Reproductive system (Gynaecology & STIs) Flashcards Preview

Clinical Pathology > Reproductive system (Gynaecology & STIs) > Flashcards

Flashcards in Reproductive system (Gynaecology & STIs) Deck (67):
1

Summary of the Reproductive System

Intraepithelial neoplasia
HPV
Vulval tumours
Cervical tumours
Uterine disorders
Ovarian disorders
Breast pathology
Infections of preg/puerperium/noenate
STIs/HIV

2

What is Intraepithelial neoplasia?

= dysplasia of squamous ep lining of genital tract

3

Intraepithelial neoplasia is an IN SITU disease. T/F?

T

Curable

4

What is the common cause of VIN, CIN, CGIN, VaIN, AIN?

HPV

5

Which HPV types are benign and cause genital warts?

HPV 6, 11

6

which HPV types are high risk and cause 70% Cervical cancers?

HPV 16, 18

7

HPV expresses early genes at onset of infection:
E6 genes --> inactivates what?
E7 genes inactivate what?

E6 - p53
E7 - RB1

8

Name of HPV vaccine?

Gardasil

9

Features of VIN?

Warty
HPV-related -- Vulval cancer ass.

10

Lichen Sclerosus in elderly women is associated with which type of VIN?

Diffrenciated VIN

Ass. with Vulval cancer

11

Vulval cancer is most commonly SCC. T/F?

Staging system?

T

FIGO system

12

Vulval tumours can be...?

SCC
Malignant Melanoma
Paget's Disease

13

Is Paget's Disease IN SITU disease?

Presents: eczematous/buring patch

IN SITU

exclude eczema

14

Which part of the cervix undergoes columnar ep --> stratified sq ep after menarche?

Transformation zone

15

Which state is the pre-invasive stage of Cervical SCC?

CIN

16

The cervical screening program is done to detect CIN and graded CIN 1-3. For what ages?

25-64yrs.

If ab --> HPV test, if +ve --> Colposcopy

17

Risk factors for CIN?

HPV*
Smoking*

Multiple partners, immunosuppression, young at 1st intercourse

18

CGIN is a pre-cursor for which cancer?

Cervical adenocarcinoma

(Same presentation/treatment as Cervical SCC)

19

State the treatment for CIN, Cervical SCC/Adenocarcinoma.

LLETZ

Large Loop Excision of the Transformation Zone

20

What is endometriosis?

Presentation?

= Ectopic endometrium

Asymptomatic ~25%
30-40yrs
Dysmenorrhoea
Dyspareunia

21

Endometriosis would be investigated using laproscopy. What is the treatment?

COCP
GnRH agonists/antagonists
Surgery

22

Endometritis can be acute or chronic. Name 4 common symptoms.

Abdo-pelvic pain
Ab vaginal bleeding/discharge
Fever
Dysuria

23

Treatment of endometritis?

Remove cause
Antibiotics
Analgesia

24

Endometrial polyps = common oestrogen-dependan growths.
It is often symptomatic. What types of bleeding can present though?

IMB
PMB
Mennorrhagia
Dysmennorhoea

25

Treatment of endometrial polyps?

Progesterone
GnRH agonists
Surgery

26

State risk factors for Leiomyomata (uterine fibroids)?

Genetics
30-50yrs
Obesity
PCOS
Nulliparity
HTN

27

Fibroids present as menometorrhagia and are investigated by bimanual exam and USS. Whats the treatment?

NSAIDs
OCP
Fe2+
Artery embolisation
TAH

*tends to regress in menopause

28

Is oestrogen high or low in endometrial hyperplasia?

High oestrogen (RISK FACTOR)
Low progesterone

29

Endometrial hyperplasia presents as any ab bleeding and is investigated using USS/hysteroscopy. What are the treatment options?

Progesterone
IUS
TAH

30

The most common gynae cancer is...?

Endometrial cancer

31

Typical presentation of Endometrial cancer?

PMB
PCB

32

Endometrial cancer is investigated by USS, hysteroscopy & biopsy. What are the treatment options?

Progesterone
TAH-BSO
Chemo/RT

33

What are the 2 types of endometrial cancer?

Which one is more common & is pre-menopausal/E2 dependant?

Type 1: Endometriod*
Type 2: Serous

34

The name of the follow ovarian disoder is...

