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Obs & Gynae > Gynaecological Cancers > Flashcards

Gynaecological Cancers Flashcards

1
Q

At what age do women most commonly get cervical cancer?

A

Younger women in peak reproductive years

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2
Q

What are the two main types of cervical cancer?

Which is more common?

A 
Squamous cell (most common) 
Adenocarcinoma
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3
Q

What is the most common cause of cervical cancer?

A

HPV

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4
Q

What types of HPV cause cervical cancer? (3)

A

16, 18 and 33

Vaccination is available

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5
Q

Apart from HPV what are risk factors/causes for developing cervical cancer?

A 
Early sexual activity
Multiple partners
Smoking
HIV
COCP
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6
Q

What symptoms are associated with cervical cancer?

A

Post-coital bleeding (+ IMB, post menopausal)
Vaginal discharge
Pelvic pain
Urinary symptoms

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7
Q

Outline the staging for cervical cancer

Stages 1 - 4

A

1 = confined to cervix

2 = invades uterus/upper 2/3 of vagina

3 = invades pelvic wall/lower 1/3 of vagina

4 = invades bladder/rectum/beyond pelvis

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8
Q

What is cervical intraepithelial neoplasia?

A

Abnormal growth of (pre-cancerous) cells on the surface of the cervix

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9
Q

What is the grading system for CIN?

CIN I - III

A

I = mild dysplasia, likely to return to normal without treatment

II = moderate dysplasia, likely to progress to cancer without treatment

III = severe dysplasia, will progress to cancer if untreated

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10
Q

What is another name for CIN III?

A

Cervical carcinoma in situ

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11
Q

Which smear results are tested for HPV?

A

Smears that show mild dyskaryosis

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12
Q

Outline the cervical screening programme in the UK

A

Smear every 3 years - ages 25-49

Smear every 5 years - ages 50-64

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13
Q

What should the next step be for the following smear results?

CIN I

CIN II

CIN III

HPV +ve

A

CIN I = no further investigation needed, continue routine screening

CIN II = refer for colposcopy under 2WW

CIN III = refer for colposcopy under 2WW (suspected cancer)

HPV +ve = colposcopy

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14
Q

Apart from cervical cancer, what other cancers is HPV linked to?

A 
Anal
Vulval
Vaginal
Penis
Mouth
Throat
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15
Q

How is HPV transmitted?

A

Sexually transmitted

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16
Q

How does HPV cause disease and cancer?

A

Invades cells and interrupts the normal replication process, inhibiting tumour suppressor genes p53 and pRb

17
Q

What strains of HPV causes genital warts? (2)

A

6 and 11

18
Q

What strains of HPV cause cervical cancer?

A

16 and 18

19
Q

Who is the cervical cancer vaccine offered to? (2)

What strains of HPV does it protect against?

A

All girls from age 12
Boys with HIV

6, 11, 16, 18

20
Q

What are risk factors for endometrial cancer?

A 
Increased age
Early menarche
Late menopause
No pregnancies
Unopposed oestrogen HRT 
Obesity 
Tamoxifen - breast cancer drug

Related to INCREASED EXPOSURE TO OESTROGEN

21
Q

What are the two most common symptoms of endometrial cancer?

A

Post-menopausal bleeding

IMB

22
Q

What investigations should be considered for suspected endometrial cancer? (2)

A

Transvaginal USS

Hysteroscopy with endometrial biopsy

23
Q

What does a transvaginal USS for endometrial cancer look for?

What values are normal?

A

Endometrial thickness

Less than 4mm = normal

24
Q

What is the name given to the surgery that removes the uterus and adnexa?

A

Total hysterectomy with bilateral saplingo-oophorectomy

25
Q

Out of endometrial, cervical and ovarian cancer, which has the worst prognosis?

Why?

A

Ovarian

Presents late due to non-specific symptoms

26
Q

What are risk factors for ovarian cancer?

A

LINKED TO INCREASED OVULATIONS

Early menarche
Increased age
Late menopause
No pregnancies
Obesity
Unopposed oestrogen HRT 
Smoking
FH - BRCA1 and BRCA2 genes
27
Q

Is breastfeeding a risk factor for ovarian cancer?

A

No - is protective

28
Q

What are some symptoms of ovarian cancer?

A

Vague, non-specific

Bloating
Pelvic pain
Weight loss
Abdominal mass

29
Q

Name some occasions where an elevated CA125 would be seen

A 
Ovarian cancer
During menstruation
Endometriosis
Liver cirrhosis
Benign ovarian cysts
Fibroids
30
Q

What investigations are indicated for suspected ovarian cancer?

A

CA125 blood test

USS

Diagnostic laparoscopy

31
Q

What staging system is used for ovarian cancers?

Outline stages 1-4

A

FIGO staging system

1 = only in ovary

2 = out of ovary, inside pelvis

3 = outside pelvis, inside abdomen

4 = distant metastases

32
Q

What is a Krukenberg tumour?

A

Ovarian malignancy that is a metastasis from another site

33
Q

What type of cancer are most vulval cancers?

A

Squamous cell carcinomas

34
Q

State 3 risk factors for vulval cancer

A

Increased age
HPV Infection
Lichen sclerosus

35
Q

What is the diagnosis and management of vulval cancer?

A

Biopsy

Surgery - wide local excision

36
Q

What is VIN?

A

Vulval intraepithelial neoplasia

Pre-malignant condition affecting the intraepithelial layer of the skin

Obs & Gynae (6 decks)

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