Gynaecological cancers Flashcards

1
Q

Types of cancer

A
Ovarian cancer
Endometrial cancer
Cervical cancer 
- squamous cell carcinoma 
- adenocarcinoma 
Vulval cancer
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2
Q

Risk factors for ovarian cancer

A
Early menarche 
Late menopause 
FHx 
BRCA1/2 
Nulliparity 
Unopposed oestrogen
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3
Q

Risk factors for endometrial cancer

A
Early menarche 
Late menopause 
Age - 60 - 70 yo 
FHx 
BRCA1/2 
Nulliparity 
PCOS 
Unopposed oestrogen - tamoxifen 
Polyps 
Obesity
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4
Q

Risk factors for cervical cancer

A
Smoking
COCP 
Immunosuppression 
HPV 16 and 18 
- multiple sexual partners
- early age of first intercourse 
- unprotected sex
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5
Q

Risk factors for vulval cancer

A
Lichen sclerosis
Herpes simplex virus type 2 
Smoking 
Immunocompromised
HPV
- multiple sexual partners
- early age of first intercourse 
- unprotected sex
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6
Q

History

A
FLAWS
Age of menarche 
IMB
PCB 
Contraception use 
Sexual history 
FHx
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7
Q

Investigations for ovarian cancer

A
Pelvic exam 
Bloods - Ca 125, FBC, U+Es, LFTs
Pelvic USS 
Biopsy 
Staging CT
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8
Q

Investigations for endometrial cancer

A
Bloods 
TV USS >5mm - further investigation 
Hysteroscopy and biopsy 
- pipelle 
- dilatation and curettage 

Other:
Staging CT - CAP
MRI pelvis
FBC, U+Es, LFTs

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9
Q

Investigations for cervical cancer

A

Bloods - Ca 125
Speculum and HPV smear test
Colposcopy and biopsy

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10
Q

Investigations for vulval cancer

A

Biopsy
HPV testing
HSV testing

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11
Q

Presentation of ovarian cancer

A
Irregular periods 
Bloating 
FLAWS
Abdominal pain 
Nausea 
Vomiting 
PMB 
Bowel symptoms
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12
Q

Presentation of endometrial cancer

A

IMB
PCB
FLAWS
Heavy, painful periods

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13
Q

Presentation of cervical cancer

A
IMB
PCB 
PMB
FLAWS
Unusual discharge - may be bloodstained
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14
Q

Presentation of vulval cancer

A

Lump
Itching
Burning
Pain

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15
Q

Management of ovarian cancer

A

Oophorectomy if low stage
TAH + BSO + chemotherapy
Chemoradiotherapy

May require HRT if early menopause

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16
Q

Management of endometrial cancer

A

Hysterectomy + BSO
Adjuvant radiotherapy if high risk of recurrence

Palliative:
Chemoradiotherapy

17
Q

Management of cervical cancer

A

LLETZ

Chemoradiotherapy

18
Q

Management of vulval cancer

A

Excision
Antihistamine for itching
Chemoradiotherapy

19
Q

How is endometrial cancer staged

A

FIGO staging

20
Q

Cervical smear test

A

Age 25yo - 50 - every 3 years
Age 50 - 65 - every 5 years

Tests for HPV
If +ve - colposcopy and biopsy

21
Q

CIN treatment

A

LLETZ

22
Q

Complications of cervical treatment

A

Radiotherapy:

  • vaginal dryness
  • vaginal stenosis
  • cystitis

Surgery:

  • Infection
  • haemorrhage
  • vesicovaginal fistula
  • bladder dysfunction
23
Q

HPV vaccination

A

Gardasil - 6, 11, 16, 18
Cervarix - 16 and 18

3 injections over 3 months
5 years of protection
Require smears