Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

cOGtext > Gynaecological Oncology > Flashcards

Gynaecological Oncology Flashcards

(60 cards)

Start Studying
1
Q

What is the most common uterine malignancy?

A

Endometrial adenocarcinoma

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

High levels of estrogen increase risk of endometrial malignancy - what factors increase estrogen levels in the body?

A 
Polycystic ovarian syndrome (PCOS)
Early menarche/late menopause
Nulliparity
Obesity
Unopposed estrogen HRT
Tamoxifen
Oestrogen-secreting tumours (granulose/theca cell ovarian tumours)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the principle symptom of endometrial malignancy?

A

Abnormal uterine bleeding (commonly postmenopausal)

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

What is the first line investigation for suspected endometrial cancer?

A

Transvaginal ultrasound

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

What finding on transvaginal ultrasound would raised suspicion of malignancy?

A

Endometrial thickness >4mm

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

What investigation/s should be carried out after a finding of thickened endometrium?

A

Hysteroscopy + endometrial biopsy +/- dilatation and curettage

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

What are the histological findings of endometrial hyperplasia?

A

Increased number of endometrial cells

Increase in the gland-to-stromal ratio

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

What are the different types of endometrial hyperplasia and what is the recommended treatment?

A

Simple/complex - progesterone treatment (e.g. Mirena)

Atypical - risk of progression to malignancy - hysterectomy recommended

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

What are some histological appearances of endometrial carcinoma?

A

Purely glandular
Areas of squamous differentiation
Papillary
Clear cell pattern

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

How does endometrial Ca commonly spread?

A

Usually direct into myometrium and cervix

Haematogenous or lymphatic spread can occur

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

What is the aetiology of type I endometrial cancer?

A 
Most common (80% of all endometrial Ca)
Usually diagnosed shortly after the menopause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the pathophysiological features of Type I endometrial cancer?

A

Endometrioid

  • estrogen dependent
  • atypical hyperplasia is a precursor
  • microsatellite instability (Lynch syndrome)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the aetiology of type II endometrial cancer?

A

Older women

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

What are the pathophysiological features of Type II endometrial cancer?

A

Serous and clear cell

  • not associated with unopposed estrogen
  • TP53 mutation
  • common extrauterine spread
  • poor prognosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a common presentation of endometrial sarcoma?

A

Lung or ovarian metastasis

Locally aggressive and metastasizes early

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

Define carcinosarcoma?

A

Mixed tumours with malignant epithelial and stromal elements

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

What staging system is used in endometrial cancer?

A

International Federation of Gynaecology and Obstetrics (FIGO) scheme

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

What is the mainstay of treatment for endometrial cancer?

A

Surgical - hysterectomy and bilateral salpingo-oophorectomy

+/- lymphadenectomy

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

What treatment is available for endometrial Ca in patients not fit for surgery?

A

Radiotherapy

High dose progestogens

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

What is the most common uterine sarcoma and how does it present?

A

Leiomyosarcoma

Women >50 years old
Abnormal vaginal bleeding, palpable pelvic mass, pelvic pain

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

What is the most common type of primary ovarian tumour?

A

Epithelial tumours (70% of cases)

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

The number of times a women ovulates is the main risk factor for ovarian Ca. What factors influence this?

A

Parity (multiparity reduces risk)
Breastfeeding reduces risk
COCP reduces risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What genetic conditions are associated with ovarian cancer?

A

HNPCC (Lynch syndrome)

BRCA1/BRCA2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How are epithelial ovarian tumours classified?

