Cancers

Question 1

3 genetic causes of ovarian cancer

Answer 1

HNPCC

BRCA 1

BRCA 1

Question 2

symptoms of ovarian cancer

Answer 2

Vague!!

bloating/ abdominal pain

indigestion/ early satiety/ poor appetite

pelvic mass (pressure symptoms)

Question 3

what is the ovarian cancer tumour marker?

Answer 3

CA125

Question 4

how do you calculate the RMI?

risk of malignancy index

Answer 4

U x M x CA125

ultrasound features x menopausal status

Question 5

how do you diagnose ovarian cancer?

Answer 5

ovarian tumour marker (CA125)

CT scan

US scan of abdomen and pelvis

Question 6

What cancer do you think of in regards to post menopausal bleeding?

Answer 6

endometrial

Question 7

how do you diagnose endometrial cancer?

Answer 7

trans-vaginal USS

endometrial biopsy

Question 8

how do you treat endometrial cancer (in a PMG situation)?

Answer 8

remove all reproductive organs

TLK - total laparoscopic hysterectomy
(BSO - bilateral salpingo oophorectomy)

Question 9

what is the classification used to stage endometrial cancer?

Answer 9

FIGO

Question 10

how do you stage endometrial cancer?

Answer 10

surgical/pathology

MRI (depth of myometrial invasion)

cervical involvement

lymph node involvement

Question 11

what are the two types of endometrial cancer?

Answer 11

type 1 - endometrioid adenocarcinoma

type 2 - uterine serous and clear cell carcinoma

Question 12

what type of endometrial cancer is the most common?

Answer 12

type 1 (endometrioid adenocarcinoma)

Question 13

what type of endometrial cancer gives a worse prognosis (is more aggressive and high grade)?

Answer 13

type 2 (uterine serous and clear cell carcinoma)

Question 14

Risk factors for endometrial cancer:

Answer 14

Post menopausal women

high circulating oestrogen levels (obesity, HRT, PCOS, early menarche/late menopause)

HNPCC

typical endometrial hyperplasia

Question 15

what are risk factors for Cervical cancer?

Answer 15

45-55 y/o

HPV related (16 and 18)

multiple partners

early age at first intercourse

smoking

Question 16

what types of HPV cause cervical cancer?

Answer 16

16 and 18

Question 17

cervical cancer symptoms:

Answer 17

abnormal vaginal bleeding

post coital bleeding

Intermenstrual bleeding

discharge

(pain)

Question 18

why do we screen for cervical cancer?

Answer 18

to detect PRECANCEROUS disease (not cervical cancer)

Question 19

what is the histology behind cervical cancer?

Answer 19

80% are squamous carcinoma

adenocarcinoma are rising in incidence

Question 20

how do you officially diagnose cervical cancer?

Answer 20

biopsy

Question 21

where do you take a biopsy from in cervical cancer?

what types of cells?

Answer 21

the transformation zone

both squamous and columnar epithelium

Question 22

local spread of cervical cancer:

Answer 22

vagina

lower vagina/ pelvis

bladder/ rectum

Question 23

metastatic spread of cervical cancer

Answer 23

lymphatic (pelvic nodes)

Blood (liver, lungs, bone)

Question 24

how do you stage cervical cancer?

what investigations

Answer 24

PET/ CT

MRI

Question 25

how do you treat cervical cancer?

Answer 25

excision of the transformation zone hysterectomy chemo/ radiotherapy

Question 26

how does vulval cancer present?

Answer 26

pain itch bleeding lump/ulcer

Question 27

risk factors for vulval cancer:

Answer 27

cancer at another genital tract site smoking lichen sclerosis immunosuppression

Question 28

HPV related vulval cancer:

Answer 28

Usual type VIN younger women multifocal/multizonal immunosuppression past history of intraepithelial neoplasia

Question 29

VIN

Answer 29

Vulval intraepithelial neoplasia

Question 30

CIN

Answer 30

cervical intraepithelial neoplasia

Question 31

Non HPV related vulval cancer:

Answer 31

differentiated VIN older women lichen sclerosus

Question 32

what is lichen sclerosus?

Answer 32

white itchy patches on the genitals can develop into vulval cancer

Question 33

how do you treat vulval cancer?

Answer 33

individualised surgery local excision unilateral and bilateral node dissection radio and chemo (also groin node excision etc)

Question 34

causes of hpv

Answer 34

Micro trauma to the epithelium damage to the surface of the cervix epithelium

Question 35

HPV immunisation programme vaccinated who?

Answer 35

girls born after September 1990

Question 36

HPV screening:

Answer 36

molecular test on cells sampled from the cervix (taken from the transformation zone) identifies high risk type HPV viral DNA or RNA HISTOLOGY

Question 37

if the cytology of cervix is abnormal - what is this called?

Answer 37

dyskaryosis