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Clinical Pathology > Reproductive system (Gynaecology & STIs) > Flashcards

Reproductive system (Gynaecology & STIs) Flashcards

1
Q

Summary of the Reproductive System

A 
Intraepithelial neoplasia
HPV
Vulval tumours
Cervical tumours
Uterine disorders
Ovarian disorders
Breast pathology
Infections of preg/puerperium/noenate
STIs/HIV
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2
Q

What is Intraepithelial neoplasia?

A

= dysplasia of squamous ep lining of genital tract

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3
Q

Intraepithelial neoplasia is an IN SITU disease. T/F?

A

T

Curable

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4
Q

What is the common cause of VIN, CIN, CGIN, VaIN, AIN?

A

HPV

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5
Q

Which HPV types are benign and cause genital warts?

A

HPV 6, 11

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6
Q

which HPV types are high risk and cause 70% Cervical cancers?

A

HPV 16, 18

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7
Q

HPV expresses early genes at onset of infection:
E6 genes –> inactivates what?
E7 genes inactivate what?

A

E6 - p53

E7 - RB1

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8
Q

Name of HPV vaccine?

A

Gardasil

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9
Q

Features of VIN?

A

Warty

HPV-related – Vulval cancer ass.

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10
Q

Lichen Sclerosus in elderly women is associated with which type of VIN?

A

Diffrenciated VIN

Ass. with Vulval cancer

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11
Q

Vulval cancer is most commonly SCC. T/F?

Staging system?

A

T

FIGO system

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12
Q

Vulval tumours can be…?

A

SCC
Malignant Melanoma
Paget’s Disease

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13
Q

Is Paget’s Disease IN SITU disease?

Presents: eczematous/buring patch

A

IN SITU

exclude eczema

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14
Q

Which part of the cervix undergoes columnar ep –> stratified sq ep after menarche?

A

Transformation zone

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15
Q

Which state is the pre-invasive stage of Cervical SCC?

A

CIN

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16
Q

The cervical screening program is done to detect CIN and graded CIN 1-3. For what ages?

A

25-64yrs.

If ab –> HPV test, if +ve –> Colposcopy

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17
Q

Risk factors for CIN?

A

HPV*
Smoking*

Multiple partners, immunosuppression, young at 1st intercourse

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18
Q

CGIN is a pre-cursor for which cancer?

A

Cervical adenocarcinoma

Same presentation/treatment as Cervical SCC

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19
Q

State the treatment for CIN, Cervical SCC/Adenocarcinoma.

A

LLETZ

Large Loop Excision of the Transformation Zone

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20
Q

What is endometriosis?

Presentation?

A

= Ectopic endometrium

Asymptomatic ~25%
30-40yrs
Dysmenorrhoea
Dyspareunia

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21
Q

Endometriosis would be investigated using laproscopy. What is the treatment?

A

COCP
GnRH agonists/antagonists
Surgery

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22
Q

Endometritis can be acute or chronic. Name 4 common symptoms.

A

Abdo-pelvic pain
Ab vaginal bleeding/discharge
Fever
Dysuria

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23
Q

Treatment of endometritis?

A

Remove cause
Antibiotics
Analgesia

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24
Q

Endometrial polyps = common oestrogen-dependan growths.

It is often symptomatic. What types of bleeding can present though?

A

IMB
PMB
Mennorrhagia
Dysmennorhoea

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25
Q

Treatment of endometrial polyps?

A

Progesterone
GnRH agonists
Surgery

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26
Q

State risk factors for Leiomyomata (uterine fibroids)?

A 
Genetics
30-50yrs
Obesity
PCOS
Nulliparity
HTN
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27
Q

Fibroids present as menometorrhagia and are investigated by bimanual exam and USS. Whats the treatment?

A 
NSAIDs
OCP
Fe2+
Artery embolisation
TAH

*tends to regress in menopause

28
Q

Is oestrogen high or low in endometrial hyperplasia?

A 
High oestrogen (RISK FACTOR)
Low progesterone
29
Q

Endometrial hyperplasia presents as any ab bleeding and is investigated using USS/hysteroscopy. What are the treatment options?

A

Progesterone
IUS
TAH

30
Q

The most common gynae cancer is…?

A

Endometrial cancer

31
Q

Typical presentation of Endometrial cancer?

A

PMB

PCB

32
Q

Endometrial cancer is investigated by USS, hysteroscopy & biopsy. What are the treatment options?

A

Progesterone
TAH-BSO
Chemo/RT

33
Q

What are the 2 types of endometrial cancer?

Which one is more common & is pre-menopausal/E2 dependant?

A

Type 1: Endometriod*

Type 2: Serous

34
Q

The name of the follow ovarian disoder is…

  1. HYPERANDROGENISM
  2. MENSTRUAL AB
  3. POLYCYSTIC OVARIES
A

Polycystsic Ovary syndrome (PCOS)

35
Q

The risk factors for PCOS are Obesity and Diabetes. How would you treat it?

