Gynae

Question 1

Risk Factors for Endometrial Cancer

Answer 1

o Oestrogen exposure:
         Nulliparity  
         HRT
         PCOS
         Obesity 
o Lynch Syndrome (HNPCC)
o HTN
o Diabetes 
o Tamoxifen therapy

Question 2

Presentation of Endometrial Cancer

Answer 2

Post menopausal bleeding

Irregular/abnormal bleeding patterns in a high risk younger woman

Question 3

Investigation of Post Menopausal Bleeding

Answer 3

TVUSS (>5mm abnormal)

Then biopsy:
Homogenous thickening: Pipelle
Focal masses: Hysteroscopy

Question 4

What is the prognosis of endometrial cancer?

Answer 4

• Stage I: 95% 5-year survival
• Stage II: 70%
• Stage III: 60%
• Stage IV: 15%

Question 5

What hereditary syndrome increases endometrial cancer risk?

Answer 5

HNPCC AKA Lynch Snydrome
(Hereditary nonpolyposis colorectal cancer)

Familial cancer syndrome predisposing to colorectal, endometrial, stomach, ovarian cancers

27% to 71% lifetime risk of endometrial cancer

Question 6

What is the staging system for endometrial cancer?

Answer 6

FIGO

Question 7

Define Endometriosis

Answer 7

“The presence of endometrial glands and stroma outside the endometrial cavity”

Question 8

Risk Factors for Endometriosis

Answer 8

First degree relative with endometriosis
Reproductive age
Nulliparity
Structural abnormality of reproductive tract

Question 9

Presentation of Endometriosis

Answer 9

Dyspareunia
Cyclical bloating
Dysmenorrhoea (usualy a few days before period)
Infertility