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Breast & Gynaecology Pathology Flashcards

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1
Q

What are the types of intraepithelial neoplasia?

A 
Cervical intraepithelial neoplasia
Cervical glandular intraepithelial neoplasia
Vulval intraepithelial neoplasia 
Vaginal intraepithelial neoplasia
Anal intraepithelial neoplasia
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2
Q

What happens if dysplasia is removed?

A

It is curative but if it is left, there is a chance of developing an invasive malignancy

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3
Q

HPV is what type of virus?

A

Double stranded DNA

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4
Q

What are the low risk HPVs?

A

6 and 11

40, 42, 43, 44, 53

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5
Q

What are the high risk HPVs?

A

16 and 18

31, 33, 35, 39, 58, 59

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6
Q

What are low risk and high risk HPVs associated with?

A

low risk= genital warts

high risk= pre-invasive and invasive diseases

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7
Q

What is a condylomata? What HPV is it associated with?

A

benign squamous neoplasm

6 and 11

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8
Q

Which HPVs are protected against in Gardasil?

A

6, 11, 16 and 18

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9
Q

Which HPVs are protected against in Cervarix?

A

16 and 18

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10
Q

What do high risk HPVs do in the cell?

A

upregulate E6 and E7 expression

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11
Q

What does E6 do? What does E7 do?

A

E6 inactivates p53

E7 binds to RB1 gene products

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12
Q

what does p53 do?

What does RB1 do?

A

p53 mediates apoptosis

RB1 is a tumour suppressor gene

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13
Q

What is the transformation zone?

A

An area of squamous metaplasia

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14
Q

Where is a CIN likely to develop?

A

Transformation zone

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15
Q

What is different about the transformation zone in post-menopausal women?

A

It is not easily excised via LLETZ

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16
Q

What is the pre-inasive stage of cervical SCC?

A

Cervical intraepithelial neoplasia

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17
Q

What is the aim of the cervical screening programme?

A

detection of CIN

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18
Q

When are women first invited for cervical screening?

A

25

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19
Q

Who is screened every 3 years and 5 years for cervical cancer?

A

3 years= 25-49

5 years= 50-64

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20
Q

What are the risk factors for cervical squamous cell carcinoma?

A 
high risk HPVs
multiple sexual partners 
young age at first intercourse
low socioeconomic groups 
smoking 
immunosuppression
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21
Q

What is the precursor for cervical adenocarcinoma?

A

CGIN

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22
Q

How is cervical carcinoma staged?

A

FIGO

I- confined to cervix
II- invades uterus wall
III- extends to pelvic wall
IV- invades bladder or rectum

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23
Q

How deep are Stage IA2 tumours?

A

3-5mm

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24
Q

What types of vulvular intraepithelial neoplasia occurs in older women?

A

Differentiated

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25
Is warty/basaloid VIN associated with HPV?
Yes It is graded from 1-3
26
Lichen sclerosus is associated with
inflammatory dermatoses in those over 70 and there is a 15% chance of malignancy risk
27
Extra-mammary Paget's disease is
an in situ adenocarcinoma of squamous mucosa
28
The most important prognostic factor in malignant melanoma is
Breslow thickness
29
How does malignant melanoma frequently spread?
via the urethra
30
What is endometriosis?
Ectopic endometrium around the body
31
How is endometriosis treated?
OCP GnRH agonists Progesterone antagonist Ablation
32
Endometritis presents as
abdo pain pyrexia discharge dysuria
33
What can cause endometritis?
Pelvic Inflammatory Disease | Endometrial TB
34
What are polypoid estradiol-dependent uterine overgrowths?
Endometrial polyps
35
How do endometrial polyps present?
Menorrhoagia | Dysmenorrhoea
36
What are leiomyomas?
Uterine fibroids benign myometrial tumours
37
What are risk factors for uterine fibroids?
Genetics Obesity PCOS HTN
38
What can uterine fibroids present as?
Menometorrhagia (Fe deficient anaemia) | Subfertility
39
The risk factors for endometrial hyperplasia are
``` obesity exogenous estradiol PCOS Tamoxifen HNPCC ```
40
What is a histological presentation of endometrial adenocarcinoma?
Invasion into the myometrium
41
What is the most common cancer of the female genital tract?
Endometrial carcinoma
42
What type of endometrical carcinoma presents in post-menopausal women?
Serous
43
What is the Rotterdam criteria?
Used to diagnose PCOS and requires 2/3 of: ``` polycystic ovaries on US hyperandrogenism irregular periods (>35 days) ```
44
How do you treat PCOS?
Weight loss Metformin, OCP Ovarian drilling
45
What does primary failure of gonads cause?
Hypergonadotropic hypogonadism
46
Hypergonadotropic hypogonadism can be caused by
Turner syndrome, Klinefelter's syndrome Infection, surgery and toxins
47
Secondary failure of the gonads is caused by
Hypothalamic/Pituitary failure
48
What does hypogonadotropic hypogonadism cause?
Sheehan syndrome Pituitary tumours Brain injury
49
How does gonadal failure present?
Amenorrhoea and absent menarche
50
Teratomas and yolk sac tumours are examples of
Germ cell tumours of the ovary
51
Sertoli-Leydig cell and thecomas are examples of
Sex-cord stromal tumours
52
CA125 is a marker for
ovarian cancer
53
What is Meig's syndrome?
Ovarian tumour, right sided hydrothorax and ascites
54
What are protective factors for ovarian cancer?
OCP, breastfeeding and hysterectomy
55
Mullerian tumours of the ovary are commonly associated with
the uterus, fallopian tube, pelvic peritoneum and contralateral ovary
56
Which women are eligble for breast screening?
50-70 | occurs every 3 years
57
What is the breast triple assessment?
Clinical examination Radiological examination Pathological examination
58
Fibrocytic changes normally affect
pre-menopausal women
59
What group are fibroadenomas most common in?
Afro-Caribbean women
60
What is a risk factor for breast cancer?
Oestrogens
61
What is commonly seen as microcalcifications on screening?
DCIS
62
How is breast cancer assessed?
Nottingham Grading System
63
What is the most common type of breast cancer?
Ductal
64
Trastuzumab targets
HER2
65
Tamoxifen is a
hormonally targeted therapy
66
What are the TORCH organisms?
``` Toxoplasmosis Other (syphilis, varicella-zoster, parvovirus B19) Rubella Cytomegalovirus (CMV) Herpes infections ``` They are some of the most common infections associated with congenital anomalies.
67
What are risk factors for puerperal endometritis?
C section prolonged labour multiple vaginal examinations
68
Pertussis is caused by
Bordatella pertussis
69
Impetigo can be caused by what organisms in childhood
S. aureus | S. pyogenes
70
Scarlet fever can be caused by
Group A beta-haemolytic streptococcus

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