1. HYPERANDROGENISM
2. MENSTRUAL AB
3. POLYCYSTIC OVARIES

Polycystsic Ovary syndrome (PCOS)

35

The risk factors for PCOS are Obesity and Diabetes. How would you treat it?

Weight loss
Metformin
OCP
Ovarian drilling
Clomiphene (conceive)

36

Gonadal failure/Hypogonadism can be characteristed by high/low FSH & LH.

Name the 2 catagories of hypogonadism.

1" = Hypergonadotrophic Hypogonadism

2" = Hypogonadotrophic Hypogonadism

37

Turner's syndrome, Infection, Surgery, Chemo/RT, Drugs are all examples of what?

1" hypergonadotrophic hypogonadism

38

2" hypogonadotrophic hypogonadism is caused by?

Pituitary/hypothalamus failure

Pituitary tumour
Brain trauma
Sheehan's syndrome
Empty sella syndrome

39

How is gonadal failure treated?

HRT

40

Ovarian neoplasms are divided into which 3 groups?

1. Epithelial tumours*

2. Germ cell tumours

3. Sex-cord stromal tumours (rare)

41

Which gynae cancer is the 2nd most common?

Risk factors?

Ovarian cancer

FH, Age, PMH breast cancer, Smoking, E2-HRT, HNPCC

42

Symptoms of ovarian cancer are non-specific. Name some.

Weight loss
Bloating
Vaginal bleeding
Urinary frequency

43

Breast anatomy is made of 2 components. T/F?

F

3 components:
-Fat
-Fibrous tissue
- Glandular tissue

44

State common presentations of any breast pathology

Lumps
Puckered skin
Nipple discharge/changes
Pain
Infection/Inflammation
Abnormal radiology

45

1 in 8 women get...?

Breast cancer

Most breast pathology

46

Breast cancer is commonly Ductal or Lobular cancer. What are the risk factors for breast cancer?

Combined contraceptives
HRT
Obesity
Radiation

47

Breast screening is for 47-73yrs. Whats the triple assessment?

For investigating breast lumps:
CLINICAL
RADIOLOGICAL
PATHOLOGY

48

What is a benign proliferation of glandular & conn tissue?

Fibroadenoma

(common)

49

Paget's D of the nipple is aka..?

Ductal carcinoma IN SITU

50

Define puerperium.

6-8 weeks post-partum

51

All antibitoics cross the placenta/enter breast milk. T/F?

T

52

Are Penicillins & Cephalosporins safe antibiotics to use in preg?

Yes

53

Which antibiotics are unsafe to use in preg?

Trimethoprim
Tetracyclin
Fluroquinolones
Chloramphenicol

54

Preg women are immunocompromised. Infections often present diff/ more severe.
Which viral infections are important to remember in preg?

CMV
Parovirus B19
Toxoplasmosis
Syphilus
VZV
Zika

55

Is screening for bacteriuria indicated in preg or not?

Indicated

If untreated --> UTI --> pyelonephritis

56

Treatment of UTIs in preg?

Amoxicillin
Cefalexin

57

25% preg with pret-term labour have what infection?

CHORIAMNIONITIS

(inflamm of umbilical cord/placenta/amniotic membranes)

58

Presentation of choriamnionitis?

Maternal fever
High WCC
Maternal/Foetal tachycardia
Foul-smelling amniotic fluid

59

C-section, PROM, Vaginal exams, Prolonged labour can all lead to what?

Puerperal endometritis

(inflamm of womb)

60

How does puerperal endometritis present?

Abdo pain
Fever
High WCC
Foul-smelling lochia

61

Puerperal mastitis often occur ~5 weeks post-delivery in whom?

Breast-feeding mothers

(Sudden fever/rigores/soreness)

62

Treatment of puerperal mastitis?

Flucloxicillin

(S.aureas from cracked skin)

63

Neonatal Sepsis/Meningitis often has subtle or atypical signs. How would it present?
Investigations?

Temp
Respiratory
CV
Hepatic
GI
Bleeding disorders
CNS

Blood, Urine, CSF

64

Jarish-Hexheimer reaction is caused by endotoxins from killed bacteria from antibiotics in what STI?

Syphilus

65

Which type of breast cancer lines up in a single file?

Lobular Carcinoma

66

What is the term for pitted/dippled skin on breast?

Peauorange

67

Condylomas are..?

Benign squamous neoplasm of lower genital tract