Gynae Oncology

Question 1

Most common cell type of endometrial cancer

Answer 1

Adenocarcioma

Question 2

Risk factors for endometrial cancer

Answer 2

Nulliparity
Late menopause
Oestrogen treatment 
Obesity
Diabetes
Corpus cancer syndrome
PCOS
Fibroids
DUB
High fat diet
Endometrial hyperplasia
Familial history

Question 3

Progression from normal cervical epithelium to invasive carcinoma takes at least how long?

Answer 3

On average 15 years

Question 4

In what cancers is alpha-feto protein raised

Answer 4

Ovary 
Testis
Liver
Pancreas 
Lung 
Stomach 
Colon

Question 5

Common symptoms of ovarian cancer

Answer 5

Abdominal distension and pain

Ascites

Question 6

What is Ca 125 a marker for?

Answer 6

Ovarian cancer

Question 7

Presentation of endometrial carcinoma

Answer 7

Postmenopausal bleeding

Premenopausal menstrual irregularity

Question 8

When CIN is found in the deeper layers of the cervical epithelium (lower 1/3) what grade of CIN would this be?

Answer 8

CIN 1

Undifferentiated cells confined to lower 1/3

Question 9

When CIN is found in the lower 2/3 of the cervical epithelium what grade of CIN would this be?

Answer 9

CIN 2

More marked nuclear abnormalities than CIN 1

Question 10

When CIN is found throughout the thickness of the cervical epithelium what grade of CIN would this be?

Answer 10

CIN 3

Question 11

Which HPV viruses are most associated with cervical cancer

Answer 11

16 and 18 (33, 31)

Question 12

Risk factors for female genital tract neoplasia

Answer 12

Increased number of sexual partners
Persistent HPV infection
Immune compromise
Cigarette smoking
Low socioeconomic status
Prolonged use of the OCP 
Higher number of pregnancies

Question 13

What are the most common symptoms of cervical cancer

Answer 13

Abnormal vaginal bleeding / discharge

Discomfort during intercourse

Question 14

How is high dose brachytherapy for cervical cancer delivered?

Answer 14

Applicators are put in the cervix and connected to an afterloading machine which delivers radiation at a high dose rate for a few minutes.
Often repeated several times, a few days apart, on an outpatient basis

Question 15

What is topotecan used to treat

Answer 15

Advanced cervical cancer
Ovarian cancer
Small cell lung cancer

Question 16

How does topotecan chemotherapy work

Answer 16

Prevents DNA replication in cancer cells by inhibiting the enzyme topoisomerase I.

Question 17

What is DySIS?

Answer 17

digital video colposcope using dynamic spectral imaging to evaluate the blanching effect of applying acetic acid to the epithelium. It measures the rate, extent and duration of the acetowhitening.

Question 18

What is the annual incidence of cervical cancer in the UK

Answer 18

The annual incidence of cervical cancer in the UK is estimated to be 9.7 per 100,000 population.

Question 19

What is the annual mortality rate for cervical cancer in the UK?

Answer 19

The annual mortality rate for cervical cancer in the UK is 3.9 per 100,000 population (2001)

Question 20

How is liquid based cytology carried out

Answer 20

Samples collected using a brush.
The head is rinsed / broken off in a vial of preservative.
Samples mixed to disperse the cells.
Cellular debris/ blood/ mucus is removed.
A thin layer of cervical cells put on a slide and stained.

Question 21

What does a Radical hysterectomy involve

Answer 21

Surgical removal of the uterus, supporting ligaments, upper vagina and pelvic lymph nodes +/- para-aortic lymph nodes.

Question 22

What approaches are possible for a radical hysterectomy

Answer 22

standard approach = abdominal incision. Laparoscopic radical hysterectomy

Question 23

What is the extent of stage 1 cervical cancer

Answer 23

stage I cervical cancer is confined to the cervix

Question 24

What is the extent of stage 2 cervical cancer

Answer 24

Stage IIA - tumour invades the cervix with endocervical glandular involvement only.
Stage IIB - Tumour has spread upward into tissues around the cervix but not into the pelvic wall.