A

Benign
Borderline (malignant characteristics with no stromal invasion)
Malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the most common ovarian cancer?
Serous carcinoma
26
What are precursor lesions for serous carcinomas?
Serous tubal intraepithelial carcinoma (STIC) --> high grade serous carcinoma Serous borderline tumour --> low grade serous carcinoma
27
What are the features of mucinous ovarian tumours?
``` Often benign (unilateral) but can be malignant (bilateral) Contain mucinous fluid ```
28
What are the features of endometrioid ovarian tumours?
Usually malignant but present early 30% of women will also have a primary tumour in endometrium Associated with Lynch syndrome
29
What are the features of clear cell ovarian tumours?
Almost all malignant Associated with endometriosis Associated with Lynch syndrome
30
What are the features of urothelial-like ovarian tumours?
Rarely malignant | Transitional type epithelium
31
What are the features of granulosa cell ovarian tumours?
Low grade but potentially malignant 75% secrete sex hormones - can cause precocious pseudopuberty and/or abnormal bleeding Call-Exner bodies (coffee bean nuclei and gland-like spaces)
32
What are the features of thecoma/fibroma ovarian tumours?
Usually benign Contain theca cells or fibroblastic-type cells May produce estrogen Can cause Meigs syndrome
33
What are the features of sertoli/leydig cell ovarian tumours?
Very rare Young women Unilateral Can be androgenic
34
What are the features of teratoma ovarian tumours?
Most common germ cell tumour Usually benign Mature teratomas may contain hair/teeth/epithelium/sebum - 'dermoid cyst'
35
What are the features of dysgerminoma ovarian tumours?
Most common malignant germ cell tumour Associated with gonadoblastoma in gonadal dysgenesis hCG may be increased
36
What are the features of endodermal sinus/yolk sac ovarian tumours?
Usually present with sudden pelvic mass hCG normal Alpha-fetoprotein increased
37
What are the features of choriocarcinoma ovarian tumours?
Secrete hCG - precocious pseudopuberty | Poor prognosis
38
How do ovarian cancers normally spread?
Trans-coelomically - tumour seeds into peritoneal cavity - death can result from intestinal blockage and cachexia - para-aortic node metastases are common finding
39
How does ovarian cancer typically present?
Late GI complications/bowel obstruction Abdominal distention
40
What is the risk of malignancy index (RMI) made up of?
USS score Menopausal score CA125
41
What are suspicious USS findings of ovarian cancer?
``` Complex mass with solid + cystic area Multi-loculated Thick septations Associated ascites Bilateral disease ```
42
CA125 is raised in 80% of ovarian cancers. What are other causes for it being raised?
``` Endometriosis Peritonitis Pregnancy Pancreatitis Ascites ```
43
What is the typical treatment for epithelial ovarian cancer?
Chemotherapy + surgery +/- fertility preservation
44
What are risk factors for cervical neoplasia?
``` Multiple sexual partners Starting intercourse at younger age Intercourse without barrier protection COCP Smoking ```
45
What types of HPV are closely linked to the development of cervical neoplasia?
16 and 18
46
What are the preinvasive phases of cervical/endocervical cancer?
Cervical intraepithelial neoplasia --> squamous cervical cancer Cervical glandular intraepithelial neoplasia --> endocervical adenocarcinoma
47
What are features of endocervical adenocarcinoma?
Harder to detect by screening Worse prognosis than squamous Risk factors: Later onset of sexual activity, smoking, HPB (particularly HPV18, higher SE class)
48
Who is recommended to have cervical screening and how often?
Anyone with a cervix aged 25-65 every 5 years
49
Define the 'transformation zone'?
The area where the columnar epithelium of the endocervix meets the squamous epithelium of the ectocervix The area targeted during a cervical smear test
50
What test is carried out at a cervical smear?
HPV test Cytology is investigated only after a positive HPV result
51
How is CIN classified?
I-III CIN I: dyskaryosis (abnormal cells) in a third of the basal epithelium CIN II: abnormal cells have extended into middle third CIN III: abnormal cells span full thickness of epithelium
52
What is the purpose of colposcopy?
Allows the cervix to be examined in more detail and the squamocolumnar junction visualised +/- biopsy/treatment
53
Why is acetic acid applied during colposcopy?
Abnormal epithelium contains more protein and less glycogen When acetic acid is applied, abnormal epithelium appears white
54
What is the risk of progression of CIN III to invasive disease?
30% over 5-20 years
55
What is the treatment for high grade CIN?
Excision at colposcopy or after biopsy Usually done by large loop excision of the transformational zone (LLETZ) Ablation is alternative option
56
What is the typical presentation of cervical cancer?
``` Post-coital bleeding Intermenstrual bleeding Menorrhagia Pelvic pain Offensive vaginal discharge ``` Often asymptomatic
57
How does cervical cancer typically spread?
Spread to adjacent structures - parametrium, upper vagina, pelvic sidewall, bladder, rectum Lymphatic spread usually results in metastases to the pelvic and para-aortic nodes
58
How is cervical cancer staged?
Based on clinical examination and confirmed by histological biopsy (does not include imaging results)
59
What is the management of cervical cancer?
Stage 1A1 - local excision Stage 1A2 - simple hysterectomy + pelvic lymphadenectomy Stage IB-IIA - Radical hysterectomy + pelvic lymphadenectomy OR radical radiotherapy +/- cisplatin Stage IIB-IV - Radical radiotherapy + cisplatin chemotherapy
60
What are the side effects of radiotherapy to the cervix?
Cystitis Diarrhoea Fibrosis which can cause vaginal stenosis Sexual dysfunction

cOGtext (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions