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Phase 3 > Week 4 - Female Reproductive Pathology > Flashcards

Week 4 - Female Reproductive Pathology Flashcards

1
Q

What type of epithelium lines the endocervix?

A

Columnar

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2
Q

What type of epithelium lines the ectocervix?

A

Non-keratinising stratified squamous epithelium

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3
Q

Where do most cervical neoplasia develop?

A

Transformation zone

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4
Q

Which strains of HPV are prevalent in Scotland?

A

16

18

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5
Q

Where are patients who have dyskaryosis suggestive of Cervical Intraepithelial Neoplasia on a cervical smear referred to?

A

Colposcopy clinic

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6
Q

Who is eligible for cervical smear in Scotland?

A

Women aged 25-65
35-50 - 3 yearly
50-65 - five yearly

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7
Q

Which strains of HPV does the vaccine protect against?

A

6, 11, 16, 18

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8
Q

Describe the steps in a colposcopy

A
  1. Cervix visualised
  2. Washed with acetic acid
  3. Application of iodine
  4. Green light filter
  5. Abnormal area can be biopsied or treatment performed at time
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9
Q

How do early (E1-7) HPV genes cause cervical carcinoma?

A

Interact with intracellular molecules to interfere with cell proliferation machinery to replicate the virus

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10
Q

How do late (L1-2) HPV genes cause cervical carcinoma?

A

Encode capsid proteins and disrupt cell cycle checkpoints

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11
Q

What are the symptoms of cervical cancer?

A 
Post-coital bleeding 
Intermenstrual bleeding 
Irregular vaginal bleeding 
Pain 
None?
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12
Q

What commonly causes atrophic vaginitis?

A

Low oestrogen after menopause

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13
Q

What are the symptoms of atrophic vaginitis?

A

Discomfort
Pain during intercourse
Bleeding

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14
Q

Name 3 non-infective inflammations of the vulva

A

Lichen planus

Lichen sclerosus

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15
Q

What proportion of vulval cancer is associated with HPV?

A

20%

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16
Q

What are the 2 different forms of vulval SCC?

A

Associated with vulval intra-epithelial neoplasm

Associated with dermatoses

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17
Q

Which embryonic structure do the gonads arise from?

A

Urogenital ridges

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18
Q

Which embryonic structure do the genital ducts arise from?

A

Mesonephric and paramesonephric ducts

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19
Q

Which ducts form female reproductive structures?

A

Paramesonephric i.e. Mullerian

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20
Q

Which ducts form male reproductive structures?

A

Mesonephric i.e. Wolffian

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21
Q

Which gene is responsible for sex determination?

A

SRY

22
Q

Which cells are present in the testes?

A

Leydig

Sertoli

23
Q

Why is testosterone essential for normal male development?

A

Stimulates development of mesonephric structures - without it, the ducts atrophy

24
Q

What causes the paramesonephric ducts to regress in males?

A

Sertoli cells produce Anti-Mullerian Hormone

25
Q

Which structures in males are formed from the urogenital sinus?

A

Bladder
Prostate gland
Bulbourethral gland
Urethra

26
Q

Why do the mesonephric ducts regress in females?

A

They do not have testosterone

27
Q

What type of epithelium lines the fallopian tubes?

A

Ciliated columnar

28
Q

What are the symptoms of salpingitis?

A 
Fever
Lower abdominal pain
Pelvic masses (if tubes distended with exudate or secretions)
29
Q

Give some examples of complications of salpingitis

A 
Abscess 
Adhesions 
Obstruction of lumen 
Infertility 
Ectopic pregnancy
30
Q

What is the most common cancer of the fallopian tubes?

A

Papillary serous carcinoma

31
Q

What is Serous Tubal Intraepithelial Carcinoma?

A

Abnormal epithelium in distal fallopian tube that is limited by BM therefore in situ, however nuclear atypia clearly seen
Likely precursor for high grade serous carcinoma

32
Q

What are the 3 types of non-neoplastic cysts?

A

Inclusion
Follicular
Luteal cysts

33
Q

What are the symptoms of PCOS?

A

Oligomenorrhoea
Hirtuism
Infertility
Obsesity

34
Q

What are the hormonal changes seen in PCOS?

A

High androgens
High LH
Low FSH

35
Q

What causes the symptoms seen in PCOS?

A

Multiple cystic follicles in the ovaries over-produce androgens

36
Q

What is a potential complication of PCOS?

A

Type II diabetes

37
Q

What are the 3 types of cell that make up the normal ovary?

A

Epithelium
Germ cells
Stromal cells

38
Q

Name 2 risk factors for epithelial ovarian cancers

A

Nulliparity

39
Q

Name common mutations found in sporadic ovarian cancer

A

BRCA (9%)
HER2 (35%)
KRAS (30%)
p53 (50%)

40
Q

Name 2 benign lesions of the ovarian epithelium

A

Cystadenoma

Cystadenofibroma

41
Q

Name the 5 types of ovarian carcinoma

A 
High grade serous (70%)
Endometrioid (10%)
Clear-cell (10%)
Low grade serous (5%)
Mucinous (3%)
42
Q

Which mutations are seen in HGSC of the ovary?

A

p53

BRCA1

43
Q

What age do women get malignant serous ovarian tumours?

A

45-60

44
Q

Which mutations are seen in LGSC?

A

BRAF

KRAS

45
Q

Which ovarian cancers arise from ovarian endometriosis?

A

Endometriod

Clear cell

46
Q

Where does HGSC of the ovary usually arise from?

A

Epithelial precursor lesions in the ovarian end of the Fallopian tubes

47
Q

What are Psammoma bodies?

A

Concentrically laminated calcified concretions commonly found in the papillae of serous tumours

48
Q

What type of disease can mimic primary ovarian mucinous carcnoma?

A

Metastatic cancer spread from the GI tract to the ovary

49
Q

How many mucinous ovarian tumours are malignant?

A

10%

50
Q

Which gene is involved in endometriod carcinomas?

A

PTEN tumour supressor gene

51
Q

What is a teratoma?

A

Tumour that contains tissues of all 3 germ cell layers

52
Q

What is a serious complication associated with a cystic teratoma?

A

Torsion

Phase 3 (12 decks)

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