13
Q

What are the features of a myometrial leiomyoma?

A

Benign smooth muscle tumour
Can be intramural, submucosal and subserosal
Common
Associated with dysmenorrhoea and infertility

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14
Q

What is endometriosis?

A

The presence of endometrial glands and stroma outside the uterine body

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15
Q

What are the consequences of endometriosis?

A

Pelvic inflammation
Infertility
Pain

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16
Q

What are small ovarian cysts a cause for concern?

A

When patient is pre-pubertal, post-menopausal, pregnant or the mean diabetes is >3cm

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17
Q

How may people with polycystic ovary disease present?

A 
Hirsutism
Acne
Hair loss
Menstrual disturbance
Infertility 
Obesity
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18
Q

How do you get polycystic ovary disease?

A

Familial/ hereditary

Multifactorial and polygenic

19
Q

What is the treatment of PCOS?

A

Combined oral contraceptive pill

20
Q

What are the complications of PCOS?

A

Risk of endometrial hyperplasia and adenocarcinoma due prolonged stimulation of uterine cells by oestrogen (progesterone absent)

21
Q

What are the symptoms of metastatic ovarian cancer?

A

Pleural effusion
Ascites
Weight loss
Fatigue

22
Q

What is a dysgerminoma?

A

Undifferentiated tumour found in young women

Counterpart to male seminoma

23
Q

What is a teratoma?

A

Tumour that contains all three germ cell layers
Mature cystic teratomas common (benign)
Immature (malignant) uncommon

24
Q

Describe yolk sac tumours

A

Young women (<30)
Produces alpha fetoprotein
Highly malignant but treatable

25
Q

What is a fibroma?

A

Benign tumour of ovary that may produce oestrogen, causing uterine bleeding

26
Q

Where do metastatic ovarian tumours commonly originate from?

A

Stomach
Colon
Breast
Pancreas

27
Q

Who are at risk of molar pregnancies?

A

Women under 16 and over 45

Asian women

28
Q

What is a complete hydatidiform mole?

A

Develops when 1 or 2 sperm cells fertilise an egg that contains no nucleus or DNA
More invasive potential that partial

29
Q

What is a partial hydatidiform mole?

A

2 sperm fertilise a normal egg

Tumours contain some foetal tissue mixed with trophoblastic tissue

30
Q

What is an invasive hydatidiform mole?

A

A mole that has grown into the myometrium

31
Q

What are the risk factors for invasive mole formation?

A

Long time between LMP and treatment for mole
Uterus has become very large
Woman >40 years
Woman has had gestational trophoblastic disease in past

32
Q

Why do women with hydatidiform moles have high hCG levels?

A

Excessive amount of trophoblastic tissue which secretes hCG

33
Q

How can choriocarcinoma develop?

A

Molar pregnancy
Abortion (spontaneous or intential)
Tubal pregnancy
Normal pregnancy

34
Q

Describe non-gestational choriocarcinomas

A

Can develop in men and women
Can be in ovaries, testicles, chest, abdomen
Often mixed with other cancers forming mixed germ cell tumour
Less favourable prognosis

35
Q

What is gestational trophoblastic disease?

A

Group of pregnancy related tumours

36
Q

What is the worry with ectopic pregnancy?

A

The uterine tube could rupture causing fatal haemorrhage

37
Q

What is the mean age women develop Cervical Intraepithelial Neoplasia?

A

25-30 years

38
Q

How many cases of LSIL become more sinister?

A

6% progress to HSIL

1% become invasive cancer

39
Q

What are some possible complications of cervical cancer spread to surrounding areas?

A

Ureteral compression resulting in hydroureter, hydronephrosis and renal failure
If bladder and rectum involved, fistula may develop

40
Q

Which nodes are involved n lymphatic spread of cervical cancer?

A

Paracervical
Hypogastric
External iliac

41
Q

What is a red flag for breast cancer in over 50s?

A

Unilateral changes in nipple including discharge

42
Q

What is the typical presentation of endometriosis?

A

Chronic pelvic pain
Pain during sex
Dysmenorrhoea
Rectal pain on defecation

43
Q

What is the gold standard test for endometriosis?

A

Gynaecological laparoscopy

44
Q

What is the common presentation of Wilm’s tumour?

A

Asymptomatic abdominal mass with insidious growth

MD3002 WEEK 11 - K (4 decks)

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