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Year 5 Histopath > Gynaecological > Flashcards

Gynaecological Flashcards

1
Q

what is the criteria for diagnosing PCOS?

A

rotterdam criteria

2/3

oligo-anovulation, hyperandrogenism and/or polycystic ovarian morphology (PCOM)

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1
Q

most common tumour of female genital tract?

A

leimyoma
benign

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2
Q

group 4 endometrial cancer
serous type

what gene?

what protein is associated with it?

how is it detected

A

TP53
P53

immunohistochemistry

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3
Q

mutation in what gene show better prognosis in endomterial cancer?

A

POLE

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4
Q

DNA mismatch repair genes in
group 2 endometrial cancer are either
______ /_____

this creates ?

A

mutated or silenced
micro satellite instability (MSI)

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5
Q

immunostaining of mismatch repair system

stains for what proteins?

these proteins are expressed by genes

if normal then what is the result?

A

MLH1
MH6
PMS2
MSH2

should show strong brown nuclear staining

abnormal results indicates genes are either mutated or silenced by tumour

so system is not functioning well

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6
Q

what is the purpose of detecting mismatching repair genes

A

produce more neo antigens]

detected by body

initiate a stronger immune response

indicate it is amenable to immunotherapy

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7
Q

complication of PID?

A

fitz-hugh curtis syndrome
> scar tissue liver capsule

ectopic
sepsis
abscess
chronic pid
peritonitis
pilical fusion

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8
Q

what is plical fusion?

A

fimbrial ends of fallopian tubes adhere together

complication of PID

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9
Q

violin string adhesions
> peri hepatic adhesion

RUQ pain from peri adhesions

A

fitz hugh curtis
PID complication 10%

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10
Q

3 aetilogies of endometriosis?

A

1) retrograde amnesia
2)metaplastic transformation
3)vascular / lymphatic dissemination

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11
Q

macroscopically endo histopath buzzwords?

A

red-blue powder burns

endometrioma’s

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12
Q

what is red degeneration of ____

A

fibroids
during pregnancy haemorrhage - infarcts; severe abdo pain

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13
Q

types of endometrioid cancer?

A

endometrioid - PTEN mutation

secretory

mucinous

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14
Q

endometrial cancer RF?

A

excess E2
nulliparity
early menarch/ late menopause

obese
tamoxifen
PCOS
DM, HTN, HNPCC

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15
Q

non-endometrioid cancer?

A

papillary

serous: p53

clear cell

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16
Q

80yr old presents with 6 month history of post menopausal bleed

she has a PMH of PCOS and has had no children. Lives alone, but unassisted. volunteers at local church

what ix would you do?
what is the likely diagnosis

genetic test shows: PTEN mutation P53 mutation HER-2 mutation

A

2WW Cancer referral as any PMB is investigated like this

TVUSS; >4mm hyperplasia

hysteroscopy
> atypia etc

Clear cell endometrial cancer type 2

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17
Q

what is vulval intraeoithelial neoplasia associated with?

A

HPV 16/ 18
smoking
immunosuppresion

dysplasia of epithelium

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18
Q

types of vulval carcinoma?

A

squamous
clear cell adenocarcinoma : teens, rare: diethyltibestrol

primary vaginal : squamous

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19
Q

most common ovarian cyst?

A

follicular
> corpus luteal

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20
Q

RF for ovarian cancer?

A

nulliparity
early menarche
obesity
FHx
HRT
BRCA1/2

21
Q

most common benign epithelial tumour

associated with psamomma bodies

A

Serous cystadenoma

22
Q

benign epithelial ovarian tumour?

A

serous cystadenoma
mucinous cystadenoma

23
Q

Benign tumour of ovary- mucin secreting cells seen on histology?

A

Benign mucinous cystadenoma

epithelial cell origin

kras mutation

24
Q

example of malignant epithelial cell Ovarian tumours?

A

endometrioid
Clear cell

25
Q

Endometrioid buzzword characteristic?

A

tubular glands on histology
ca125 raised

26
Q

hobnail appearance on histology

A

Clear cell carcinoma

27
Q

Germ cell tumours - Ovarian cancers?

A

Dysgerminoma (benign)

mature Teratoma (dermoid cyst- benign)
immature teratoma: malignant

choriocarcinoma (malignant)

28
Q

sex cord ovarian tumours?

A

fibroma

granulosa-theca

sertoli-leydig

29
Q

what is meig’s syndrome?

A

triad

fibroma
ascites
right pleural effusion

50% associated with fibroma (no hormone)

30
Q

what tumour produces E2
on histology call-exner bodies

A

garnulosa-theca

31
Q

what is krukenberg tumour?

A

malignancy of ovary that is from mets

gastric
colon

32
Q

on histology you see mucin producing signet ring cells

A

krukenberg tumour

33
Q

risk of malignancy index?

A

USS- multilocular, solid, mets, bilateral, ascites

menopause
1 for pre
3 for post

ca125 IU/mL

34
Q

pathophysiology of HPV and cervical cancer?

A

HPV 16/18 encodes E6
E7

these inactivate 2 tumour supprrsor gene

35
Q

what does E6 do?

A

E6 is a protein produced by HPV 16/18 which inactivates

p53> prolifertaion

36
Q

What inactivates retinoblastoma gene?

A

E7

37
Q

what is a normL BREAST histology?

A

ductal lobular system
lined by glandular epithelium

38
Q

empty fat spaces
giant cells
histiocytes

what can this be?

A

fat necrosis

39
Q

on Histology
‘central, stellate area, fibrous’

A

radial scar - benign sclerosing lesion

40
Q

benign papillary tumour
> papillary mass within a dilated duct lined by epithelium?

A

intraductal papilloma

41
Q

where does a phyllodes tumour arise from?

what is histology buzzword?

A

interlobular stroma
artichoke appearnace
leaf like fronds

42
Q

most common breast carcinoma subcategory

A

invasive ductal carcinoma (most common); pleimorphic cells

43
Q

invasive lobular

A

single file /strands

44
Q

well formed tubules on histology
non palballe breast lump

A

tubular carcinoma

45
Q

4 types of breast cancer

A

invasive ductal (pleimorphic)
invasive lobular
tubular carcinoma (tubules)
mucinous carcinoma (mucin)

46
Q

qhat is associated with good prognosis?

why?

A

ER/Pr receptor +

will respond to tamoxifen

47
Q

what is associated with bad prognosis in breast cancer?

A

HEr 2+

48
Q

most iimportant factor for prognostics of breast cancer is HER2 status?

A

false

status of axillary lymph node

49
Q

high grade tumour - breast cancer?

A

ER/PR - and HER2 +
respond to herceptin

50
Q
A

Year 5 Histopath (11 decks)

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