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Obstetrics & Gynae RIA > malignancy > Flashcards

malignancy Flashcards

1
Q

what is an ectoprion?

A

eversion of the endocervix, exposing the columnar epithelium

(the stratified squamous epithelial cells of the ectocervix undergo metaplastic changes to become simple columnar epithelium)

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2
Q

symptoms of cervical ectroprion?

A

light mucus discharge, spotting betwen periods, pain&bleeding during or after intercourse

on visualisation: reddenedd area about the external os

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3
Q

high risk HPV strains?

A

16 & 18

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4
Q

who is enrolled in cervical cancer screening

A

25 to 49 years: 3 yearly
&
50-64 years: 5 yearly

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5
Q

what does a cervical biopsy asess

A

the depth of invasion & therefore the grade of CIN (dyskaryosis)

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6
Q

management of high grade, moderate dyskaryosis?

A
  • urgent referral for colposcopy 2 week wait

- follow up in 6 months with smear

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7
Q

management if 3 inadequate smears are taken?

A

assess by colposcopy

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8
Q

80% of cervical cancers are….

A

squamous cell epithelium

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9
Q

outline the 4 stages of FIGO staging of cervical cancer

A

1) Confined to cervix
2) Invades the uterus or upper 2/3 of the vagina
3) Invades the pelvic wall or lower 1/3 of the vagina
4) Invades the bladder, rectum or beyond the pelvis

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10
Q

which strain does the cervical cancer vaccine prevent against?

A

6, 11, 16, 18

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11
Q

what cancer needs to be ruled out: POST MENOPAUSAL BLEEDING

A

endometrial cancer

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12
Q

how does PCOS increase risk of endometrial hyperplasia?

A

PCOS leads to increased exposure to unopposed oestrogen due to lack of ovulation as when ovulation occurs the corpus luteum forms which releases progesterone (endometrial protection)

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13
Q

why is obesity a risk factor for endometrial hyperplasia

A

because adipose tissue contains aromatase which converts androgens e.g. testosterone into oestrogen

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14
Q

protective factors against endometrial cancer

A
  • COCP
  • mirena coil
  • increased pregnancies
  • ciagrette smoking
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15
Q

1st line investigation for suspected endometrial ca?

A

Transvaginal ultrasound for endometial thickness

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16
Q

what is normal endometrial thickness?

A

< 4 mm post menopause

17
Q

treatment for stage 1 & 2 endometrial cancer

A

total abdominal hysterectomy with bilateral salpingo-oophorectomy

18
Q

what markers may be raised in germ cell tumours

A

AFP & hCG

19
Q

3 factors that may increase ovulation therefore increase risk of ovarian cancer

A
  • early menarche
  • late menopause
  • no pregnancies
20
Q

risk factors for ovarian cancer

A
  • BRCA1&2
  • incresed no of ovulations
  • obesity
  • smoking
  • recurrent use of clomifene
21
Q

3 protective factors for ovarian cancer through reducing number of ovulations

A
  • pregnancy
  • breastfeeding
  • COCP
22
Q

2 initial investigations when suspecting ovarian cancer

A
  • Ca125

- Pelvic USS

23
Q

presenting symptoms of vulval cancer

A
  • vulval lump
  • ulceration
  • bleeding
  • pain
  • itching
  • groin lymphadenmopathy
24
Q

4 reasons to delay cervical screening appointment

A
  • menstruating
  • abnormal
  • < 12 weeks post natal
  • < 12 weeks post pregnancy termination or miscarriage
25
Q

dose of folic acid to take whilst couple trying to conceive?

A

400 mcg OD

26
Q

what does high FSH suggest

A

poor ovarian reserve (no. of follicles the woman has left in her ovaries)

as the pituitary gland is producing extra FSH in an attempt to stimulate follicular development

27
Q

investigation to assess tubal patency

A

Hypersalpingogram

28
Q

severe complication of IVF

A

ovarian hyperstimulation syndrome

29
Q

pathophysiology of ovarian hyperstimulation syndrome…

A

hCG stimulates the release of VEGF from granulosa cells of the follicles;

VEGF increases vascular permeability causing fluid to leak from capillaries and fluid moves from intravascular to extravascular space

  • oedema
  • ascites
  • hypovolaemia
30
Q

formula to calculate risk of malignancy score

A

U x M x Ca125

31
Q

when does cervical screening commence

A

ate age 25

32
Q

frequency of cervical screening?

A

3 yearly between 25 to 49
&
5 yearly between 50 to 64

33
Q

next step if HPV +ve & normal cytology

A

smear repeated at 12 months

34
Q

next step is HPV remains positive 24 months later?

A

refer to colposcopy

35
Q

next step if HPV +ve & abnormal cytology

A

colposcopy

Obstetrics & Gynae RIA (9 decks)

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