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J Repro > Uterus > Flashcards

Uterus Flashcards

1
Q

are endometrial polyps usually benign or malignant

A

benign

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2
Q

how do polyps differ from fibroids

A

polyps contain glands and stroma

fibroids contain smooth muscle

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3
Q

lump with smooth muscle

A

fibroid

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4
Q

lump with glands and stroma

A

polyp

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5
Q

how do polyps present

A

bleeding

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6
Q

when are polyps most common

A

around menopause

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7
Q

investigations for polyps (abnormal bleeding)

A

TVUS

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8
Q

treatment of endometrial polyps

A

nothing, reassurance

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9
Q

are fibroids and polyps common

A

yes!!

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10
Q

are fibroids benign or malignant

A

benign

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11
Q

another name for fibroids

A

leiomyoma

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12
Q

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

A

neoplasm - abnormal excessive growth

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13
Q

presentation of fibroids

A

menorrhagia
infertility
pelvic mass

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14
Q

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

A

fibroids

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15
Q

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

A

‘red degeneration’

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16
Q

investigations for fibroids

A

TVUS - see white ring

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17
Q

management of fibroids

A

nothing, reassurance

myomectomy (removal of fibroid)

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18
Q

what is the most common type of uterine tumour

A

endometrioid carcinoma

19
Q

who get endometrioid carcinoma

A

post menopausal women

20
Q

top differential for post menopausal bleeding

A

endometrioid carcinoma

21
Q

risk factors for endometrioid carcinoma (5)

A 
post menopausal 
HRT (unopposed oestrogen) 
obesity = increased oestrogens 
lynch syndrome 
PCOS
22
Q

another name for lynch syndrome

A

HNPCC - hereditary non polyposis colorectal cancer

23
Q

how is lynch syndrome inherited

A

autosomal dominant

24
Q

which 3 cancers are increased risk in lynch syndrome

A

endometrial cancer
ovarian cancer
bowel cancer

25
Q

investigation for lynch syndrome

A

immunohistochemistry for abnormal proteins

26
Q

management for lynch syndrome

A 
family screening 
prophylactic hysterectomy (or keep screening - patients choice)
27
Q

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

A

causes endometrial hyperplasia = precursor for endometrial cancer

28
Q

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

A

yes it is glandular = adenocarcinoma

29
Q

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

A

simple
complex
atypical

30
Q

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

A

atypical = has atypical nuclei in it

31
Q

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

A

glands are dilated in simple endometrial hyperplasia

glands are crowded in complex/atypical hyperplasia

32
Q

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

A

mirena coil

33
Q

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

A

hysterectomy

34
Q

what is the prognosis of endometrioid carcinoma (adenocarcinoma)

A

good!

35
Q

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

A

inner!

endometrial surface

36
Q

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

A

outer

37
Q

what is the serosa

A

1 thin layer of cells on outer surface of uterus

38
Q

what is prognosis like for serous carcinoma

why

A

bad

bc of easy spread to peritoneum

39
Q

which layer of the uterus is affected in fibroids

A

myometrium (middle layer)

40
Q

presentation of uterine tumours

A

abnormal bleeding
bloating
weight loss
fatigue

probs not pelvic mass unless late stage

41
Q

investigations for uterine tumours (diagnosis)

A

TVUS

biopsy

42
Q

investigations for uterine tumours after diagnosis for staging

A

MRI for local spread PET CT for distant mets

43
Q

first line treatment for uterine tumours

A

surgery - hysterectomy and salphinoectomy

alternatives - chemo, radiotherapy (brachytherapy)

J Repro (28 decks)

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