Week 12.0 - Gynae Tumours Flashcards

1
Q

What is CIN?

A

-Cervical Intraepithelial Neoplasia -> premalignant changes of the cervix (dysplasia)

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2
Q

How long does CIN I take to progess to CINIII?

A

-7 years

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3
Q

What risk factor gives you the highest risk of developing CIN?

A

-HPV 16 and 18

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4
Q

Which part of the cervix is most commonly affected by CIN?

A

-Transformation zone

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5
Q

Besides HPV, give 3 risk factors for CIN

A
  • Sexual intercourse
  • Multiple births
  • Longterm use of OCP
  • Partner with carcinoma of the penis
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6
Q

Describe 3 disease factors which make cervical screening a good programme

A
  • 3rd most common female cancer -> relevant
  • Natural history and progression of disease well understood
  • Has an early detectable stage
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7
Q

What is the most common type of cervical cancer?

A

-SCC

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8
Q

At what age does cervical cancer typically occur?

A

-Average age is 45

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9
Q

How does cervical cancer characteristically spread?

A
  • Locally to para-cervical soft tissues eg bladder, rectum

- Lymphatics to surrounding lymph nodes

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10
Q

How does cervical cancer usually present?

A
  • Screening abnormality

- Post-coital, intermenstrual or post-menopausal bleeding

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11
Q

What is endometrial hyperplasia a precursor to?

A

-Endometrial carcinoma

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12
Q

What is the main risk factor for endometrial carcinoma?

A

-Prolonged oestrogen exposure

eg exogenous oestrogen, increased oestrogen from endogenous sources eg adipose, annovulation

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13
Q

When does endometrial adenocarcinoma commonly occur?

A

-between ages 55-75 (rare before 40)

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14
Q

What are the two main types of endometrial adenocarcinoma and state the differences between them

A
  • Endometrioid -> Common, glandular proliferation, arising after endometrial hyperplasia,
  • Serous -> poorly differentiated, aggressive, worse prognosis, exfoliates
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15
Q

What is a leiomyoma?

A

-Fibroid -> beinign tumour of smooth muscle of myometrium

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16
Q

Where does leiomyosacroma metastasise?

A

-Lungs

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17
Q

When do malignant ovarian tumours commonly occur?

A

-45-65

18
Q

Why does ovarian cancer have a poor survival rate?

A

-Often spread to other sites by the time it presents

19
Q

Which tumour marker can be used to monitor ovarian cancer?

A

-CA125

20
Q

Which genetic mutation is linked to ovarian cancer?

A

-BRCA

21
Q

Give some risk factors for ovarian epithelial tumours

A
  • Null or low parity
  • Smoking
  • BRCA
22
Q

What are the 4 groups of ovarian tumours?

A
  • Mullarian epithelial
  • Germ cell
  • Sex cord
  • Mets
23
Q

Why are serous ovarian tumours associated with acites?

A

-Exfoliative and thus seed to the peritoneum

24
Q

What is pseudomyxoma perinotei

A

-An extensive mucinous ascites caused by mets to the peritoneum, often involves the ovaries but the primary is the appendix

25
Q

What is the most common germ cell tumour?

A

-Teratoma

26
Q

Besides teratoma, give another germ-cell tumour

A

-Yolk sac tumour

27
Q

What is a-fetoprotein?

A

-A tumour marker which is used in yolk sac tumours and liver tumours

28
Q

In who do mature teratomas most commonly occur?

A

-Young women

29
Q

What is struma ovarii?

A

-Monodermal teratoma consisting solely of thyroid tissue

30
Q

What is meant by a sex-chord tumour being feminising or masculinising?

A

-Can contain any of the 4 sex cells eg granulosa, theca, sertoli or leydig, thus can produce testosterone or oestrogen

31
Q

Typically at what age does vulva cancer occur?

A

-Over 60

32
Q

What types of vulva cancer are there?

A
  • BCC
  • SCC
  • Malignant melanoma
  • Extramammary pagets disease
33
Q

With which infection is vulva cancer associated with? What age group does this affect?

A
  • HPV (16)

- 6th decade

34
Q

What age group does vulva cancer not associated with HPV affect?

A

-8th decade

35
Q

What is VIN?

A
  • Vulva intraepithelial Neoplasia
  • An in situ precursor with no mucosal invasion.
  • Often white patches on mucosa or brown patches on anus
36
Q

What are the 3 major types of gestational tumours?

A
  • Hydatidiform mole
  • Invasive mole
  • Choriocarcinoma
37
Q

What is a hydatidiform mole?

A

-Molar pregnancy when all the cells are dedicated to the outercell mass (trophoblast)

38
Q

What is an invasive mole?

A

-Hydatidiform mole which penetrates and invades the endometrium/myometrium

39
Q

Why is an invasive mole so dangerous?

A

-Invasion can be extensive leading to haemorrhage and local destruction of tissue. (needs to be treated with chemo)

40
Q

What is a gestational choriocarcinoma?

A

-Malignant neoplasm of trophoblast cells which is rapidly invasive and metastasises