Week 8 - Female Genital Tract Flashcards
(41 cards)
What cervical pathology can arise?
Cervical intra-epithelial neoplasia (CIN)
Cervical carcinoma
Endocervical polyps
What is the routine of a cervical smear test and what does it aim to detect?
Aims to detect early disease stages before it becomes invasive
- normal routine 3/5 year re-smear
- if abnormal - referred to colposcopy (direct visualisation of the cervix)
How is the human papilloma virus transmitted?
By sexual contact
What are the symptoms of human papilloma virus?
Asymptomatic
Many different types (low risk - warts and verrucas, high risk - cervical cancer)
What is the human papilloma virus thought to be the main cause of?
Cervical intra-epithelial neoplasia (CIN)
And therefore cervical cancer
What are 12-13 year girls offered to help protect them against infection from human papilloma virus?
HPV vaccination
-offers protection against infection for strains associated with 70% of cervical smears
What is CIN?
Cervical intra-epithelial neoplasia (CIN)
-microscopic lesion that affects the cervix that could potentially develop into cervical cancer if left untreated
How common is cervical cancer/carcinoma, what are the risk factors and symptoms?
-2nd most common female malignancy
Risk factors - HPV, smoking, non-attendance to cervical screening
Symptoms - abnormal discharge and bleeding, on examination the cervix appears abnormal
How is cervical cancer/carcinoma treated?
Depends on stage - either local excision or radical hysterectomy +/- chemo/ radiotherapy
What are endocervical polyps?
- benign lesions
- usually present with vaginal bleeding/spotting
- can remove at hysteroscopy
What conditions can arise in uterine pathology?
- menorrhagia
- fibroids
- endometritis and pelvic inflammatory disease
- endometriosis
- endometrial polyps
- endometrial cancer
What is menorrhagia and what is the cause of it?
Heavy periods - >80ml blood loss
-very common
Causes:
- diagnosis not known - 50%
- fibroids, endometriosis, polyps
How is menorrhagia treated?
- mirena coil
- mefanamic and transexamic acid
- COCP (combined oral contraceptive pill)
- depo provera - injection
- endometrial ablation
- hysterectomy
What is the other word for fibroids?
Leiomyomas
What are fibroids/Leiomyomas?
- very common benign tumours (smooth muscle)
- arise from myometrium (uterine muscular wall)
- can present with heavy or painful periods, pelvic pain or distension
What is endometritis or pelvic inflammatory disease caused by and what are its symptoms?
- caused by infections, usually sexually transmitted
- can present with abnormal discharge, pain, bleeding BUT can be asymptomatic
-major cause of infertility
What is endometriosis and its symptoms?
- endometrial tissue in the wrong location (outside the endometrium)
- very common benign condition
-can present with heavy or painful periods, pelvic pain, painful sex
How is endometriosis treated?
Depends on symptoms - often difficult
-COCP, Mirena coil, zoladex - injection/implant, surgery
What are endometrial polyps?
- benign growths from endometrial cavity
- can be removed at hysteroscopy
What is endometrial carcinoma, what are the symptoms and risk factors?
- cancer of the lining of the uterus
- often presents as post-menopausal bleeding (detected early)
- risk factors - nulliparity (never given birth), high BMI, HRT and late menopause, oestrogen exposure
How is endometrial carcinoma diagnosed and how is it treated?
Diagnosed on biopsy - either pipelle or hysteroscopy
Treatment:
- usually TAH (total abdominal hysterectomy)
- BSO (bilateral salpingo-oopherectomy)
What ovarian cysts can arise?
Follicular cysts
Cystadenomas
Benign mature teratomas
When do ovarian cysts usually occur?
Can be benign or malignant
- can occur in young women (usually benign - 20-45)
- can occur in older women (usually malignant - >45)
What are follicular cysts?
- benign
- very common
- usually less than 6cm
- often asymptomatic, no treatment needed
