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Flashcards in Repro 12 Deck (66)
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1

What type of cancer are most carcinomas of the cervix?

Squamous
Adenocarcinoma 25-30%

2

What is required for cervical changes to be malignant?

HPV

3

What is CIN?

Cervical intraepithelial neoplasia.
Grade given based on mitotic activity, nuclear pleomorphism/hyperchromasia and nuclear/cytoplasmic ratio

4

What are the aetiology factors associated with carcinoma of the cervix?

Lifestyle - Number of sexual partners, promiscuity, low social class, smoking
Immunocompromised
OCP
Number of pregnancies
Familial

5

What is the aim of cervical screening?

Detect the pre-invasive lesion and to excise the involved area completely before a tumour can develop

6

Why is exfoliative cytology adequate for cervical screening?

Cells at surface level always affected no matter what CIN stage

7

What does cervical screening detect?

Cells with abnormally enlarged nuclei possessing abnormal chromatin

8

When are women referred for colposcopy?

Abnormal cells and HPV positive

9

What chemical is used in colposcopy?

Diluted acetic acid

10

How are abnormal cells commonly existed for biopsy?

Diathermy

11

How often and at what age are women screened for cervical cancer?

3 years age 25-50
5years age 50-65

12

What features determine the prognosis of carcinoma of the cervix?

Spread - depth of invasion, size (much more important that differentiation)

13

Where do cervical carcinomas tend to spread?

Iliac and aortic lymph nodes initially before wider systemic dissemination
Local - ureters, bladder, rectum (extemely distressing with pain and fistula formation)

14

Who receives the vaccination for HPV?

12-13 year old girls (not effective if already exposed)

15

What is the most common type of vulval tumour?

Squamous carcinoma
Rarer - adenocarcinoma, basal cell and malignant melanoma

16

What is the cause of vulval tumour?

HPV in pre-menopausal women
In older women, the causative agent is unknown but are probably related to chronic irritation and longstanding dermatoses such as lichen sclerosis and squamous hyperplasia

17

How might vulval squamous cell carcinoma present?

Scaly red patch
Sore
Itchy
White
Incidental finding in 30%

18

Where do vulval carcinomas commonly spread to?

locally and metastasise to the inguinal lymph nodes

19

Can vuval sqaumous cell carcinoma be cured?

Yes if caught early - vulvectomy

20

Describe extramammary Paget's disease?

Commonly found in the vulva
Grows downwards
24-30% associated with invasive neoplasm
0.2% vulval carcinoma
Average age 63

21

How does vulval basal cell carcinoma present?

Pearly white/pigmented nodule
Ulcerated

22

Does vulval basal cell carcinoma have a positive prognosis?

Deeply infiltrative if neglected
Does not metastasise
Vulvectomy does not work

23

What is the common treatment of vulval squamous carcinomas?

Vulvectomy

24

Who commonly develops endometrial adenocarcinoma?

Perimenopausal and older women

25

What causes endometrial adenocarcinoma?

Unopposed oestrogen:
- obesity
- exogenous oestrogen administration
- hormone-secreting tumour
- late menopause/early menarche (long reproductive lifespan)
- Tamoxifen

26

What types of cancer may occur in the endometrium?

Adenocarcinoma
Adenosquamous
Malignant stroma

27

What does the prognosis of endometrial adenocarcinoma depend on?

Grade
Spread in the myometrium

28

Where does endometrial adenocarcinoma commonly spread to?

Invades myometrium and cervix
Bladder
Rectum
Through peritoneal cavity
Regional lymph nodes
Adnex

29

When might adjuvant therapy be required to treat endothelial adenocarcinoma?

With involvement of more than half the myometrium depth

30

Who is endometrial carcinoma easier to treat in?

Younger women with type I (hormone related) as hormone dependent tumours are generally simpler to treat