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MED4 ACP > Gynaecological and breast pathology > Flashcards

Gynaecological and breast pathology Flashcards

1
Q

Pathology of HPV infection in cervix

A

koilocytosis

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2
Q

Diagnosis of CA cervix

A

Colposcopy

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3
Q

Screening for CA cervix (inclusion criteria, site, reporting system)

A

Pap smear + reflex HPV test
Inclusion: 21~65y female
Site: transformation zone
Reporting system: Bethesda system

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4
Q

Endometrial sampling methods (4)

A

Pipelle endometrial aspirator
Vabra aspiration
Dilataion & curettage
Hysteroscopic-guide biopsy

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5
Q

Pathology of endometrial hyperplasia (↑ … ratio)

A

↑ gland to stroma ratio

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6
Q

MC carcinoma in female genital tract

A

endometrial carcinoma

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7
Q

Which type of endometrial carcinoma resembles normal endometrium? Which type has the worst prognosis?

A

Endometrioid
Serous

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8
Q

Staging for endometrial carcinoma

A

FIGO staging

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9
Q

MC gynaecological tumour

A

uterine leiomyoma/ fibroids

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10
Q

Which ovarian germ cell tumour is…
(a) benign?
(b) most malignant?
(c) 2nd most malignant?

A

(a) Mature teratoma
(b) Dysgerminoma
(c) Yolk sac tumour

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11
Q

MC site of ectopic pregnancy

A

fallopian tube

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12
Q

MC cause of placental choriocarcinoma

A

complete mole

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13
Q

Tumour with synctiotrophoblast and cytotrophoblast

A

Placental choriocarcinoma

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14
Q

MC soft & firm breast lump in young and old female respectively

A

Soft: fibrocystic changes
Young & Hard: Fibroadenoma
Old & Hard: Carcinoma

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15
Q

MC mastalgia cause

A

fibrocystic changes

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16
Q

Yellow / green nipple discharge DDx (2)

A

infection, ductal ectasia

17
Q

Bloody nipple discharge DDx (3)

A

fibrocystic changes, intraductal papilloma, carcinoma

18
Q

Triple assessment for breast

A

Clinical assessment
Radiological assessment: USG or mammogram (>35y)
Pathological assessment: core needle biopsy

19
Q

Inflammatory diseases of breast (1+3)

A

Acute: mastitis
Chronic: ductal ectasia, fat necrosis, idiopathic granulomatous mastitis

20
Q

Risk factors for mastitis (3)

A

post-partum nursing, ↑ viscosity of milk, trauma

21
Q

Benign epithelial lesions at breast (1+3+2)

A

Non-proliferative: fibrocystic changes
Proliferative without atypia:
- usual ductal hyperplasia
- sclerosing adenosis (↑ CA risk)
- intraductal papilloma (↑ CA risk)
Proliferative with atypia (4x risk of CA)
- atypical lobular hyperplasia
- atypical ductal hyperplasia

22
Q

Pathogenesis of fibrocystic changes

A

exaggeration of cyclic breast change related to menstrual cycle
- simple cysts (lining cells often undergo apocrine metaplasia)
- apocrine secretions may calcify
- cysts rupture –> chronic inflammation & fibrosis

23
Q

CA breast: DCIS vs LCIS
(presentation, invasion risk, mammography, HG pathology, management)

A

unifocal; multifocal
same breast; bilateral breasts
pleomorphic microcalcification; /
comedo, pleomorphic cells
BCS + RT, tamoxifen; surveillance / bilateral total mastectomy

24
Q

Which invasive breast carcinoma is not palpable?

A

invasive lobular carcinoma

25
Q

Genetics for CA breast (4)

A

BRCA1/2, TP53, PTEN, STK11

26
Q

Adjuvent therapy regimen for CA breast

A
  1. Hormonal therapy if ER+ or PR+
  2. Targeted therapy if HER2+
  3. Cytotoxics if HER2+ or Ki67 high
  4. chemotherapy for high risk cancers
27
Q

Gene-based assay for risk scores of CA breast

A

Oncotype DX

28
Q

Hormonal therapy for CA breast

A

Tamoxifen (SERM — selective estrogen receptor modulator)
Anastrozole (aromatase inhibitor)

29
Q

Describe koilocyte (3)

A

enlarged smudged nuclei
perinuclear cytoplasmic halo
condensed cytoplasmic borders

30
Q

IHC subtypes / molecular classes of CA breast (4)

A

Luminal A (HR+/Ki67 low)
Luminal B (HR+/Ki67 high)
HER-2 positive (HR-/HER2+)
Triple negative (HR-/HER2-)

31
Q

Carcinogenesis of HPV infection

A

↑ oncoprotein E6, E7 –> bind to and degrade p53 & pRb (tumour suppressors)

MED4 ACP (13 decks)

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