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Medicine > Week 4 - Female GU > Flashcards

Week 4 - Female GU Flashcards

1
Q

What are the 2 Main components of Breast tissue?

A
  • Stroma (fibrous and Fatty tissue)

- Glandular tissue (Lobes and Ducts)

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2
Q

What are 3 developmental abnormalities of the breast?

A

1) Ectopic breast tissue - usually along the milk line
2) Breast hypoplasia - itty bitty titty committee
3) Macromastia - Stromal overgrowth

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3
Q

Name 5 inflammatory conditions of the breast?

A

1) Acute mastitis
2) Granulomatous inflammation
3) Foreign body reaction
4) Duct ectasia
5) Fat necrosis

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4
Q

Briefly outline Acute mastitis

A
  • Infection and inflammation of the skin over the breast

- Associated with breast feeding

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5
Q

Briefly outline Granulomatous inflammation

A
  • Inflammation of the breast tissue that occurs in systemic disease
  • e.g. TB and Sarcoidosis
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6
Q

Briefly outline Foreign body reaction

A
  • Inflammation occurs around breast implant
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7
Q

Briefly outline Duct ectasia

A
  • Dilation of lactiferous ducts and periductal inflammation

- Calcification seen on mammogram

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8
Q

Briefly outline Fat necrosis

A
  • Usually follows trauma
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9
Q

Name the general characteristics of fibrocystic change

A
  • Multi focal and bilateral
  • Breast tenderness
  • Nodularity
  • Benign
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10
Q

Give 6 examples of fibrocystic changes

A

1) Sclerosing adenosis
2) Increased fibrous stroma
3) Apocrine metaplasia
4) Epithelial hyperplasia
5) Papillomas/ papillomatosis
6) Radial scars

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11
Q

How are fibrocystic changes classified?

A

1) Non-proliferative
2) Proliferative without atypia
3) Proliferative with atypia

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12
Q

Briefly outline Sclerosing adenosis

A
  • Benign proliferation of glandular tissue and stroma

- Micro-calcification on mammogram

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13
Q

Briefly outline Increased fibrous stroma

A
  • Proliferation of stroma
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14
Q

Briefly outline Apocrine metaplasia

A
  • Do not need to know its way to random
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15
Q

Briefly outline Epithelial hyperplasia

A

1) Ductal hyperplasia
2) Atypical ductal hyperplasia (calcification on mammo)
3) Atypical Lobular hyperplasia
4) Columnar cell lesions (calcification on mammo)

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16
Q

Briefly outline Papillomas/ papillomatosis

A
  • Benign tumour of the epithelial lining of ducts
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17
Q

Briefly outline Radial scars

A
  • Area of hardened tissue

- Can be confused for breast cancers on mammograms

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18
Q

Give 4 examples of benign neoplasms

A

1) Fibroadenoma
2) Phyllodes tumour
3) Pure adenoma
4) Hamartoma

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19
Q

Briefly outline Fibroadenoma

A
  • Overgrowth of epithelium and stroma
  • Firm, Non-tender, and mobile
  • Hormone sensitive
  • Commonest in teens to 30’s
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20
Q

Briefly outline Phyllodes tumour

A
  • Can be malignant or benign

requires surgical excision

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21
Q

Briefly outline Pure adenoma

A
  • Overgrowth of glandular tissue
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22
Q

Briefly outline Hamartoma

A
  • Benign overgrowth of the regular tissue
23
Q

Name 6 risk factors for breast cancer

A

1) Earlier menarche
2) Later menopause
3) HRT
4) Obesity
5) Family history
6) Genetics (BRCA1)

24
Q

Name 4 symptoms associated with breast cancers

A

1) New lumps
2) Pain
3) Skin changes
4) Nipple changes

25
Q

How do you diagnose breast cancers?

A

Triple assesment:

1) Clinical examination
2) Imaging (mammo/US)
3) Biopsy (core/FNA)

26
Q

What are the treatment options for breast cancer?

A

1) Chemo therapy
2) Surgery
3) Radiotherapy
4) Hormone therapy

27
Q

What are the main prognostic factors for breast cancers?

A

1) Grading

2) Stage

28
Q

what 3 histological properties are used to Grade breast cancers?

A

1) Nuclear polymorphism
2) Mitoses per mm(2)
3) Degree of gland formation by cancer cells

29
Q

How do you stage breast cancers?

A

TNM:

1) Tumour - size of tumout
2) Nodes - No of involved lymph nodes
3) Metastases - has it spread

30
Q

Other then stage and grade what else can be used to guide treatment of breast cancers?

A

classification based on gene expression:

  • ER/PR (oestrogen/progeterone) status
  • Her2 status
31
Q

What can be used to manage ER/PR positive breast cancers?

A

1) ER antagonist -Tamoxifen

2) Aromatase inhibitors - Letrazole

32
Q

What are the potential side affects of Tamoxifen?

A

increased risk of endometrial cancers

33
Q

What can be used to manage HER2 positive breast cancers?

A

Herceptin

34
Q

Over expression of what gene results in a worse prognosis in breast cancers?

A

HER2

35
Q

Name 2 pathologies of low grade dysplasia in the breast

A

1) Atypical ductal hyperplasia

2 Atypical Lobular hyperplasia

36
Q

What is the clinical relevance of low grade dysplasia in the breast?

A

Increases the risk of developing breast cancer

37
Q

Name 2 non-invasive breast cancers

A

1) Ductal carcinoma in situ

2) Lobular carcinoma in situ

38
Q

What are the properties of carcinoma in situ?

A
  • They are contained within the basement membrane

- No involvement of blood vessels or lymph vessels

39
Q

What are the 2 major division of breast malignancy?

A

1) Invasive ductal carcinoma

2) invasive lobular carcinoma

40
Q

What cells make up the epithelium of the endocervix?

A

simple columnar cells

41
Q

What cells make up the epithelium of the ectocervix?

A

non keratinised stratified squamous cells

42
Q

What is Cervical Intraepithelial Neoplasia (CIN)

A
  • Replacement of normal squamous epthelium by neoplastic squamos cells
  • Does not pass the basement membrane
43
Q

What is CIN 1?

A

Neoplastic cells present only in the basal 1/3rd

44
Q

What is CIN 2?

A

Neoplastic cells present within the basal 2/3rd

45
Q

What is CIN 3?

A

Neoplastic cells present through the width of the epithelium

46
Q

What is the clinical relevance of CIN?

A
  • Almost all invasive squamous carcinomas develop from pre-existing CIN
  • It is premalignant
47
Q

What virus is associated with cervical carcinomas?

A

Human papilloma Virus (HPV)

48
Q

which particular HPV types are strongly associated with CIN?

A

HPV 16 and 18

49
Q

What pathology is associated with cervical adenomas?

A

Cervical Glandular Intraepithelial Neoplasia (CGIN)

50
Q

What test is used to screen for cervical neoplasia or cancer?

A

Pap smear - samples taken from transformation zone

51
Q

What is the age range for cervical screening?

A
  • Smears taken every 3-5 yrs

- From 20-64

52
Q

What is the follow up if you see mild, moderate or severe dyskaryosis on a pap smear?

A

COLPOSCOPY

53
Q

How do you treat CIN 2 and 3?

A

Loop excision of the transformation zone (LETZ)

Medicine (4 decks)

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