Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 3a Gynae > Gynae malignancy > Flashcards

Gynae malignancy Flashcards

1
Q

what is the mc gynae cancer world-wide ?

A

endometrial
85% survival rate 5y at stage 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

All gynae malignancies have what staging?
imaging?

A

FIGO 1-4 Staging

imaging for staging = PET, CT AP, MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common type of endometrial cancer?
% and type of cell?

A

80% ADENOCARCINOMA (Glandular epithelium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

type 1 and type 2 endometrial cancer:
prognosis?
cause?

A

Type 1 - MC, Better prognosis, high oestrogen related

type 2 - Poor prognosis, atrophic, may resemble ovarian tumours, p53 Mutation (clear cell carcinoma, serous carcinoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

RF for endometrial cancer?

A

unopposed oestrogen
genetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what causes unopposed oestrogen causing endometrial cancer?

A

nulliparous, early menarche, late menopause, oestrogen only HRT, PCOS, Tamoxifen (breast cancer med), T2DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are protective factors?

A

COCP, IUS, Multiparty and breast feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some of the genetic factors causing endometrial cancer?

A

HNPCC (MLH/MSH Mutation auto dom)
KRAS
p53
PTEN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sx of endometrial cancer?
typical PX?

A

ANY 50+ post menopausal women coming with unexplained post menopausal bleeding

+dysparanunia, pelvic mass, dysuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what happens if this Px comes in?

A

2 WW cancer pathway referral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dx for endometrial cancer?

A

bimanual exam = large and irregular uterus

1st = TV USS

GS = hysteroscopy and biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what would be seen on TV USS?
How thick in the endometrium normally and abnormally?

A

> 5mm thick = worry
8mm if on HRT/Tamoxifen

if myometrium involved, may see subendometrial halo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the staging for endometrial cancer 1-4 and spread?

A

1 = uterus only
2 = + cervix
3 = + pelvis + lymph nodes
4 = + extra pelvic eg. mets to bladder, lungs, liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tx for stages 1,2,3+4?

A

1+2 = hysterectomy + bilateral salp

3+4 = debunking + adjuvant chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the survival rate for stage 1 making it 5 years for ovarian cancer?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the 3 types of ovarian cancer and %?

A

epithelial 70%
germ cell 20%
sex cord 10%

+ 2^ from GIT (KRUKENBURN TUMOUR (signet ring adenocarcinoma) + 2^ from breast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

epithelial + germ + sex cord - what types of cells?

A

MC serous, mucinous (large, rupture = pseudomyxoma peritones)

teratoma (hair and teeth), dysgerminoma

theca - granulosa (coffee bean nuclei on histopathology), sertoli-leydig, fibroma (meg syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

RF for ovarian cancer?

A

unstopped oestrogen (as endometrial)
BRCA 1+2 Genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Sx of ovarian cancer?
typical Px?

A

50+ post menopausal female with first Time IBS-like or GI Sx
bloating, constipation, indigestion, abdo pain vague, dysuria/retention
+/- mets (eg. jaundice)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Dx of ovarian cancer?

A

1st = TV USS (Complex cysts - multilocular bilateral free fluid heterogeneous)
+ CA 125
GS = Pipelle biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

when do you do TV USS?

A

only do it then CA 125 IS 35 IU/L or greater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Other causes for raised CA 125?

A

Menstruation
benign cysts
PID

23
Q

What would you consider testing for in germ cell?

A

AFP + BetahCG

24
Q

What is RMI and how do we access it?

A

Risk of malignancy index

Menopause status + CA 125 + USS Findings

250+ = specialist assessment for biopsy

25
Q

what is the staging for ovarian cancer and location of spread?

A

1 = ovaries
2 = + pelvis
3 = + peritoneum/LNs
4 = + distant mets (liver, brain, bowel)

26
Q

Tx for each stage?

A

1 = hyst + b/l salp
2-4 = debunking + adjuvant chemo (cisplatin)

27
Q

what are pre surgery bloods that are done?

