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Reproduction and Sexual Health > Female Reproductive Tract Pathology > Flashcards

Female Reproductive Tract Pathology Flashcards

1
Q

What is a functional ovarian cyst?

A

Cyst formed when the follicle doesn’t release an egg and swells

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2
Q

What is endometriosis?

A

Chronic inflammatory condition caused by ectopic endometrial tissue (commonly in the ovaries)

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3
Q

Blood-filled cyst on ovary.

Diagnosis?

A

Endometriosis (chocolate cyst)

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4
Q

What is the general management of an ovarian mass?

A

Exclude malignancy

CA-125 blood test
USS

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5
Q

Patient present with weight loss, early satiety, heartburn bloating and diarrhoea.

Diagnosis?

A

Ovarian cancer

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6
Q

What are the risk factors for ovarian cancer?

A

Family history
Post-menopausal
Nulliparous

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7
Q

Where do ovarian cancers spread?

A

Peritoneal surfaces

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8
Q

What tumours commonly metastasise to the ovaries?

A

Breast

GI

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9
Q

In suspected ovarian cancer, what investigations should you do and why?

A

CA-125 tumour marker (raised in ovarian cancer)
CEA tumour marker (excludes colorectal primary)

USS (image tumour)
CT (image peritoneal surfaces)

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10
Q

How do you treat ovarian cancer?

A

Surgery, examine peritoneal surfaces and adjuvant chemotherapy

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11
Q

Gynaecological cancer most likely to recur.

A

Ovarian

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12
Q

Name the 3 layers of the uterine wall

A

Endometrium: inner
Myometrium: muscular middle
Perimetrium: outer

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13
Q

What is dysfunctional uterine bleeding (DUB)?

A

Menorrhagia without organic cause (thought to be hormone dysfunction) common in extremes of reproductive years

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14
Q

What is an endometrial polyp and who gets them?

A

Benign growth of endometrium

Women going through menopause

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15
Q

What is adenomyosis and how does it present?

A

Endometrium breaking into myometrium

Heavy/painful bleeding

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16
Q

What is the commonest uterine mass?

A

Leiomyoma

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17
Q

What is leiomyoma?

A

“fibroids”

Benign proliferation of smooth muscle in myometrium

18
Q

How do fibroids present?

A

Often asymptomatic.

Menorrhagia, pain

19
Q

What is red degeneration?

A

Painful haemorrhagic infarction of leiomyoma common in pregnancy

20
Q

What causes endometrial hyperplasia?

How does it present?

What are the 3 classes?

A

Excess oestrogen
Post-menopausal bleeding

Simple: generalised hyperplasia
Complex: focal hyperplasia with normal cytology
Atypical: focal hyperplasia with atypical cytology

21
Q

How does endometrial cancer present?

A

Post-menopausal bleeding

22
Q

What is Lynch syndrome? What does it increase your risk of?

A

Autosomal dominant DNA mismatch repair defect

Colorectal, endometrial, ovarian cancer

23
Q

What do Lynch syndrome tumours show?

A

Micro-satellite instability (MSI)

24
Q

What are the risk factors for endometrial cancer? Explain them.

A

Family history (Lynch syndrome)

Obesity (adipose tissue converts androgens to oestrogen and obesity increases oestrogen levels in blood through SHBG/insulin dysfunction)

25
Q

What are the two classes of endometrial cancer and which is the commonest?

A

Endometroid carcinoma (type 1) and serous/clear cell carcinoma (type 2)

Endometroid carcinoma is the commonest

26
Q

What are the precursor lesions for the two types of endometrial cancer?

A

Endometroid carcinoma: atypical endometrial hyperplasia

Serous/clear cell carcinoma: serous intraepithelial carcinoma

27
Q

What is the relationship of the 2 types of endometrial cancer to oestrogen?

A

Endometroid carcinoma is caused by excess oestrogen

Serous/clear cell carcinoma is not caued by oestrogen (rather by TP52 mutation)

28
Q

What is the

  • transformation zone?
  • ectocervix?
  • endocervix?
A

TZ: junction between ecto/endocervix

Endocervix: columnar epithelium inside cervix

Exocervix: squamous epithelium outside cervix

29
Q

Where do nabothian cysts arise and what causes them?

A

Cervix

Caused by cervical erosion: endocervical epithelium exposure to acidic vagina causes squamous metaplasia

30
Q

What causes cervicitis and why is it important to recognise?

A

Inflammation commonly by chlamydia/gonorrhoea

Asymptomatic but can cause PID/infertility

31
Q

What is cervical intraepithelial neoplasia (CIN)? How is it graded?

A

Asymptomatic, preinvasive squamous dysplasia at the TZ (picked up at screening)

graded depending on extend of dysplasia
CIN1: basal third
CIN2: extends to middle third
CIN3: full thickness

32
Q

Describe the development of cervical cancer.

A

normal > koilocytosis > CIN 1>3 > cancer

33
Q

What is the name for the cytology pattern which indicates HPV infection

A

Koilocytosis

34
Q

What are the risk factors for cervical cancer?

A

HPV 16/18 infection
Smoking
Multiple sexual partners
Early first sexual encounter (vulnerable TZ)

35
Q

How does cervical cancer present?

A

Early disease asymptomatic

Late disease: bleed, discharge, pain, renal failure (obstructive uropathy)

36
Q

Who gets cervical screening?

A

25-50: 3 years

50-65: 5 years

37
Q

What does cervical screening pick up?

A

Screening identifies cells which have the potential to become pre-cancerous
These aren’t positive cancer results but could develop into cancer untreated
Treatment at this stage is effective
Screening “stops and treats the cancer before you get it”

38
Q

What HPV strains cause cervical cancer and which cause warts?

A

6,11 – cause warts, low risk

16, 18 – cause cancer, high risk

39
Q

Who gets vaccinated against HPV? What does this vaccinate them against?

A

Girls S1-S3
MSM < 45

HPV 6,11,16,18 (quadrivalent - gardasil)

40
Q

What is vulvar intraepithelial neoplasia?

A

Cancerous precurose affecting old/young woman (bimodal)

More likely to progress in elderly

41
Q

Who gets vulvar invasive squamous carcinoma and what determines their prognosis?

A

Elderly woman

Inguinal lymph node spread

42
Q

Vulvar invasive squamous carcinoma management.

A

Vulvectomy and inguinal lymphadenectomy

Reproduction and Sexual Health (5 decks)

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