A 
Weight loss
Metformin
OCP
Ovarian drilling
Clomiphene (conceive)
36
Q

Gonadal failure/Hypogonadism can be characteristed by high/low FSH & LH.

Name the 2 catagories of hypogonadism.

A

1” = Hypergonadotrophic Hypogonadism

2” = Hypogonadotrophic Hypogonadism

37
Q

Turner’s syndrome, Infection, Surgery, Chemo/RT, Drugs are all examples of what?

A

1” hypergonadotrophic hypogonadism

38
Q

2” hypogonadotrophic hypogonadism is caused by?

A

Pituitary/hypothalamus failure

Pituitary tumour
Brain trauma
Sheehan’s syndrome
Empty sella syndrome

39
Q

How is gonadal failure treated?

A

HRT

40
Q

Ovarian neoplasms are divided into which 3 groups?

A
  1. Epithelial tumours*
  2. Germ cell tumours
  3. Sex-cord stromal tumours (rare)
41
Q

Which gynae cancer is the 2nd most common?

Risk factors?

A

Ovarian cancer

FH, Age, PMH breast cancer, Smoking, E2-HRT, HNPCC

42
Q

Symptoms of ovarian cancer are non-specific. Name some.

A

Weight loss
Bloating
Vaginal bleeding
Urinary frequency

43
Q

Breast anatomy is made of 2 components. T/F?

A

F

3 components:

  • Fat
  • Fibrous tissue
  • Glandular tissue
44
Q

State common presentations of any breast pathology

A 
Lumps
Puckered skin
Nipple discharge/changes
Pain
Infection/Inflammation
Abnormal radiology
45
Q

1 in 8 women get…?

A

Breast cancer

Most breast pathology

46
Q

Breast cancer is commonly Ductal or Lobular cancer. What are the risk factors for breast cancer?

A

Combined contraceptives
HRT
Obesity
Radiation

47
Q

Breast screening is for 47-73yrs. Whats the triple assessment?

A

For investigating breast lumps:
CLINICAL
RADIOLOGICAL
PATHOLOGY

48
Q

What is a benign proliferation of glandular & conn tissue?

A

Fibroadenoma

common

49
Q

Paget’s D of the nipple is aka..?

A

Ductal carcinoma IN SITU

50
Q

Define puerperium.

A

6-8 weeks post-partum

51
Q

All antibitoics cross the placenta/enter breast milk. T/F?

A

T

52
Q

Are Penicillins & Cephalosporins safe antibiotics to use in preg?

A

Yes

53
Q

Which antibiotics are unsafe to use in preg?

A

Trimethoprim
Tetracyclin
Fluroquinolones
Chloramphenicol

54
Q

Preg women are immunocompromised. Infections often present diff/ more severe.
Which viral infections are important to remember in preg?

A 
CMV
Parovirus B19
Toxoplasmosis
Syphilus
VZV
Zika
55
Q

Is screening for bacteriuria indicated in preg or not?

A

Indicated

If untreated –> UTI –> pyelonephritis

56
Q

Treatment of UTIs in preg?

A

Amoxicillin

Cefalexin

57
Q

25% preg with pret-term labour have what infection?

A

CHORIAMNIONITIS

inflamm of umbilical cord/placenta/amniotic membranes

58
Q

Presentation of choriamnionitis?

A

Maternal fever
High WCC
Maternal/Foetal tachycardia
Foul-smelling amniotic fluid

59
Q

C-section, PROM, Vaginal exams, Prolonged labour can all lead to what?

A

Puerperal endometritis

inflamm of womb

60
Q

How does puerperal endometritis present?

A

Abdo pain
Fever
High WCC
Foul-smelling lochia

61
Q

Puerperal mastitis often occur ~5 weeks post-delivery in whom?

A

Breast-feeding mothers

Sudden fever/rigores/soreness

62
Q

Treatment of puerperal mastitis?

A

Flucloxicillin

S.aureas from cracked skin

63
Q

Neonatal Sepsis/Meningitis often has subtle or atypical signs. How would it present?
Investigations?

A 
Temp
Respiratory
CV
Hepatic
GI
Bleeding disorders
CNS

Blood, Urine, CSF

64
Q

Jarish-Hexheimer reaction is caused by endotoxins from killed bacteria from antibiotics in what STI?

A

Syphilus

65
Q

Which type of breast cancer lines up in a single file?

A

Lobular Carcinoma

66
Q

What is the term for pitted/dippled skin on breast?

A

Peauorange

67
Q

Condylomas are..?

A

Benign squamous neoplasm of lower genital tract

Clinical Pathology (13 decks)

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