Gynae Flashcards
Types of benign ovarian disease?
- functional cysts
Follicular
Corpus luteal - Pathological cysts
Endometrioma
Polycystic ovaries
Theca lutein cyst
Corpus luteal cyst - key feature?
“Ring of fire” sign on US
Endometrioma - key feature?
Chocolate cysts
Polycystic ovaries - key feature on US?
“Ring of pearls” sing on US
Theca lutein cyst - why does it develop?
Consequence of extremely high hCG (e.g. due to a molar pregnancy)
4 type sof ovarian cancer?
- Epithelial cell tumours
- germ cell tumours
- sex cord/stromal tumours
- Metastatic
Types of ovarian epithelial cell tumours?
- Serous type (most common)
- Mucinous
- Clear cell
Types of ovarian Sex cord/stromal tumours?
- Sertoli-leydig cell
- Granulosa cell tumours
Features of germ cell tumours?
- Benign
- High AFP and hCG
Classic metastatic ovary tumour?
- Krunkenberg (commonly from stomach primary_
- Signet ring cells on histology
Risk Factors for endometrial malignancy?
- Obesity
- Diabetes (independent risk factor)
- Polycystic ovarian syndrome (must have withdrawal bleed every 3 months)
- Increased age
- Earlier onset of menstruation (48kg)
- Late menopause
- Oestrogen-only hormone replacement therapy
- No or fewer pregnancies
- Tamoxifen (selective oestrogen receptor modulator - antagonist in the ER in breast, agonist in bone => very good to protect from osteoporosis, and agonist in endometrium - which increases risk for endometrial cancer)
Risk factors for cervical malignancy:
Increased risk of catching HPV occurs with:
- Early sexual activity
- Increased number of sexual partners
- Sexual partners who have had more partners
- Not using condoms
Non-engagement with cervical screening is a significant risk factor. Many cases of cervical cancer are preventable with early detection and treatment of precancerous changes.
Other risk factors are:
- Smoking
- HIV (patients with HIV are offered yearly smear tests)
- Combined contraceptive pill use for more than five years (>8 years)
- Increased number of full-term pregnancies
- Family history
- Exposure to diethylstilbestrol during fetal development (this was previously used to prevent miscarriages before 1971)