Gynecology 2 Flashcards
What’s the most common cause of death in cervical cancer?
Renal failure = due to hydronephrosis. blockage of bladder as cancer invades.
What do the early genes in HPV code for?
INteract with molecules to disrupt normal cell cycle:
E6= p53
E7 = Rb
What do the late genes in HPV code for?
Capsid proteins for the virus
What is HPV 18 more associated with?
Adenocarcinoma
What are the risk factors for cervical cancer?
Multiple sexual partners
smoking
early sexual intercourse
multiple pregnancies
If there is invasion of cervical cancer within 3mm - microinvasion, what is the treatment?
Hysterectomy with sparing of lymph nodes
What’s the biggest cause of endometrial adenocarcinoma?
Unopposed oestrogen
There are two main types of endometrial adenocarcinomas, what are they and how do they differ?
Endometrial Intraepithelial Neoplasia - dereives from hyperplasia - Oestrogen
Sporadic form/ serous carcinoma: P53 mutation. occurs in more elderly
Is simple endometrial hyperplasia associated with increase in cancer risk? what is?
No
Atypical type is associated with endometrial cancer - endometrial intraepithelial carcinoma
How is endometrial adenocarcinomas managed?
Oestrogen antagonists - mirena
Hysterectomy
Radiation therapy
What is the other type of endometrial cancer which can develop?
Endometrial stroma carcinoma
What are the investigations for endometriosis and management?
Ultrasound
- transvaginal
- transrectal
NSAIDs
progesterone
Oral contraceptive
What is it called when there is endometrial tissue within the muscle of the uterus?
Adenomyosis
How are endometrial polyps treated?
Hysteroscope
Where do leiomyosarcomas tend to metastasis to?
Liver, brain, lungs
What are the symptoms of a hydatidiform molar pregnancy?
Odematous villie
Trophoblast proliferation
Large for due date
Increase Beta- hCG
What the most common genetic link to serous cystoadenocarcinomas of the ovaries?
BRCA1
What substances can be seen in granuloma/ theca cell tumours?
Cal Exner bodies
- little fluid filled sacs
What are the two main types of tumour that develop on the vulva?
HPV related - young person. VIN
Non - HPV. usually lichen sclerosis related - old person.
What can extra mamillary paget disease of the vulva be hard to differentiate between? and how is it done?
Melanoma
evidence of keratin = squamous
S100 = melanoma
Whats the symptoms of salpingitis:
Pain in pelvis
Fever
Feeling of fullness
What are complication of salpingitis?
Tubo-ovarian abscesses
Ectopic pregnancy
Infertility
endometriosis
- increases the chance of this occurring in the tubes
Whats the most common cancer of the fallopian tubes? and what is it associated with?
Papillary serious carcinoma
BRCA1
often involve omentum
What are some risk factors of ovarian tumours?
Never having children
Family history
Oral contraceptive
What are the most common cause of sporadic ovarian cancers?
p53
- causes high grade
KRAS - 30%
- most common for mucinous
HER2
- 35%
if there is a lack of cystic formation, i.e. they are solid, what are ovarian then called?
Adenofibromas
- usually always benign
AS opposed to (cystadenocarcinoma)
What are the two types of serous carcinomas of the ovary? and what are they associated with?
Low grade
- KRAS mutations
- young women
High grade
- p53
- older women
If you have bilateral mucinous tumours - what has most likely happened?
Metastasis from the G.I
What is associated with malignant teratomas of the ovary?
Immature cells
How do thecoma/ granulosa tumours often present and why?
Postmenopausal bleeding
- to the increase in oestrogen again
What are the two common types of endometrial cancer
and how are they diagnosed?
Adenocarcinoma = hyperplasia related. >50 years old
Serous carcinoma = sporadic related to p53 defect - >70 years old
List some common symptoms of ovarian cancer and list the investigations you would do:
Pelvis Mass often presents as G.I symptoms
- bloating
- discomfort abdominally
- early satiety
- sister mary umbilical nodules
Ultrasound
CT scan
Ca125
Cytology - biopsy
Some ovarian tumours can present with hirsutism, why is this and what tumour are the most likely to be? and what class of tumours do they belong to?
Sertoli- leydig ovarian tumours.
Secrete androgens leading to the hirtuism.
Belong to the:
- sex chord stromal
Outline some strategies that can be implemented to improve breast cancer detection to prevent early deaths:
Education around breast cancer
IMportance of self checking - with education in how to do so
regular physical examination
Mammograms 50- 70 year olds every 3 years
List some risk factors for cervical cancer:
Multiple sexual partners
Early Sexual activity
HPV infection
Multiple Pregnancies
Smoking
How many breast cancers are picked up by examination?
50%
Where does the breast expand from vertically?
2nd - 7th rib
Not having children is a risk factor for breast cancer, what age and over is considered a risk?
30 years old
