Gynae cancer Flashcards

1
Q

Cervical cancer screening - how often, what is assessed

A

3 yearly 25-50 5 yearly 50-64 Swept over transformation zone - assessing dyskaryosis

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2
Q

Assessment of dyskaryosis - what are the histological findings

A

Nuclear enlargement, variation in size + shape of nuclei, hyperchromasia, reduction in cytoplasm

CIN appears white when stained with 5% acetic acid

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3
Q

CIN - causes

A

Cervical intraepithelial neoplasia Needs infection with HPV 16, 18, 31, 33

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4
Q

RF for CIN

A

Persistent HPV infection Multiple partners Smoking Immunocompromise COCP

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5
Q

S+S cervical cancer

A

PCB PMB Vaginal discharge Advanced: heavy bleeding, ureteric obstruction, weight loss, bowel disturbance, swollen legs, fistulas

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6
Q

Cervical cancer investigations + management (stage 1a1, 1a2-1b1, 1b2 + >1b2)

A

Colposcopy, histology, MRI for staging

Stage 1a1: local excision (cone biopsy)

Stage 1a2 - 1b1: lymphadectomy + Wertheims hysterectomy

Stage 1b2: RT + lymphadectomy + Wertheims hysterectomy

>1B2: RT

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7
Q

Endometrial cancer causes

A

Unopposed oestrogen leads to hyperplasia Oestrogen comes from: Peripheral conversion in adipose tissue Granulosa cell tumour PCOS Oestrogen only HRT Tamoxifen

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8
Q

RF for endometrial cancer

A

Obesity Nulliparity PCOS Early menarche/ late menopause HNPCC Breast cancer - tamoxifen use

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9
Q

S+S endometrial cancer

A

PMB Menstrual disturbance PV discharge

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10
Q

Diagnosis of endometrial cancer

A

TVUSS (endometrial thickness) MRI pelvis CXR (for staging) Endometrial biopsy if >4mm

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11
Q

Endometrial cancer staging

A

I = confined to uterus II = involving cervix III = spread outside the uterus IV = bowel, bladder or distant organ involvement

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12
Q

Management of endometrial cancer

A

Total abdominal hysterectomy with bilateral salpingo-oophrectomy

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13
Q

Types of ovarian tumours

A

Epithelial - from Mullerian epithelium Sex cord Germ cell

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14
Q

Causes/RF of ovarian cancer

A

Irritation of ovarian epithelium, due to damage during ovulation RF: multiple ovulations Nulliparity, endometriosis, early menarche, late menopause, HRT BRCA 1 (39% chance of developing ovarian cancer) BRCA 2 (11%) HNPCC (12%)

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15
Q

S+S ovarian cancer

A

Abdo distension, pain Pressure effects on bladder + rectum SOB, GI upset Abnormal vaginal bleeding Ascites Presents late

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16
Q

Ovarian cancer investigations

A

CA125, Pelvic USS, CXR

17
Q

Ovarian cancer management

A

Laparotomy, hysterectomy, BSO Adjuvant chemo

18
Q

Vulval carcinoma

A

90% squamous cell Commonly arise on a background of lichen sclerosus or VIN VIN = associated with HPV (16) S+S: lump, pain, irritation, bleeding Surgery + groin lymphadenopathy

Ulcer with indurated base + everted margins

19
Q

Classification of CIN

A

lower 1/3 of epithelium, CIN 2 = lower 2/3 epithelium, CIN 3 – full thickness of endothelium

20
Q

management of CIN 2-3

A

treat with excision to depth of 8mm via LLETZ (large loop excision of transformation zone) – increases risk of preterm labour

21
Q

Follow up after CIN findings

A

Cytology at 6 months

22
Q

Staging of ovarian cancer

A

1 = limited to ovaries, 2 = pelvic implantation, 3 = peritoneal implants/ small bowel/ omentum 4 = distant mets