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Obstetrics And Gynaecology > Gynae-Oncology > Flashcards

Gynae-Oncology Flashcards

1
Q

What is the commonest gynaecological cancer?

A

Endometrial

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2
Q

Name some risk factors for endometrial cancer

A 
Obesity 
Early menarche/late menopause
Nulliparity 
PCOS
Unopposed oestrogen 
Previous breast/ovarian Ca 
BRCA1/2
Endometrial polyps
Diabetes
Parkinson’s
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3
Q

What factors decrease the risk of endometrial cancer?

A 
Continuous combined HRT
COCP
Smoking
Exercise
Tea and coffee
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4
Q

What is the management of endometrial hyperplasia?

A

Progesterones or surgery

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5
Q

What type of cancer generally occurs in the uterus?

A

Endometrial adenocarcinoma

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6
Q

What staging is used for endometrial Ca?

A

FIGO

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7
Q

Briefly describe the FIGO staging for endometrial Ca

A

1 - limited to myometrium
2 - cervical spread
3 - uterine serosa, ovaries, vagina, lymph nodes
4 - bladder/bowel involvement, distant mets

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8
Q

What investigations can be done for suspected endometrial Ca?

A

US TV- increased endometrial thickness
Biopsy - pipelle
Hysteroscopy

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9
Q

What is the management of endometrial Ca?

A

Surgery - hysterectomy and bilateral SPO
Radiotherapy
Advanced disease - chemo/hormone/radio

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10
Q

What is a woman’s lifetime risk of ovarian Ca?

A

1 : 50

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11
Q

What increases the risk of ovarian Ca?

A 
Obesity 
Nulliparity 
Early menarche/late menopause
Unapposed oestrogen 
Family hx 
Endometriosis 
BRCA1/2
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12
Q

What factors decrease the risk of ovarian Ca?

A 
COCP 
Breastfeeding
Pregnancy 
Hysterectomy/oophorectomy 
Sterilisation
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13
Q

What are the symptoms of ovarian Ca?

A 
Non-specific 
Abdo swelling
Pain
Anorexia
N+V
Weight loss
Vaginal bleeding
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14
Q

What is the management of ovarian Ca?

A

Surgery and chemotherapy

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15
Q

What is the age distribution of cervical Ca?

A

Bimodal 30s and 80s

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16
Q

What increases the risk of cervical Ca?

A 
HPV
Young age at first intercourse
Multiple partners
Smoking
Long term COCP 
immunosuppression/HIV
Non-compliant with screening
17
Q

What decreases the risk of cervical Ca?

A

HPV vaccine

Compliance with screening

18
Q

Which types of HPV are most likely to be oncogenic?

A

16 and 18

19
Q

How is HPV oncogenic?

A

Produces proteins E6 and E7 which suppress the product is of p53 tumour suppressor gene in keratinocytes therefore increases proliferation

20
Q

What is the management of cervical Ca?

A

Cone biopsy if need to preserve fertility
Radical hysterectomy
Chemo/radiotherapy

21
Q

Give some complications of treating gynaecological cancers with radiation

A 
Vaginal dryness
Vaginal stenosis 
Radiation cystitis
Radiation proctitis 
Loss of ovarian function
22
Q

Describe the cervical smear programme

A

25-50 every 3 years

50-65 every 5 years

23
Q

Describe the outcomes/pathway of a smear result

A

Normal - routine recall
Borderline/mild dyskaryosis - check HPV status. Positive = colposcopy and histology, negative = routine recall
Moderate/severe dyskaryosis - colposcopy and histology

24
Q

What is the management of CIN?

A 
Large loop excision of transformation zone (LLETZ)
Cold knife cone
Cryocautery 
Diathermy 
Laser
25
Q

What is VIN?

A

Pre malignant condition of vulval that can resolve spontaneously or progress to cancer
Can be asymptmatic or can cause itching/burning/pain

26
Q

What is the management of VIN?

A

Antihistamine
Imiquimod
Excision

27
Q

What are the risk factors for VIN/Ca?

A 
HPV
Herpes simplex 2
Smoking
Immunosuppression
Chronic vulvar irritation 
Lichen sclerosus
28
Q

Vulva cancer is usually which type of Ca?

A

Squamous cell carcinoma

29
Q

What is the management of CIN1?

A

Often resolves spontaneously

Screening in 12 months

30
Q

What is the management of CIN2?

A

Treatment to remove usually recommended

31
Q

What is the management of CIN3?

A

Treatment to remove needed

Large loop excision of transformation zone

Obstetrics And Gynaecology (6 decks)

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