Uterus

Question 1

are endometrial polyps usually benign or malignant

Answer 1

benign

Question 2

how do polyps differ from fibroids

Answer 2

polyps contain glands and stroma

fibroids contain smooth muscle

Question 3

lump with smooth muscle

Answer 3

fibroid

Question 4

lump with glands and stroma

Answer 4

polyp

Question 5

how do polyps present

Answer 5

bleeding

Question 6

when are polyps most common

Answer 6

around menopause

Question 7

investigations for polyps (abnormal bleeding)

Answer 7

TVUS

Question 8

treatment of endometrial polyps

Answer 8

nothing, reassurance

Question 9

are fibroids and polyps common

Answer 9

yes!!

Question 10

are fibroids benign or malignant

Answer 10

benign

Question 11

another name for fibroids

Answer 11

leiomyoma

Question 12

what pathological process happens in the formation of a fibroid (remember benign)

Answer 12

neoplasm - abnormal excessive growth

Question 13

presentation of fibroids

Answer 13

menorrhagia
infertility
pelvic mass

Question 14

are fibroids or polyps more likely to cause a palpable uterine mass

Answer 14

fibroids

Question 15

what is it called when blood supply to a fibroid is cut off (eg during pregnancy) and fibrosis of fibroid occurs

Answer 15

‘red degeneration’

Question 16

investigations for fibroids

Answer 16

TVUS - see white ring

Question 17

management of fibroids

Answer 17

nothing, reassurance

myomectomy (removal of fibroid)

Question 18

what is the most common type of uterine tumour

Answer 18

endometrioid carcinoma

Question 19

who get endometrioid carcinoma

Answer 19

post menopausal women

Question 20

top differential for post menopausal bleeding

Answer 20

endometrioid carcinoma

Question 21

risk factors for endometrioid carcinoma (5)

Answer 21

post menopausal 
HRT (unopposed oestrogen) 
obesity = increased oestrogens 
lynch syndrome 
PCOS

Question 22

another name for lynch syndrome

Answer 22

HNPCC - hereditary non polyposis colorectal cancer

Question 23

how is lynch syndrome inherited

Answer 23

autosomal dominant

Question 24

which 3 cancers are increased risk in lynch syndrome

Answer 24

endometrial cancer
ovarian cancer
bowel cancer

Question 25

investigation for lynch syndrome

Answer 25

immunohistochemistry for abnormal proteins

Question 26

management for lynch syndrome

Answer 26

``` family screening prophylactic hysterectomy (or keep screening - patients choice) ```

Question 27

why is oestrogen (eg obesity and HRT) a risk factor for endometrial cancer

Answer 27

causes endometrial hyperplasia = precursor for endometrial cancer

Question 28

is endometrial carcinoma glandular or not (hence what type or carcinoma is it)

Answer 28

yes it is glandular = adenocarcinoma

Question 29

what are the 3 types of endometrial hyperplasia that can predispose endometrioid carcinoma

Answer 29

simple complex atypical

Question 30

how does atypical endometrial hyperplasia differ from simple/complex endometrial hyperplasia

Answer 30

atypical = has atypical nuclei in it

Question 31

what do the glands look like in simpler endometrial hyperplasia in comparison to complex/atypical hyperplasia

Answer 31

glands are dilated in simple endometrial hyperplasia glands are crowded in complex/atypical hyperplasia

Question 32

how do you treat simple/complex endometrial hyperplasia to stop it progressing to atypical hyperplasia/cancer

Answer 32

mirena coil

Question 33

how do you treat atypical hyperplasia to stop it progressing to cancer

Answer 33

hysterectomy

Question 34

what is the prognosis of endometrioid carcinoma (adenocarcinoma)

Answer 34

good!

Question 35

which part of the uterus is affected in endometrioid carcinoma (inner or outer)

Answer 35

inner! | endometrial surface

Question 36

which part of the uterus is affected in an serous carcinoma (inner or outer)

Answer 36

outer

Question 37

what is the serosa

Answer 37

1 thin layer of cells on outer surface of uterus

Question 38

what is prognosis like for serous carcinoma why

Answer 38

bad bc of easy spread to peritoneum

Question 39

which layer of the uterus is affected in fibroids

Answer 39

myometrium (middle layer)

Question 40

presentation of uterine tumours

Answer 40

abnormal bleeding bloating weight loss fatigue probs not pelvic mass unless late stage

Question 41

investigations for uterine tumours (diagnosis)

Answer 41

TVUS | biopsy

Question 42

investigations for uterine tumours after diagnosis for staging

Answer 42

MRI for local spread PET CT for distant mets

Question 43

first line treatment for uterine tumours

Answer 43

surgery - hysterectomy and salphinoectomy alternatives - chemo, radiotherapy (brachytherapy)