Week 6 - Core clinical problems Flashcards
What process happens during cervical erosion?
where does this process happen?
Exposure of endocervical columnar epithelium to acid environment of vagina - leads to squamous metaplasia
(columnar cells - squamous cells at TZ zone)
Name some of the risk factors involved in CIN and squamous carcinoma?
Lots of sexual partners Long term oral contraceptive use Not using condoms Smoking Persistence of HPV infection
CIN is the pre-invasive stage of cervical cancer? T/F
T
Cervical polyp is premalignant? T/F
F
What are the 3 stages of CIN and briefly describe them?
CIN 1 - lower third dysplasia. Low grade
CIN 2 - 2/3rds dysplasia. High grade
CIN 3 - More than 2/3rds. High grade
Cervical cancer can either be squamous or adenocarcinoma.
a) What one is picked up by screening more often?
b) Which one has a worst prognosis?
a) Squamous
b) Adenocarcinoma
What is an adenocarcinoma?
a malignant tumour formed from glandular structures in epithelial tissue.
An anastomosis occurs between what 2 sets of 2 arteries in the female anatomy?
1) Uterine and Ovarian artery
2) Uterine and vaginal artery
Where will most venous drainage occur into?
Internal iliac vein
Will ureter damage occur more on the left side or right?
Left.
Because the right is constant and usually crosses the external iliac, the left is more medial and crosses common iliac
Where do most arterial blood supply come from?
what is the exception?
Internal iliac artery
Gonadal arteries come from abdominal aorta
Nerves of the lateral wall of the pelvis - what nerves supply the lower limb?
What nerve supplies the perineum?
Obturator nerve and Sciatic nerve - lower limb
Pudendal nerve supplies perineum
Where do the gonadal lumphatics spread to?
Lumbar nodes (in the abdomen)
What happens to FSH and LH during menopause?
They will rise
What is perimenopausal dysfunctional uterine bleeding?
The time period prior to going through menopause where a women has irregular periods & intra menstrual bleeding.
Due to fluctuating hormone levels
What hormone causes endometrial hyperplasia?
Oestrogen
There are 2 main types of endometrial cancer:
Type 1 = endometrioid
Type 2 = serous clear cell
Where do both types spread to?
Type 1 - myometrium
Type 2 - peritoneal cavity (i.e. more aggressive)
Type 1 endometrial cancer is more likely to affect older women? T/F
F
Type 1 = younger women with lynch syndrome
Type 2 = older women
What is the precursor for type 1 endometrial cancer?
Atypical endometrial hyperplasia
What is a sarcoma?
Cancer of connective tissue
What is the name of a tumour found in the myometrium
Leiomyoma (fibroid)
What 2 symptoms are associated with a fibroid?
Menorrhagia
Infertility
What cell type is involved in a leiomyosarcoma?
Spindle cells (elongated cells)
Ix leiomyoma’s
1st line - US
2nd line - MRI
Mx for leiomyomas
Nothing (as they are usually asymptomatic), watch and wait. They are very common
What is a hydrosalpinx?
Fallopian tube gets filled with serous clear fluid
What is endometriosis?
A condition where the endometrium is found outside the womb - in ovaries or in fallopian tube
Where do chocolate cysts come from? Where are they located?
Form due to endometriosis
Located on ovaries
What 2 genetic situations are related to ovarian cancer?
BRCA 1 & 2
Lynch syndrome
Symptoms of ovarian cancer
Early satiety Weight loss Pressure symptoms Change in bowel habit SOB Pleural effusion DVT
The OCP increases your risk of ovarian cancer? T/F
F
It decreases your risk as it decreases the amount a woman ovulates
1st line imaging for ovarian cancer
US
if mets - CT
What 2 tumor markers increase during ovarian cancer?
Ca-125
CEA
When do follicular cysts form?
When the follicle doesn’t go through ovulation - it just keeps growing and growing
Gold standard Ix for endometriosis
Laparoscopy
When does an ovarian tumour go from being borderline to malignant?
When there is stromal invasion
How are endometroid and clear cell carcinoma diagnosed?
Ascitic fluid
At what stage would an ovarian cancer have spread to the retroperitoneal lymph nodes
Stage 3A
What happens during stage 2A of ovarian cancer?
Cancer extends to fallopian tube
What types of HPV cause 70% of all cervical cancers?
16 & 18
