Gynaecological

Question 1

what is the criteria for diagnosing PCOS?

Answer 1

rotterdam criteria

2/3

oligo-anovulation, hyperandrogenism and/or polycystic ovarian morphology (PCOM)

Question 1

most common tumour of female genital tract?

Answer 1

leimyoma
benign

Question 2

group 4 endometrial cancer
serous type

what gene?

what protein is associated with it?

how is it detected

Answer 2

TP53
P53

immunohistochemistry

Question 3

mutation in what gene show better prognosis in endomterial cancer?

Answer 3

POLE

Question 4

DNA mismatch repair genes in
group 2 endometrial cancer are either
______ /_____

this creates ?

Answer 4

mutated or silenced
micro satellite instability (MSI)

Question 5

immunostaining of mismatch repair system

stains for what proteins?

these proteins are expressed by genes

if normal then what is the result?

Answer 5

MLH1
MH6
PMS2
MSH2

should show strong brown nuclear staining

abnormal results indicates genes are either mutated or silenced by tumour

so system is not functioning well

Question 6

what is the purpose of detecting mismatching repair genes

Answer 6

produce more neo antigens]

detected by body

initiate a stronger immune response

indicate it is amenable to immunotherapy

Question 7

complication of PID?

Answer 7

fitz-hugh curtis syndrome
> scar tissue liver capsule

ectopic
sepsis
abscess
chronic pid
peritonitis
pilical fusion

Question 8

what is plical fusion?

Answer 8

fimbrial ends of fallopian tubes adhere together

complication of PID

Question 9

violin string adhesions
> peri hepatic adhesion

RUQ pain from peri adhesions

Answer 9

fitz hugh curtis
PID complication 10%

Question 10

3 aetilogies of endometriosis?

Answer 10

1) retrograde amnesia
2)metaplastic transformation
3)vascular / lymphatic dissemination

Question 11

macroscopically endo histopath buzzwords?

Answer 11

red-blue powder burns

endometrioma’s

Question 12

what is red degeneration of ____

Answer 12

fibroids
during pregnancy haemorrhage - infarcts; severe abdo pain

Question 13

types of endometrioid cancer?

Answer 13

endometrioid - PTEN mutation

secretory

mucinous

Question 14

endometrial cancer RF?

Answer 14

excess E2
nulliparity
early menarch/ late menopause

obese
tamoxifen
PCOS
DM, HTN, HNPCC

Question 15

non-endometrioid cancer?

Answer 15

papillary

serous: p53

clear cell

Question 16

80yr old presents with 6 month history of post menopausal bleed

she has a PMH of PCOS and has had no children. Lives alone, but unassisted. volunteers at local church

what ix would you do?
what is the likely diagnosis

genetic test shows: PTEN mutation P53 mutation HER-2 mutation

Answer 16

2WW Cancer referral as any PMB is investigated like this

TVUSS; >4mm hyperplasia

hysteroscopy
> atypia etc

Clear cell endometrial cancer type 2

Question 17

what is vulval intraeoithelial neoplasia associated with?

Answer 17

HPV 16/ 18
smoking
immunosuppresion

dysplasia of epithelium

Question 18

types of vulval carcinoma?

Answer 18

squamous
clear cell adenocarcinoma : teens, rare: diethyltibestrol

primary vaginal : squamous

Question 19

most common ovarian cyst?

Answer 19

follicular
> corpus luteal

Question 20

RF for ovarian cancer?

Answer 20

nulliparity
early menarche
obesity
FHx
HRT
BRCA1/2

Question 21

most common benign epithelial tumour

associated with psamomma bodies

Answer 21

Serous cystadenoma

Question 22

benign epithelial ovarian tumour?

Answer 22

serous cystadenoma
mucinous cystadenoma

Question 23

Benign tumour of ovary- mucin secreting cells seen on histology?

Answer 23

Benign mucinous cystadenoma

epithelial cell origin

kras mutation

Question 24

example of malignant epithelial cell Ovarian tumours?

Answer 24

endometrioid Clear cell

Question 25

Endometrioid buzzword characteristic?

Answer 25

tubular glands on histology ca125 raised

Question 26

hobnail appearance on histology

Answer 26

Clear cell carcinoma

Question 27

Germ cell tumours - Ovarian cancers?

Answer 27

Dysgerminoma (benign) mature Teratoma (dermoid cyst- benign) immature teratoma: malignant choriocarcinoma (malignant)

Question 28

sex cord ovarian tumours?

Answer 28

fibroma granulosa-theca sertoli-leydig

Question 29

what is meig's syndrome?

Answer 29

triad fibroma ascites right pleural effusion 50% associated with fibroma (no hormone)

Question 30

what tumour produces E2 on histology call-exner bodies

Answer 30

garnulosa-theca

Question 31

what is krukenberg tumour?

Answer 31

malignancy of ovary that is from mets gastric colon

Question 32

on histology you see mucin producing signet ring cells

Answer 32

krukenberg tumour

Question 33

risk of malignancy index?

Answer 33

USS- multilocular, solid, mets, bilateral, ascites menopause 1 for pre 3 for post ca125 IU/mL

Question 34

pathophysiology of HPV and cervical cancer?

Answer 34

HPV 16/18 encodes E6 E7 these inactivate 2 tumour supprrsor gene

Question 35

what does E6 do?

Answer 35

E6 is a protein produced by HPV 16/18 which inactivates p53> prolifertaion

Question 36

What inactivates retinoblastoma gene?

Answer 36

E7

Question 37

what is a normL BREAST histology?

Answer 37

ductal lobular system lined by glandular epithelium

Question 38

empty fat spaces giant cells histiocytes what can this be?

Answer 38

fat necrosis

Question 39

on Histology 'central, stellate area, fibrous'

Answer 39

radial scar - benign sclerosing lesion

Question 40

benign papillary tumour > papillary mass within a dilated duct lined by epithelium?

Answer 40

intraductal papilloma

Question 41

where does a phyllodes tumour arise from? what is histology buzzword?

Answer 41

interlobular stroma artichoke appearnace leaf like fronds

Question 42

most common breast carcinoma subcategory

Answer 42

invasive ductal carcinoma (most common); pleimorphic cells

Question 43

invasive lobular

Answer 43

single file /strands

Question 44

well formed tubules on histology non palballe breast lump

Answer 44

tubular carcinoma

Question 45

4 types of breast cancer

Answer 45

invasive ductal (pleimorphic) invasive lobular tubular carcinoma (tubules) mucinous carcinoma (mucin)

Question 46

qhat is associated with good prognosis? why?

Answer 46

ER/Pr receptor + will respond to tamoxifen

Question 47

what is associated with bad prognosis in breast cancer?

Answer 47

HEr 2+

Question 48

most iimportant factor for prognostics of breast cancer is HER2 status?

Answer 48

false status of axillary lymph node

Question 49

high grade tumour - breast cancer?

Answer 49

ER/PR - and HER2 + respond to herceptin