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Leila's Yr 5 Pathology > Histopathology 6s - Gynae > Flashcards

Histopathology 6s - Gynae Flashcards

1
Q

which part of the Fallopian tube is the most common site for ectopic?

A

Ampulla (isthmus most lethal)

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2
Q

Top 3 most common cancers affecting women worldwide

A

Breast
Lung
Bowel

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3
Q

HPV low risk and high risk subtypes?

A

High risk: HPV 16 &18

Low risk: HPV 6 % 11

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4
Q

How does HPV cause cervical dysplasia?? which proteins are involved?

A

The virus has 2 proteins: E6 + E7 which bind to and inactivate TSGs
E6 –> p53
E7 –> retinoblastoma

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5
Q

CIN I
CIN II
CIN III

A

CIN I = mild dyskaryosis, limited to lower 1/3 of epithelium
CIN II = moderate dyskaryosib, lower 2/3 of epithelium
cIN III = severe dyskaryosis, entire epithelium but BM intact

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6
Q

dysplasia of cervical glandular epithelium = ?

A

Cervical glandular intraepithelial neoplasia (CGIN), much rarer

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7
Q

What are the two types of cervical cancer?

A

SCC or adenocarcinoma

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8
Q

How is cervical cancer staged?

A

FIGO, staged 1-4

1 = confined to cervix 
2 = involves uterus but NOT lower 1/3 of vagina nor pelvic wall 
3 = involves pelvic wall or lower 1/3 vagina or hydronephrosis of kidney 
4 = involves bladder/rectal mucosa or beyond true pelvis
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9
Q

Prognosis in stage 1 vs stage 4 cervical cncer

A

90% 5 year survival stage I

10% 5 year survival stage II

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10
Q

national vaccination programme for cervical cancer

A

girls aged 12
boys aged 13
offered Gardasil (quadrivalent vaccine)

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11
Q

what is the most common uterine tumour?

A

Leiomyoma (fibroids) (smooth muscle tumour of myometrium)

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12
Q

what is the name of the malignant counterpart of a fibroid?

A

Leiomyosarcoma

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13
Q

which ovarian tumours can give rise to endometrial hyperplasia?

A

Granulosa cell tumours of ovary

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14
Q

most common gynae malignancy in developed countries?

A

Endometrial ca

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15
Q

2 types of endometrial cancer, which one is more common?

A 
Type I (85%)= oestrogen dependent, young age, atypical endometrial hyperplasia precedes, MOST COMMON
Type II = post-menopausal, not oestrogen dependant
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16
Q

Subtypes of type I endometrial carcinoma

A

Endometrioid, secretory, mucinous adenocarcinoma

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17
Q

Subtypes of type II endometrial carcinoma

A

serous and clear cell

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18
Q

The genetic mutations needed for type I endometrial Ca

A

accumulation of >/= 4 mutations e.g. PTEN, p53, k-RAS

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19
Q

which type of endometrial Ca tends to express Her-2 receptor?

A

Type 2

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20
Q

FIGO staging endometrial ca (I-IV)

A

I: Confined to uterus
II: Spread to cervix
III: Adjacent spread (adnexae/ vagina/ LNs)
IV: Distant spread

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21
Q

Which 4 conditions does gestational trophoblastic disease encompass?

A

Partial mole, complete mole, invasive mole, choriocarcinoma

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22
Q

Which type of mole can give rise to choriocarcinoma

A

Complete mole

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23
Q

In which type of mole do you still have some foetal tissue?

A

Partial mole (normal egg which is fertilised by two sperm or one sperm which duplicates its DNA) –> 69 XXY

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24
Q

Origin of choriocarcinomas?

A

50% in moles

25% from previous abortions

25
Q

Number of chromosomes in a complete mole egg?

A

46XX (empty egg fertilised by two sperm or one sperm with duplicated DNA)

26
Q

What is adenomyosis?

