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Obstetrics and Gynaecology > Gynaecological Cancers > Flashcards

Gynaecological Cancers Flashcards

1
Q

List 3 types of ovarian cancer

A
  • Epithelial
  • Germ cell tumours
  • Ovarian stromal tumours
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2
Q

Define epithelial ovarian cancer

A

Arises from single layer of cells covering ovary or cysts

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3
Q

What are the two subtypes of epithelial ovarian cancer?

A

High grade serous
OR
Those arising from surface epithelium/Mullerian inclusion cysts

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4
Q

Where do germ cell ovarian tumours arise from?

A

Oocytes

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5
Q

Name 3 ways which ovarian cancer can metastasise

A

Trancoelemic

Exfoliation into peritoneal cavity

Lymphatic invasion

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6
Q

Give 4 risks factors for ovarian cancer

A

Smoking
Low parity
Early menarche
Late menopause

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7
Q

Give 3 features which may be suggestive of familiar ovarian cancer

A

o Early onset breast cancer <50y/o
o Male breast cancer
o Ashkenazi Jewish

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8
Q

Which surgery is used as risk reduction in familiar ovarian cancer

A

Prophylactic bilateral salpingo-oophrectomy

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9
Q

Give 4 symptoms of ovarian cancer

A
  • Altered bowel habit
  • Abdominal pain/bloating
  • Feeling full quickly
  • Difficulty eating
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10
Q

Give 4 clinical signs of ovarian cancer

A
  • Abdominal distension
  • Upper abdominal mass (omental disease)
  • Pleural effusion
  • Nodules on PV exam
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11
Q

Give 5 methods which may be used to investigate ovarian cancer

A
  • USS
  • Ca125
  • RMI
  • CT
  • Biopsy
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12
Q

How is risk of malignancy index (RMI) calculated?

A

RMI = USS x menopausal status x CA125

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13
Q

What are the main treatment options for ovarian cancer?

A
  • Chemotherapy
  • Surgery
  • Palliative
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14
Q

In general terms, define the surgical staging of ovarian cancer

A

1: limited to ovaries
2: limited to pelvis
3: limited to abdomen
4: distant metastases to outside abdominal cavity

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15
Q

Which is the most common gynaecological cancer in the UK?

A

Endometrial

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16
Q

Give 4 symptoms of endometrial cancer

A
  • Post-menopausal bleeding
  • Post coital bleeding
  • Intermenstrual bleeding
  • Altered menstrual pattern
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17
Q

What is the difference between type 1 and type 2 adenocarcinoma of the endometrium?

A

1: oestrogen excess
2: no osterogen excess

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18
Q

What is sarcoma of the endometrium?

A

Cancer derived from the muscle layer

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19
Q

What is the significance of endometrial hyperplasia in endometrial cancer?

A

Hyperplasia can progress to cancer, especially atypical hyperplasia

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20
Q

Give 5 risks of developing endometrial cancer

A
  • Unopposed oestrogen exposure
  • Nulliparity
  • Obesity
  • Physical inactivity
  • HRT
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21
Q

What is the difference between type 1 and type 2 Lynch syndrome?

A

1: Predisposes to site-specific colorectal cancer
2: Predisposes to many types of cancer including endometrial and ovarian

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22
Q

In general, what are the 4 stages of endometrial cancer according to FIGO?

A

1: Confined to uterus
2: Cervical stromal invasion but not beyond uterus
3: Tumour outside uterus
4: Distant metastases

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23
Q

Give 4 investigations which may be used to diagnose endometrial cancer

A
  • TV USS (measuring endometrial thickness)
  • CT
  • MRI
  • Pipelle biopsy
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24
Q

According to the SIGN guidelines for the investigation of post-menopausal bleeding, at which endometrial thickness should non-HRT users go for biopsy?

A

> 3mm endometrial thickness

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25
Q

According to the SIGN guidelines for the investigation of post-menopausal bleeding, at which endometrial thickness should HRT users go for biopsy?

A

> 5mm endometrial thickness

26
Q

Which patients should automatically go for biopsy or hysteroscopy if presenting with post-menopausal bleeding?

A

Those on Tamoxifen

27
Q

What is the treatment for early stage endometrial cancer?

