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GLA Y3S1 > GU/Breast > Flashcards

GU/Breast Flashcards

1
Q

what are the two types of epithelium that line the glandular tissue and ducts in the breast

A

inner: luminal
outer: myoepthelial

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2
Q

What is the commonest type of congenital breast abnormality

A

ectopic/heterotopic breast tissue

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3
Q

what is breast hypoplasia associated with

A

ulnar-mammary syndrome, polands syndrome, turners syndrome and congenital adrenal hyperplasia

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4
Q

what are the two types of stromal overgrgowth

A

juvenile hypertrophy and gestational hypertrophy

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5
Q

two strains of inflammatory infections

A

infective and non-infective

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6
Q

acute mastitis

A

a cellulitis associated with breast feeding, the skin fissuring may let the bacteria in and the milk stasis favours their growth which leads to the infection of the breast tissue

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7
Q

granulomatous inflammation

A

can occur is systemic diseases including sarcoidosis, and infections including tuberculosis

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8
Q

recurrent subareolar abscesses

A

these can be associated with maxillary fistula and is said to be associated with squamous metaplasia of lactiferous ducts and smoking

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9
Q

periductal mastitis/duct ectasia

A

dilation of the central lactiferous ducts, periductal chronic inflammation and scarring

CALCIFIED LUMINAL SECRETIONS SEEN ON MAMOGRAM

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10
Q

adenosis

A

increase in glandular breast tissue

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11
Q

Radial scars

A

benign lesions characterised by a fibrotic core with elastic fibres, trapped glands and a pseudo-infiltrative appearance

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12
Q

intraduct papilloma

A

benign tumour of the epithelium lining the mammary ducts

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13
Q

Phyllodes Tumour

A

they are like fibroadenomas, combine epithelium and mesenchyme, but with more celullar stroma, mitotic activity, cytological atypic and an infiltrative border

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13
Q

Phyllodes Tumour

A

they are like fibroadenomas, combine epithelium and mesenchyme, but with more celullar stroma, mitotic activity, cytological atypic and an infiltrative border

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14
Q

When is axillary clearance necessary

A

if the sentinel node biopsy is positive (but sometimes not even then)

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15
Q

what would you treat breast tumours with if they were ER/PR-positive carcinomas

A

response to endocrine treatment with tamoxifen (predominantly an ER antagonist)

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16
Q

what are aromatase inhibitors used for

A

postmenopausal women are given this to prevent oestrogen stimulation of tumour growth as it blocks the conversion of adrenal (androgens) to oestrogen’s, a process which usually occurs within adipose tissue (link between obesity and breast cancer?)

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17
Q

HER2 Positive cancers

A

worse prognosis and are treated with monoclonal antibody Trastuzymab (Herceptin) AND others

this reduces risk of relapse and prolongs survival

18
Q

what is breast cancer grading based off of

A
  1. nuclear pleomorphism
  2. the number of mitosis per mm2
  3. the degree of gland formation by the cancer cells

grade 1 = well differentiated and slow growing
grade 3 = poorly differentiated and fast growing

19
Q

what are the three main imaging modalities used in imaging of the pelvis in relation to female anatomy

A

MRI
CT
US - requires a full bladder as it opens up a good window to the uterus as the fluid does not reflect the beams

20
Q

why is US less effective in people with obesity

A

the sonar beam gets reflected by the fat, this means there is less beam to penetrate deeper tissues

21
Q

what can you see on a normal MRI in terms of pelvic imaging

A

in terms of T2 imaging it shows water and fat as bright areas and junctional zones as dark with the myometrium in the middle

22
Q

what are some examples of benign ovarian pathology

A

ovarian follicle
dermoid cysts
haemorrhage cysts
endometriosis
polycystic ovarian syndrome
ovarian torsion

23
Q

what size do follicles have to exceed to be diagnosed as cysts

A

above 2.5cm - these appear with completely dark centres

24
Q

hemorrhagic cysts

A

the US would not appear just dark it would also show internal echos that appear like speckles and this is a sign its blood

mostly symptomatic but can present with pain

25
Q

endometrioma

A

this is also known as the chocolate cyst
it appears much more dense on US as it also has haemorrhage debris and won’t go away after 6 weeks

26
Q

dermoid cysts

A

this is usually incidentally found in young women and is a very common benign neoplasm
this contains elements from multiple germ cells laters (teeth/calcification) and appear dark due to its fat content (on US its got a variable appearance on CT it appears well defined and dark with calcification)

27
Q

PCOS

A

this is a syndrome associated with excess androgens - on US it would present with multiple immature follicles (they often lack a central oocyte) as development has been prematurely stopped
- patients have irregular periods and androgen excess leading to hirsutism, acne and weight gain
can also result in fertility problems

28
Q

ovarian torsion

A

this is when he ovary twists on its vascular pedicle - young women present with abdominal/pelvic pain, nausea and vomitting and its mostly associated with an ovarian mass such as a dermoid cyst

29
Q

symptoms of ovarian cancer

A

feeling the need to urinate urgently or often
trouble eating or feeling full quickly
pelvic or abdo pain
bloating persistently

30
Q

how do you calculate the RMI (risk of malignancy index)

A

ultrasound score x menopausal score x CA 125

Premenopausal = 1
post menopausal = 3

ultrasound abnormalities:
0 = 0
1 = 1
3 = two or more
more than 200 is concerning

31
Q

what are some features of malignancy on an US

A

irregular solid or multi-lobulated cystic mass
solid components on the cyst wall
bilateral ovarian less
ascites, peritoneal nodules, or other evidence of metastases

32
Q

staging of endometrial cancer

A

1 = carcinoma in the uterus
2 = spread to the cervix
3 = outside the uterus but is still within the pelvis
4 = beyond the pelvis such as the bladder or bowel

33
Q

parametrium

A

this is a fibrous band that separates the cervic from the bladder

this is often invaded in stage 2b and above

if its invaded then surgery is not an option and it must be treated with chemo or radiation

34
Q

what is the metastatic theory of endometriosis

A

retrograde menstruation or surgical procedures introduce endometrium to sites outwit the uterine cavity

35
Q

what is the metaplastic theory of endometriosis

A

endometrium arises directly from the coelomic epithelium (i.e the peritoneum) of the pelvis

36
Q

leiomyoma

A

benign smooth muscle tumour of the myometrium

37
Q

leiomyosarcoma

A

malignant smooth muscle tumour of the myometrium

38
Q

most common cause of enlarged ovaries in post-menopausal women

A

ovarian stromal hyperplasia

39
Q

inflammation of the fallopian tube

A

salpingitis

40
Q

what is the presentation of PID

A

abdominal/pelvic pain, adnexal tenderness, fever and vaginal discharge

REQUIRES ANTIBIOTICS

aggregates of neutrophils are present

41
Q

molecular abnormalities in low grade serous carcinomas

A

BRAF and KRAS

there is an absence of the p53 mutation

42
Q

molecular abnormalities in high grade serous carcinomas

A

can be associated with the BRCA mutation in younger patients but this condition usually effects peri-menopausal and post-menopausal women. it is also associated with the p53 mutation

SURGERY AND CHEMO

thought to originate from the Fallopian tube as a STIC

43
Q

epithelial clear cell carcinomas

A

these are associated with endometriosis but can also occur in women without this
resistant to platinum based chemotherapy

NO P53 MUTATION
this is what can differentiate between high grade serious and clear cell

GLA Y3S1 (13 decks)

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