A

Endometrial tissue deep within the myometrium

27
Q

name 3 types of non-neoplastic ovarian cysts

A

follicular and luteal cysts

endometrioitic cysts

28
Q

Which type of cancer is endometriosis a strong risk factor for?

A

Ovarian cancer (particularly clear cell and endometroid)

29
Q

2 protective factors for ovarian cancer

A

Pregnancy and COCP

30
Q

3 main groups of ovarian cancer, which is most common?

A

Epithelial - most common
Stromal/ sex cord
Germ cell

31
Q

Types of epithelial ovarian cancer

A

Serous, mucinous, endometroid, clear cell

32
Q

2 main types of benign ovarian tumours

A

Serous cystadenoma

Mucinous cystadenoma

33
Q

Most common type of epithelial ovarian tumour

A

Serous cystadenocarcinoma

34
Q

Age distribution of germ cell ovarian tumours?

A

Bimodal age distribution (young and old peak)

35
Q

In what age group do you commonly see sex cord/stromal tumours?

A

post-menopausal

36
Q

How are epithelial ovarian carcinomas divided?

A

Type I and type II

37
Q

Difference between type I and type II ovarian epithelial carcinomas?

A

Type I: low grade serous, endomtrioid, clear cell, mucinous, precursor lesions
Type II: HIGH grade, mostly high grade serous

38
Q

Which mutation commonly seen in serous ovarian cancers?

A

BRCA

39
Q

Which mutation in mucinous and endometrioid?

A

HNPCC

40
Q

Clear cell ovarian carcinoma main risk factor?

A

Endometriosis

41
Q

Main mutations in type I epithelial ovarian carcinomas

A

BRAF, K-RAS

42
Q

mAIN Mutation in type II epithelial ovarian carcinoma?

A

p53

43
Q

Psammoma bodies?

A

Serous epithelial ovarian cancer

44
Q

WhICH epithelial ovarian cancer has the best prognosis?

A

Endometrioid

45
Q

Why are clear cells clear?

A

Lots of intracellular glycogen

46
Q

What kind of epithelium are benign serous epithelial cancers lined with?

A

Bland epithelium

47
Q

Name some examples of sex cord/stromal ovarian cancers

A

Fibromas, Thecomas, granulosa cell tumours, sertoli-leydig cell tumours

48
Q

Germ cell tumours predominantly benign or malignant?

A

95% benign

49
Q

Which female tumour is the counterpart for testicular seminoma?

A

DYSGERMINOMA (type of germ cell tumour)

50
Q

What is the most common type of germ cell tumour?

A

mature teratoma

51
Q

Differences between mature and immature teratoma

A 
Mature = benign, adult-type tissues present
Immature = MALIGNANT, embryonal tissue
52
Q

Meig’s syndrome?

A

Ascites, pleural effusion, fibroma

53
Q

Krukenberg tumour

A

bilateral. ovarian mets from GI cancer, mucin producing signet-ring cells

54
Q

o Children of women with threatened abortion treated with diethyl stilbosterol –> risk of what kind of tumour?

A

Vaginal clear cell adenocarcinoma

55
Q

most common ovarian tumour in younger women?

A

Mature teratoma

56
Q

HPV infection can either be latent or productive, what does this mean?

A

Latent: HPV DNA resides within the cells but viral DNA replication is coupled with replication of epithelial cells so the virus only replicates when the host cells replicate. Complete viral particles are not produced and cellular changes associated with HPV are not seen.

Productive: HPV DNA replicates independently of host epithelial cells + cytological changes seen

57
Q

In metastatic ovarian cancer, where is the primary cancer likely to be?

A

COLON

58
Q

thinning of vulval epithelium with underlying hyalinization

A

LICHEN SCLEROSUS

59
Q

Endometrioid ovarian epithelial carcinoma is often found alongside which other type of cancer?

A

Endometroid ovarian carcinoma often found alongside endometroid endometrial carcinoma

Leila's Yr 5 Pathology (100 decks)

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