gynaecological cancers Flashcards

1
Q

a) when is peak incidence of ovarian cancer?

b) prognosis?

A

a) 60 years old

b) poor, due to vague presentation

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2
Q

risk factors for ovarian cancer?

A
  • FHx
  • early menarche
  • late menopause
  • nulliparity
  • (last 3 all increase number of ovulations)
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3
Q

presentation of ovarian cancer?

A
  • abdominal distension, bloating
  • abdominal and pelvic pain
  • urinary urgency
  • early satiety
  • diarrhoea
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4
Q

investigations in ovarian cancer?

A
  • CA125
  • if this >35IU/ml, then USS of abdo/pelvis
  • diagnostic laparotomy
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5
Q

why is CA125 not used for screening of ovarian cancer?

A

it gets falsely raised by:

  • endometriosis
  • menstruation
  • benign ovarian cysts
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6
Q

age of presentation for endometrial cancer?

A
  • 75% are post-menopausal

- 25% before then

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7
Q

risk factors for endometrial cancer?

A
  • obesity
  • nulliparity
  • early menarche
  • late menopause
  • unopposed oestrogen (add a progesterone to HRT)
  • diabetes
  • tamoxifen
  • PCOS
  • HNPCC
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8
Q

features of endometrial cancer?

A
  • post-men bleeding

- intermenstrual bleeding

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9
Q

investigations of endometrial cancer?

A
  • if >55 with post-men bleed, refer to suspected cancer pathway
  • TVUSS is first line
  • hysteroscopy with endometrial biopsy
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10
Q

management of endometrial cancer?

A
  • total abdominal hysterectomy with bilateral salpingo-oophorectomy
  • if frail, progestogen therapy
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11
Q

protective factors for endometrial cancer?

A
  • COCP

- smoking

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12
Q

peak age for cervical cancer incidence?

A

25-29 years old

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13
Q

when is cervical cancer often picked up?

A

on routine screening

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14
Q

features of cervical cancer?

A
  • vaginal discharge
  • abnormal bleeding:
  • postcoital
  • intermenstrual
  • postmen
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15
Q

a) which virus is biggest risk factor for cervical cancer?

b) which serotypes?

A

a) HPV

b) 16, 18, 33

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16
Q

risk factors for cervical cancer?

A
  • HPV
  • smoking
  • HIV
  • early first intercourse
  • many sexual partners
  • high parity
  • lower socioeconomic status
  • COCP
17
Q

how often are 25-49 year olds screened for cervical cancer?

A

3-yearly

18
Q

how often are 50-64 year olds screened for cervical cancer?

A

5-yearly

19
Q

pros of liquid-based cytology over pap smear?

A
  • fewer inadequate samples
  • more sensitive
  • more specific
20
Q

when is the cervical smear most accurate?

A

mid-cycle

21
Q

how is a negative hrHPV result managed?

A

return to normal recall

22
Q

how is a positive hrHPV result managed?

A
  • sample examined cytologically
  • if normal, repeat at 12 months
  • if abnormal, then colposcopy
23
Q

how is an inadequate sample for cervical smear managed?

A
  • repeat within 3 months

- if this is inadequate too, colposcopy

24
Q

how is cervical cancer classified?

A

FIGO staging

25
Q

strains of HPV that cause genital warts?

A
  • 6

- 11

26
Q

when is HPV vaccinated against?

A
  • boys and girls aged 12-13

- MSM <45