Gynaecological Flashcards
what is the criteria for diagnosing PCOS?
rotterdam criteria
2/3
oligo-anovulation, hyperandrogenism and/or polycystic ovarian morphology (PCOM)
most common tumour of female genital tract?
leimyoma
benign
group 4 endometrial cancer
serous type
what gene?
what protein is associated with it?
how is it detected
TP53
P53
immunohistochemistry
mutation in what gene show better prognosis in endomterial cancer?
POLE
DNA mismatch repair genes in
group 2 endometrial cancer are either
______ /_____
this creates ?
mutated or silenced
micro satellite instability (MSI)
immunostaining of mismatch repair system
stains for what proteins?
these proteins are expressed by genes
if normal then what is the result?
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
what is the purpose of detecting mismatching repair genes
produce more neo antigens]
detected by body
initiate a stronger immune response
indicate it is amenable to immunotherapy
complication of PID?
fitz-hugh curtis syndrome
> scar tissue liver capsule
ectopic
sepsis
abscess
chronic pid
peritonitis
pilical fusion
what is plical fusion?
fimbrial ends of fallopian tubes adhere together
complication of PID
violin string adhesions
> peri hepatic adhesion
RUQ pain from peri adhesions
fitz hugh curtis
PID complication 10%
3 aetilogies of endometriosis?
1) retrograde amnesia
2)metaplastic transformation
3)vascular / lymphatic dissemination
macroscopically endo histopath buzzwords?
red-blue powder burns
endometrioma’s
what is red degeneration of ____
fibroids
during pregnancy haemorrhage - infarcts; severe abdo pain
types of endometrioid cancer?
endometrioid - PTEN mutation
secretory
mucinous
endometrial cancer RF?
excess E2
nulliparity
early menarch/ late menopause
obese
tamoxifen
PCOS
DM, HTN, HNPCC
non-endometrioid cancer?
papillary
serous: p53
clear cell
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
2WW Cancer referral as any PMB is investigated like this
TVUSS; >4mm hyperplasia
hysteroscopy
> atypia etc
Clear cell endometrial cancer type 2
what is vulval intraeoithelial neoplasia associated with?
HPV 16/ 18
smoking
immunosuppresion
dysplasia of epithelium
types of vulval carcinoma?
squamous
clear cell adenocarcinoma : teens, rare: diethyltibestrol
primary vaginal : squamous
most common ovarian cyst?
follicular
> corpus luteal
RF for ovarian cancer?
nulliparity
early menarche
obesity
FHx
HRT
BRCA1/2
most common benign epithelial tumour
associated with psamomma bodies
Serous cystadenoma
benign epithelial ovarian tumour?
serous cystadenoma
mucinous cystadenoma
Benign tumour of ovary- mucin secreting cells seen on histology?
Benign mucinous cystadenoma
epithelial cell origin
kras mutation
example of malignant epithelial cell Ovarian tumours?
endometrioid
Clear cell
Endometrioid buzzword characteristic?
tubular glands on histology
ca125 raised
hobnail appearance on histology
Clear cell carcinoma
Germ cell tumours - Ovarian cancers?
Dysgerminoma (benign)
mature Teratoma (dermoid cyst- benign)
immature teratoma: malignant
choriocarcinoma (malignant)
sex cord ovarian tumours?
fibroma
granulosa-theca
sertoli-leydig
what is meig’s syndrome?
triad
fibroma
ascites
right pleural effusion
50% associated with fibroma (no hormone)
what tumour produces E2
on histology call-exner bodies
garnulosa-theca
what is krukenberg tumour?
malignancy of ovary that is from mets
gastric
colon
on histology you see mucin producing signet ring cells
krukenberg tumour
risk of malignancy index?
USS- multilocular, solid, mets, bilateral, ascites
menopause
1 for pre
3 for post
ca125 IU/mL
pathophysiology of HPV and cervical cancer?
HPV 16/18 encodes E6
E7
these inactivate 2 tumour supprrsor gene
what does E6 do?
E6 is a protein produced by HPV 16/18 which inactivates
p53> prolifertaion
What inactivates retinoblastoma gene?
E7
what is a normL BREAST histology?
ductal lobular system
lined by glandular epithelium
empty fat spaces
giant cells
histiocytes
what can this be?
fat necrosis
on Histology
‘central, stellate area, fibrous’
radial scar - benign sclerosing lesion
benign papillary tumour
> papillary mass within a dilated duct lined by epithelium?
intraductal papilloma
where does a phyllodes tumour arise from?
what is histology buzzword?
interlobular stroma
artichoke appearnace
leaf like fronds
most common breast carcinoma subcategory
invasive ductal carcinoma (most common); pleimorphic cells
invasive lobular
single file /strands
well formed tubules on histology
non palballe breast lump
tubular carcinoma
4 types of breast cancer
invasive ductal (pleimorphic)
invasive lobular
tubular carcinoma (tubules)
mucinous carcinoma (mucin)
qhat is associated with good prognosis?
why?
ER/Pr receptor +
will respond to tamoxifen
what is associated with bad prognosis in breast cancer?
HEr 2+
most iimportant factor for prognostics of breast cancer is HER2 status?
false
status of axillary lymph node
high grade tumour - breast cancer?
ER/PR - and HER2 +
respond to herceptin
