Histopath - Gynae Flashcards

1
Q

HPV - most common high risk types?

Most common low risk types?

A

High risk: HPV 16 +18

Low risk: HPV 6+11

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2
Q

How does HPV cause cervical dysplasia?? with proteins are involved?

A

Proteins E6 + E7 inactivate 2 TS genes:

Rb gene + p53 gene

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3
Q

Risk factors for HPV infection

A

Early age of first intercourse, multiple partners, smoking, HIV, immunosuppression

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4
Q

Smear test - what results are seen?

A

Mild/moderate/severe dyskaryosis

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5
Q

If smear test shows dyskaryosis, what is the next test done? what results can it find?

A

Biopsy to undergo histology

Results –> CIN1/2/3

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6
Q

CIN1/2/3 =?

A
CIN1 = dysplasia confined to lower 1/3 of epic
CIN2 = confined to 2/3
CIN3 = full thickness but BASEMENT MEMBRANE INTACT
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7
Q

Cervical cancer: 2 types?

How do you differentiate between CIN and cancer?

A

SqCC and adenocarcinoma

CIN progresses to carcinoma if BM is compromised

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8
Q

How is Cervical cancer staged?

A

FIGO system
1 = confined to cervix
2 = involves uterus but NOT lower 1/3 of vagina nor pelvic wall
3 = involves pelvic wall or lower 1/3 vagina or hydronephrosis of kidney
4 = involves bladder/rectal mucosa or beyond true pelvis

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9
Q

Key Sx seen in endometrial cancer

A

Post menopausal bleeding

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10
Q

System of staging for endometrial cancer? Describe it?

A

FIGO system

1) uterus alone
2) cervix involved
3) adnexae/vagina/LNs involved
4) other pelvic organs/distant LNs involved

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11
Q

2 types of endometrial cancer? Which one is more common?

A

Type I, Endometrioid = more common(80%)

Type II, Non-endometrioid

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12
Q

pathophysiology of endometrial cancer - what is the difference between the 2 types?

A

Endometrioid type = OESTROGEN DEPENDENT, assoc with endometrial hyperplasia

Non-endometrioid type = unrelated to oestrogen, assoc with endometrial atrophy

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13
Q

Endometrioid type endometrial cancer = what kinda cells are usually seen?

A

85% are adenocarcinomas

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14
Q

Gene mutations seen in the 2 types of endometrial cancer

A

Endometrioid: all pts have at least 4 mutations, eg K-Ras, PTEN, CTNNB1, p63, Pl3KCa

Non-endometrioid: p53 in 90%, Her2 amplification

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15
Q

3 main groups of ovarian tumours? Most common?

A

Epithelial - most common
Stromal/sex cord
Germ cell

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16
Q

Most common type of epithelial ovarian tumour? what 2 cells are seen on cytology?

A

Serous cyst adenoma

  • columnar epithelium
  • Psammoma bodies
17
Q

Psammoma bodies?

A

Serous epithelial ovarian tumour

18
Q

Mucinous cystadenoma

- 2 types? What do they secrete?

A
  • endocervical or intestinal type

- Mucin and oestrogen secreting tumour

19
Q

What familial syndrome is mucinous ovarian carcinoma assoc with?

A

HNPCC

20
Q

What familial syndrome is serous ovarian carcinoma assoc with?

A

BRCA1

21
Q

Tubular glands seen in epithelial ovarian tumour… what type is it?

A

Endometrioid

22
Q

which epithelial ovarian cancer has the best prognosis?

A

Endometrioid

23
Q

Histology of an ovarian mass shows:

  • Intracellular glycogen
  • Hobnail appearance
A

Clear cell

24
Q

Which female tumour is the counterpart for testicular seminoma?

A

Dysgerminoma

25
Q

2 types of teratoma - what are their differences? (Benign or malignant, structure, tissues)

A

Mature(dermoid) or immature
Mature = benign, cystic, lots of mature tissues

Immature = malignant, usually solid, immature embryonal tissues

26
Q

Origin of choriocarcinomas?

A

50% arise in moles

25% from previous abortions

27
Q

Choriocarcinomas and immature teratomas - what do they secrete?

A

Choriocarcinomas - b-hCG

Immature teratomas - AFP

28
Q

3 types of stromal ovarian tumours. Which one doesn’t secrete hormones?

A

Fibromas - no hormone production
Granulosa-thecal cell tumours
Sertoli-Leydig cell tumours

29
Q

Meig’s syndrome

A

ascites, pleural effusion, fibroma

30
Q

Krukenberg tumours

A

bilateral ovarian mets (from GI/breast)

mucin-secreting, signet ring cells

31
Q

3 familial syndromes of ovarian cancer

A
  • Familial breast-ovarian cancer syndrome
  • Site specific ovarian ca
  • HNPCC