Gynae Flashcards
3 theories of aetiology of endometriosis
Regurgitant/implantation from retrograde menstrual flow of endometrial cells
Transformation of coelomic epithelial cells
Vascular or lymphatic dissemination of endometrial cells
Microscopy of endometriosis
Red-blue to brown nodules - powder burn
Chocolate cysts in ovaries - endometriomas
Relation of fibroids to oestrogen
Oestrogen stimulation important
Regress in menopause
Enlarge during pregnancy
Microscope of fibroids
Bundles of smooth muscle cellar
Complication of fibroids during pregnancy
Red degeneration
Here haemorrhagic infarction occurs
Severe abdominal pain
Post partum torsion can also occur
What system is used to stage endometrial cancer
FIGO system
What are endometrial carcinomas subdivided into
Endometroid
Non endometroid
Most endometrial cancers are
Endometroid (80%)
Pathophysiology of endometroid endometrial cancer
Oestrogen excess
Usually in peri-menopausal women
What type of cancer is endometroid endometrial cancer
ADENOCARCINOMA (85%)
But may show squamous differentiation
Pathophysiology of non endometroid endometrial cancer
Unrelated to oestrogen excess
Usually in elderly women with endometrial hypertrophy
Types of cancers which are non endometroid endometrial cancer
Papillary
Serous
Clear cell
Normal vulval histology
Squamous epithelium
What HPV is associated with vulval intraepithelial neoplasia
HPV 16
What are the usual types of vulval intrapepithelial neoplasia
Graded as I, II, III
Warty, basaloid, mixed
Usual type age group of vulval intraepithlial neoplasia
35-55
Differentiated type of vulval intraepithlial neoplasia
Older women
Associated with keratinising SCC
Which type of vulval intraepithlial neoplasia has highest risk of malignant transformation
Differentiated type
Which cancer is usual type of Vulval intraepithlial neoplasia associated with
Warty/basaloid SCC
What type of cancer is Vulval carcinoma
Squamous cell carcinoma
What type of cancer are majority of ovarian cancers
90% are epithelial ovarian cancers
Most common type of epithelial ovarian cancer?
Serous cystadenoma
What are the 4 subtypes of epithelial ovarian cancer
Serous cystadenoma
Mucinous cystadenoma
Endometroid
Clear cell
What cell seen in serous cystadenoma
Columnar epithelium
Characteristic of serous cystadenoma
Psammoma bodies
Affects women aged 30-40
What’s the most common oestrogen secreting tumour
Mucinous cystadenoma
Characteristic of endometroid epithelial ovarian carcinoma
Mimics endometrium
Forms tubular glands
Characistic of clear cell epithelial ovarian carcinoma
Abundant clear cytoplasm
Intracellular glycogen
Hobnail appearance
Subtypes of germ cell ovarian carcinoma
Dysgerminoma
Teratoma
Choriocarcinoma
Most common ovarian malignancy in young women
Dysgerminoma
Which type of teratoma is malignant
Malignant
Characteristic of immature teratoma
Malignant Usually solid Contains immature, embryo all tissue Secrete AFP Produce thyroxine
What do choriocarcinomas secrete
HCG
Characteristic of fibroma
Sex cord tumour
No hormone production
Associated with Meig’s syndrome
Meig’s syndrome
Ascites
Pleural effusion
Ovarian tumour
Ovarian fibroma malignant or benign
Benign
What does granulosa theca cell tumour produce
e2
What does sertoli leydig cell tumour secrete
Androgens
staging system used for ovarian cancer
FIGO
HPV associated with CIN
HPV 16, 18 , 33
Most common cell type of cervical carcinoma
Squamous cell (70-80%) 20% are adenocarcinoma, adenosquamous carcinoma
What marks the change of CIN to carcinoma
Invasion through the basement membrane
Staging system used for cervical cancer
FIGO
