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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
Treatment of endometrial polyps?
Progesterone GnRH agonists Surgery
26
State risk factors for Leiomyomata (uterine fibroids)?
``` Genetics 30-50yrs Obesity PCOS Nulliparity HTN ```
27
Fibroids present as menometorrhagia and are investigated by bimanual exam and USS. Whats the treatment?
``` NSAIDs OCP Fe2+ Artery embolisation TAH ``` *tends to regress in menopause
28
Is oestrogen high or low in endometrial hyperplasia?
``` High oestrogen (RISK FACTOR) Low progesterone ```
29
Endometrial hyperplasia presents as any ab bleeding and is investigated using USS/hysteroscopy. What are the treatment options?
Progesterone IUS TAH
30
The most common gynae cancer is...?
Endometrial cancer
31
Typical presentation of Endometrial cancer?
PMB | PCB
32
Endometrial cancer is investigated by USS, hysteroscopy & biopsy. What are the treatment options?
Progesterone TAH-BSO Chemo/RT
33
What are the 2 types of endometrial cancer? Which one is more common & is pre-menopausal/E2 dependant?
Type 1: Endometriod* | Type 2: Serous
34
The name of the follow ovarian disoder is... 1. HYPERANDROGENISM 2. MENSTRUAL AB 3. POLYCYSTIC OVARIES
Polycystsic Ovary syndrome (PCOS)
35
The risk factors for PCOS are Obesity and Diabetes. How would you treat it?
``` Weight loss Metformin OCP Ovarian drilling Clomiphene (conceive) ```
36
Gonadal failure/Hypogonadism can be characteristed by high/low FSH & LH. Name the 2 catagories of hypogonadism.
1" = Hypergonadotrophic Hypogonadism 2" = Hypogonadotrophic Hypogonadism
37
Turner's syndrome, Infection, Surgery, Chemo/RT, Drugs are all examples of what?
1" hypergonadotrophic hypogonadism
38
2" hypogonadotrophic hypogonadism is caused by?
Pituitary/hypothalamus failure Pituitary tumour Brain trauma Sheehan's syndrome Empty sella syndrome
39
How is gonadal failure treated?
HRT
40
Ovarian neoplasms are divided into which 3 groups?
1. Epithelial tumours* 2. Germ cell tumours 3. Sex-cord stromal tumours (rare)
41
Which gynae cancer is the 2nd most common? Risk factors?
Ovarian cancer FH, Age, PMH breast cancer, Smoking, E2-HRT, HNPCC
42
Symptoms of ovarian cancer are non-specific. Name some.
Weight loss Bloating Vaginal bleeding Urinary frequency
43
Breast anatomy is made of 2 components. T/F?
F 3 components: - Fat - Fibrous tissue - Glandular tissue
44
State common presentations of any breast pathology
``` Lumps Puckered skin Nipple discharge/changes Pain Infection/Inflammation Abnormal radiology ```
45
1 in 8 women get...?
Breast cancer Most breast pathology
46
Breast cancer is commonly Ductal or Lobular cancer. What are the risk factors for breast cancer?
Combined contraceptives HRT Obesity Radiation
47
Breast screening is for 47-73yrs. Whats the triple assessment?
For investigating breast lumps: CLINICAL RADIOLOGICAL PATHOLOGY
48
What is a benign proliferation of glandular & conn tissue?
Fibroadenoma | common
49
Paget's D of the nipple is aka..?
Ductal carcinoma IN SITU
50
Define puerperium.
6-8 weeks post-partum
51
All antibitoics cross the placenta/enter breast milk. T/F?
T
52
Are Penicillins & Cephalosporins safe antibiotics to use in preg?
Yes
53
Which antibiotics are unsafe to use in preg?
Trimethoprim Tetracyclin Fluroquinolones Chloramphenicol
54
Preg women are immunocompromised. Infections often present diff/ more severe. Which viral infections are important to remember in preg?
``` CMV Parovirus B19 Toxoplasmosis Syphilus VZV Zika ```
55
Is screening for bacteriuria indicated in preg or not?
Indicated If untreated --> UTI --> pyelonephritis
56
Treatment of UTIs in preg?
Amoxicillin | Cefalexin
57
25% preg with pret-term labour have what infection?
CHORIAMNIONITIS | inflamm of umbilical cord/placenta/amniotic membranes
58
Presentation of choriamnionitis?
Maternal fever High WCC Maternal/Foetal tachycardia Foul-smelling amniotic fluid
59
C-section, PROM, Vaginal exams, Prolonged labour can all lead to what?
Puerperal endometritis | inflamm of womb
60
How does puerperal endometritis present?
Abdo pain Fever High WCC Foul-smelling lochia
61
Puerperal mastitis often occur ~5 weeks post-delivery in whom?
Breast-feeding mothers | Sudden fever/rigores/soreness
62
Treatment of puerperal mastitis?
Flucloxicillin | S.aureas from cracked skin
63
Neonatal Sepsis/Meningitis often has subtle or atypical signs. How would it present? Investigations?
``` Temp Respiratory CV Hepatic GI Bleeding disorders CNS ``` Blood, Urine, CSF
64
Jarish-Hexheimer reaction is caused by endotoxins from killed bacteria from antibiotics in what STI?
Syphilus
65
Which type of breast cancer lines up in a single file?
Lobular Carcinoma
66
What is the term for pitted/dippled skin on breast?
Peauorange
67
Condylomas are..?
Benign squamous neoplasm of lower genital tract

Clinical Pathology (13 decks)

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