From Dropbox Notes

Question 1

Define Carcinoma.

Answer 1

Cancer of (any) epithelial tissue

Question 2

Define adenocarcinoma.

Answer 2

Cancer originating from glandular epithelial tissue

Question 3

Define dysplasia.

Answer 3

Disordered growth, cells show abnormalities

Question 4

Define pleomorphism.

Answer 4

2 or more species existing at the same time (rapid growth)

Question 5

Define neoplasia.

Answer 5

Abnormal, uncontrolled cell growth.

Question 6

What is the most common female cancer in the UK?

Answer 6

Breast

Question 7

What is the most common gynaecological cancer in the UK?

Answer 7

Uterine

Question 8

What is the most common gynaecological cancer in the world?

Answer 8

Cervix

Question 9

For TNM staging, what does 4a mean?

Answer 9

Spread beyond primary organ to neighbouring areas

Question 10

What does 4b of the TNM staging represent?

Answer 10

Distant metastasis

Question 11

What is the tumour marker for Ovarian Cancer?

Answer 11

CA125

Also uterine

Question 12

For which cancers is radiotherapy a possible primary curative treatment?

Answer 12

Cervical and Endometrial

Question 13

What is used for concomitant chemo and radio therapy?

Answer 13

Cis-platin sensitises the cell for better radiotherapy effect

Question 14

Is endometrial cancer more common in pre or post menopausal women?

Answer 14

Post-menopausal

Question 15

What do oestrogen and progesterone do to the endometrial lining in the menstrual cycle?

Answer 15

Oestrogen → Proliferation of the endometrium

Progesterone → Softening of endometrium for implantation; withdrawal → shedding

Question 16

What are three ways oestrogen may be increased leading to increased risk of endometrial cancer?

Answer 16

Unopposed Oestrogen HRT → endometrium proliferation without progestogen control

Longer fertile period → endometrium exposed to oestrogen for longer

Obesity: Fat → oestrogen

Question 17

What is the most common type of endometrial cancer?

Answer 17

Endometrioid Adenocarcinoma

Question 18

What is the presentation of endometrial cancer?

Answer 18

Post-menopausal bleeding

or Irregular/heavy bleeding in pre-menopausal women

Pelvic pain, vaginal discharge, metastases

Question 19

What investigations should be conducted for suspected endometrial cancer? And what will it show?

Answer 19

Trans-vaginal USS → thickened endometrium

Endometrial biopsy

MRI - staging

Question 20

What is the treatment for endometrial cancer?

Answer 20

Laparoscopic Hysterectomy +/- bilateral salpingoophorectomy

Question 21

What is the most common type of ovarian cancer?

Answer 21

Epithelial Ovarian Cancer (ovarian carcinoma)

Question 22

What genes are implicated in ovarian cancer risk factors?

Answer 22

BRCA1 - Dominant - ↑breast,ovarian Ca

BRCA2 - Dominant - ↑breast, ovarian, pancreatic Ca

HNPCC - Dominant - ↑ovarian, endometrial, colorectal Ca

Question 23

Which gynaecological cancers do Tamoxifen or Oestrogen only pills increase the risk of?

Answer 23

Endometrial and Ovarian

Question 24

How does ovarian cancer spread?

Answer 24

Intraperitoneal dissemination

Question 25

What stage does ovarian cancer most commonly present?

Answer 25

Stage 3 - extension beyond pelvis into abdominal organs

Question 26

What symptoms and signs are associated with ovarian cancer?

Answer 26

_Ascites_ → Abdominal pain, distension, bloating/feeling full, shifting dullness _Palpable abdominal mass_ _Constitutional: fatigue, weight loss_

Question 27

What chemotherapy drug is used for ovarian cancer?

Answer 27

Carboplatin

Question 28

What virus is Cervical cancer linked to?

Answer 28

HPV so high no. of sexual partners is a risk factor and HIV/immunosuppression → HPV clearance more difficult

Question 29

What is cervical interaepithelial neoplasia?

Answer 29

Cervical dysplasia before it becomes neoplastic Stage 1 - mild dysplasia Stage 3 - severe dysplasia/carcinoma in situ

Question 30

What type of cancer are most cervical cancers?

Answer 30

Squamous carcinoma

Question 31

What are the treatements for the different stages of cervical cancer?

Answer 31

Colposcopy +/- Loop excision for Severe dysplasia/TNM stage 1 Biopsy + diathermy excision of transformation zone Resectable tumour - TAH +/- vaginal excision Non-resectable - Radiotherapy +/- chemotherapy

Question 32

What vaccination program is useful for cervical cancer?

Answer 32

Cervarix → HPV 16&18

Question 33

What type of cancer are vulvar cancers likely to be?

Answer 33

Squamous cell carcinoma \>90% 5% melanoma

Question 34

Which gynaecological cancers are linked with HPV?

Answer 34

Cervical, Vulvar, Vaginal

Question 35

What cancers are the following age groups associated with? Post menopausal women \>50 yo Equal in all \>25 yo \>70 yo

Answer 35

Post-menopausal women - Endometrial \>50 yo - Ovarian Equal in all \>25 yo - Cervical \>70 yo - Vulvar