A

Total hysterectomy/bilateral salpingo-oophrectomy + washings

28
Q

Give 3 treatment options for patients with advanced endometrial cancer

A

Surgery
Chemotherapy
Hormonal therapy

29
Q

Give 4 side effects of radiotherapy

A
  • Proctitis
  • Cystitis
  • Lethargy
  • Skin changes
30
Q

What are the two peaks of incidence of cervical cancer?

A

25-29 years

>80 years

31
Q

Which two type of HPV are associated with cervical cancer?

A

16 and 18

32
Q

Give 4 risks for the development of cervical cancer

A
  • HPV infection
  • Smoking
  • Early first episode of sexual intercourse
  • COCP use
33
Q

The vaccination scheme against HPV in Scotland occurs when and protects against which types of HPV?

A

2nd year pupils in Scotland with Gardasil

HPV 6, 11, 16, 18

34
Q

Where do abnormal smear results get automatically referred?

A

Colposcopy clinic

35
Q

Which ages receive cervical screening in Scotland and how often?

A
  • 25-65y/o’s screened
    o 25-49 every 3 years
    o >50s every 5 years
36
Q

Which type of epithelium line the outer cervix?

A

Squamous cell epithelium

37
Q

Which type of epithelium line the inner cervix?

A

Columnar epithelium

38
Q

What joins the inner and outer cervical epithelium?

A

Tranformation Zone (TZ)

39
Q

How does HPV cause CIN?

A

By altered the transformation zone

40
Q

In which circumstances are smear tests inappropriate?

A

When the cervix appears visibly abnormal

41
Q

What is CIN 1?

A

Low grade changes which are given time to resolve on their own

42
Q

What is CIN2 and 3?

A

High grade changes for which treatment is offered

43
Q

Give 3 types of treatment for CIN

A
  • Cold coagulation
  • LLETZ
  • Cryotherapy
44
Q

Which is the most common type of cervical cancer?

A

Squamous cell carcinoma

45
Q

Give 2 symptoms of cervical cancer

A
  • Unscheduled vaginal bleeding

- Offensive discharge

46
Q

Give 4 investigations used in the diagnosis of cervical cancer

A
  • Examination
  • Colposcopy
  • MRI/CT
  • Biopsy
47
Q

What is the general staging of cervical cancer?

A
  • 1: confined to cervix
  • 2: upper 2/3rds vagina/parametrial involvement
  • 3: lower 1/3 vagina or extending to pelvic side wall
  • 4: tumour to adjacent pelvic organs/distant organs
48
Q

How can early stage cervical cancer be managed surgically?

A

Trachelectomy (cervix removal)

49
Q

Give 2 surgical procedures used to treat advanced cervical cancer

A

Simple hysterectomy

Radical hysterectomy and pelvic lymphadenectomy

50
Q

What is the peak incidence of vulval cancer?

A

80-84 years old

51
Q

What is the most common type of vulval cancer?

A

SCC

52
Q

Give 4 contributing factors to vulval cancer

A
  • VIN (HPV and non-HPV related)
  • HPV
  • Squamous metaplasia
  • Smoking
53
Q

What is VIN1?

A

Usual changes, not a precursor to VIN2/3

54
Q

What are VIN2 and VIN3?

A

HIGH GRADE CHANGES

2: Warty
3: Basaloid

55
Q

Name 3 common sites for VIN

A

Labia majora
Labia minora
Posterior fourchette

56
Q

Give 4 symptoms of VIN

A
  • Pruritis
  • Pain
  • Ulceration
  • Leukoplakia (thickened white areas)
57
Q

How is VIN diagnosed?

A

Biopsy

58
Q

Give 2 management options for VIN

A

Excisions surgery

Imiquimod

59
Q

Give 4 symptoms of vulval cancer

A

Lump
Pain
Bleeding
Discharge

60
Q

Give 4 signs of vulval cancer

A

Mass
Ulceration
Elevated surface
Inguinal lymphadenopathy

61
Q

Give 3 surgical procedures which may be used to treat vulval cancer

A

o Simple or radical vulvectomy

o Wide local excision

o +/- inguinal lymphadenectomy

Obstetrics and Gynaecology (10 decks)

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