Anatomical Pathology - Female Genital Tract

Question 0

Major complication of ectopic preg

Answer 0

Haemorrhage

Question 1

Ectopic pregnancy due to..

Answer 1

1. Partial tubal obstruction (eg salpingitis)

2. Delayed pick up by fimbriae

Question 2

Possible causes of endometriosis

Answer 2

Retrograde spread during menstruation
Implantation (during C/S)
Metaplasia
Lymphatic spread
Heamatogenous spread

Question 3

Macroscopic characteristics of endometriosis

Answer 3

Chocolate cysts

Fibrosis (cyclical haemorrhage)

Question 4

Microscopic characteristics of endometriosis

Answer 4

Endometrial glands + stroma
Fibrosis
Haemosiderin laden macrophages

Question 5

Complications of endometriosis

Answer 5

Infertility
Adhesions
Intermittent intestinal obstruction
Some endometrial cancer

Question 6

Complications of leiomyomas

Answer 6

Menstrual disturbances
Infertility
Repeated abortions
Obstetric complications

Question 7

Possible locations of leiomyomas

Answer 7

Intramural
Subserosal
Submucosal

Question 8

Possible macroscopic characteristics of squamous Ca Cx

Answer 8

Ulcerating
Exophitic
Nodular

Question 9

Risk factors for squamous Ca Cx

Answer 9

Low SES
Early sexual debut
Multiple partners
Smoking
COC
Immunosuppression
STIs
Long time since last pap smear

Question 10

Causes of death in Ca Cx

Answer 10

Renal failure
Haemorrhage
Superadded infection
Blood borne metastasis 
Iatrogenic (eg PE)

Question 11

Stage 1A Ca Cx

Answer 11

Visible microscopically

Question 12

Stage 1B Ca Cx

Answer 12

Visible macroscopically
1< 4cm
2> 4 cm

Question 13

Stage 2A Ca Cx

Answer 13

Upper 2/3 vagina

Question 14

Stage 2B Ca Cx

Answer 14

Parametrial involvement

Question 15

Stage 3A Ca Cx

Answer 15

Lower 1/3 vagina

Question 16

Stage 3B Ca Cx

Answer 16

Pelvic sidewall/ hydronephrosis/ non functional kidney

Question 17

Stage 4A Ca Cx

Answer 17

Mucosa bladder / rectum

Question 18

Stage 4B Ca Cx

Answer 18

Distant metastasis

Question 19

Why cytology NB for Ca Cx

Answer 19

LSIL and HSIL can’t be seen macroscopically

Question 20

Three sections on cytology report

Answer 20

Adequacy of smear
Epithelial cells changes
Organisms

Question 21

What makes a Pap smear adequate

Answer 21

Endocervical cells present

Cells not obscured by blood/ exudate etc

Question 22

Colposcopy looks at …

Answer 22

Margin of lesion
Color of lesion
Arrangement of superficial blood vessels

Question 23

Rx CIN 1

Answer 23

Colposcopy

Question 24

Rx CIN 2-3

Answer 24

``` LLETZ If margins involved: LLETZ Cone biopsy Hysterectomy ```

Question 25

Rx stage 1A1

Answer 25

Cone biopsy

Question 26

Rx stage 1A2

Answer 26

Total abdo hysterectomy | Pelvic lymphadenectomy

Question 27

Rx stage 1B

Answer 27

Radical hysterectomy Pelvic lymphadenectomy (Wertheim's hysterectomy)

Question 28

Rx stage 2 and above

Answer 28

Chemoradiation | Intracavitary brachytherapy

Question 29

Type1 endometrial Ca pathogenesis

Answer 29

Unopposed oestrogen > endometrial hyperplasia > hyperplasia with atypia > carcinoma

Question 30

Prognosis for endometrial Ca type 1

Answer 30

Good with surgery

Question 31

Causes of unopposed oestrogen

Answer 31

Obesity PCOS HRT

Question 32

Prognosis for type 2 endometrial Ca

Answer 32

Poor (chemo needed as tendency to metastasize)

Question 33

Four types of endometrial cancer

Answer 33

Endometrial Ca Carcinosarcoma Endometrial stromal sarcoma Gestational Trophoblastic disease

Question 34

Two types of gestational Trophoblastic disease

Answer 34

Hyatidiform mole | Choriocarcinoma

Question 35

Features of partial mole

Answer 35

Trophoblastic proliferation with normal villi Triploid Little malignant potential

Question 36

Feature of complete mole

Answer 36

Molar tissue with no normal villi Diploid (empty egg) Malignant potential

Question 37

Features of invasive mole

Answer 37

Molar tissue extends into parametrium | May metastasize

Question 38

What is choriocarcinoma

Answer 38

Malignant tumour of cyto- and syncytio- trophoblasts without chorionic villi

Question 39

Prognosis for choriocarcinoma

Answer 39

Good with chemo