A

FBC = Anemia
U+E = renal function
Crossmatch group and save = transfusion
clotting screen = DIC/Bleeding risk

28
Q

what are 2 comps of ovarian cancer?

A

stroma ovarii
meig syndrome

29
Q

What is stroma ovarii?

A

high t4 due to ovarian tumour (teratoma) - comprising ectopic thyroid tissue

30
Q

what is meig syndrome ?

A

fibroma (benign) = ovarian fibroma + ascites + pleural effusion

31
Q

Who does cervical cancer mostly affect?
age?

A

30-45 y sexually active females

32
Q

what are the 2 types of cervical cancer and %?

A

squamous - 90%
adenocarcinoma - 10%

33
Q

RF for cervical cancer?

A

high risk HPV strains

Unprotected sexual intercourse (non screening)

Non HPV vaccinated

COCP Use

HIV

Smoking

Immunosuppression

34
Q

which strains of HPV Can cause cervical cancer?

A

16, 18, 31, 45 (inhibit p53 + tumour supressor genes)

35
Q

what can HPV 6 + 11 Cause?

A

genital warts and oral ulcers

36
Q

what is the 5 year survival rate for stage 1 and stage 2 cervical cancer?

A

stage 1 = 95%
stage 2 = 5%

SCREENING IS KEY

37
Q

when is cervical screening done, at what ages and how often?

A

25 - 49 = every 3 years
50-65 = every 5 years

38
Q

what 3 tests are conduced for cervical screening?

A

PAP smear, cytology biopsy, colposcopy

39
Q

how often do people with HIV get cervical screening done?

A

annually

40
Q

what happens if someone gets an inadequate sample?
what happens if this happens again?

A

inadequate sample
again in 3 months
happens again
3 months
AGAIN!!!
= colposcopy

41
Q

what happens if a high risk HPV strain comes back positive but the cytology is normal?
what happens if this happens again?

A

12 months recall
same again
12 months
AGAIN!!!
colposcopy

42
Q

when should a PAP smear be avoided?

A

menstruation
PID
<12 months Postpartum, TOP or miscarriage

43
Q

what does CIN stand for?

A

cervical intraepithelial neoplasia

44
Q

what are the 3 results it can come back as?

A

CIN 1 = not worrying

CIN 2 = Moderate dyskaryosib = risk of ca

CIN 3 = Major dyskaryosus - cervical cancer in situ

45
Q

Sx:
early?
later?

A

early = aSx

later = cervicitis =
post coital/intermentrual bleeding,
abnormal discharge increased,
vaginal DISCOMFORT

46
Q

Dx of cervical cancer?

A

Screening

exam = speculum = erosions, masses, ulcers

colposcopy + biopsy

47
Q

what are the FIGO levels of spread for cervical cancer?

A
  1. Cervix (A=Microscopic, B=Visible)
    • upper 2/3 vagina
    • lower 1/3 vagina or pelvic wall
    • bladder/rectum/extrapelvic
48
Q

Tx for:
CIN?
1-2A?
2B-4A?
4B?

A

Large loop excision of the transformational zone (LLETZ)

Hysterectomy and chemo

Cisplatin chemo +/- radio

Cisplatin + bevacizumab (VEGF blocker - vascular endothelial GF)
=PALLIATIVE CHEMO

49
Q

What are the 2 types of vulval cancers?
age it affects?

A

squamous - 90%
melanoma - 10%
(sunbed use)

35-55 y/o

50
Q

RF for vulval cancers?
younger?
older?

A

younger = HPV associated, unprotected sex

older = lichen sclerosis (kravosis vulvae)

51
Q

Sx of vulval cancer?

A

vulvadynia!!!! (pain)
superficial dysparanunia
ulcers
inguinal lymadenopathy

52
Q

Dx for vulval cancer?

A

2 WW for biopsy

53
Q

Tx for figo 1A and 1B+

A

1A = <2cm - wide local excision (+ LN removal)

1B+ = 2+ cm or 1+ cm deep
vulvectomy + B/L LN removal

Phase 3a Gynae (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions