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23 Cards in this Set
- Front
- Back
Smear
After effects Schedule Sensitivity Results → actions |
Can get spotting after
25-49: 3 yrs 50-65: 5 yrs 70% sensitive Borderline/mild (CIN1) HPV test Repeat smear in 3-6 mths ≥moderate / HPV found Colposcopy |
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Cervical transformation zone
What cell types are present What hormone influences cell change form one to the other What conditions can cause metaplasia |
Columnar – inner
Squamous – outer Oestrogen influenced Δ pH → metaplasia |
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HPV
Which HPV cause warts / cancer |
Warts: HPV 6 + 11
Cancer: HPV 16 + 18 |
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Colposcopy
Procedure Result interpretation Schiller’s stain: What is it + result interpretation |
3-5% acetic acid
White = bad Schillers: Iodine on ectocervix Ø stain = bad ∴ for both: light = bad dark/pink = good |
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Cervical cancer
Location |
100% in transformation zone
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CIN 1
What structure and layer does it arise from |
Deepest 1/3 epithelium
From basal layer |
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Cervical cancer
Stage 1, 2, 3, 4: Criteria + Rx |
1: Cervix only
Rx: loop excision / hysterectomy 2: Upper 2/3 vagina / parametrium 3: lower 1/3 vagina / pelvic side wall 4: bladder, rectum, other Rx 2, 3, 4: Radical TAH + R/T |
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Ectropion
What is it Symptoms, Mx |
CSJ moved – columnar cells now on outside
Non-purulent discharge, PCB Mx: ablation |
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Endometrial polyps
Demographic, symptoms Which drugs predispose |
♀ >40
HRT (∵ gives endometrial stimulation) Tamoxifen: Partial oestrogen agonist Endometrial stimulation Polyp, hyperplasia, cancer |
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Fibroids
Tissue type Oestrogen relationship Complications in pregnancy Mx |
Uterine s.muscle
Oestrogen driven ↑PPH ∵ ↓contractions Mx Repeat USS in 6-12 mths Established growth rate GnRH: ↓ovarian function →↓fibroid size Mifepristone: anti-progesterone Myomectomy: for pressure symptoms |
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Leiomyosarcoma
Origin Cell types present Mx |
2% fibroids convert to leiomyosarcoma
Spindle / rounded cells Mx: TAH + BSO + R/T |
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Endometrial cancer
Symptoms RF Types Stages Mx |
PMB, IMB, PM discharge
N.B. 1/3 – just heavy periods RF: unopposed oestrogen Functioning ovarian tumour – granulosa cell Previous R/T Smoking = protective Type I: adenosquamous/adenoacanthoma (adenocarc + squam cells) Type II: Papillary serous + clear cell, v aggressive Stage I: Uterus only Stage II: Uterus + cervix Stage III: invasion through uterus + cervix Stage IV: local/distant spread Mx: 1+2: TAH + BSO 2, 3, 4: Wertheim’s radical hysterectomy, laparotomy, LNectomy |
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Ovarian cysts + tumours
α fetoprotein indicates what Physiological, follicular, luteal types Dermoid, struma ovari |
α feto: Yolk sac tumour
Phys: lg version of normal Fol: granulosa cell lining Non-rupture of dominant follicle Lut: corpus luteum ≥3cm Intraperitoneal bleed, rupture day 20-26 of cycle Dermoid: germ cell cystic teratoma BENIGN Differentiate into embryonic tissue Struma ovari: dermoids composed mainly of thyroid tissue |
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Benign ovarian epithelial tumours
Tissue origin Types Theca cell |
From coelomic epithelium on embryonal gonadic ridge
∴ endocervical (mucinous) Endometrial Tubal (serous) Uroepitheial (Brenner) lines Theca cell: solid, unilateral ♀ >50 |
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Ovarian tumours
Serous cystadenoma Benign/malignant, features, histology |
Can be either benign / malignant
Thin serous fluid Psammoma bodies |
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Ovarian tumours
Mucinous cystadenoma Benign/malignant, features Can become what type of tumour |
Can be either benign / malignant
Lg up to 14kg Thick glutinous fluid Can become pseudomyxoma peritonei |
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Ovarian tumours
Clear cell (mesonephroid) tumour Benign/malignant, features, histology |
Can be either benign / malignant
But RARELY BENIGN Serosal cells Hobnail pattern on lining of epithelium |
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Ovarian tumours
Endometrioid cystadenoma Benign/malignant, histology |
Can be either benign / malignant
Difficult to differentiate from endometriosis |
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Ovarian tumours
Sex chord stromal Benign/malignant, types |
Can be either benign / malignant
Granulosa stroma cell Androblastoma – sertoli leydig cell Gynandroblastoma |
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Ovarian tumours
Granulosa cell Benign/malignant |
Malignant but confined to ovary
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Ovarian tumours
Germ cell Benign/malignant, types |
Malignant
Dysgerminoma Embryonal cell Endodermal sinus (yolk sac) Choriocarcinoma teratoma Mixed |
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Malignant ovarian mass
Signs + symptoms, Ix, Rx Mets commonly found where |
Hard abdo mass
Ascites Urinary frequency Indigestion Ix: β hCG – choriocarcinoma α fetoprotein – endodermal < stage 1c: TAH + BSO, omentectomy, peritoneal lavage > stage 1c: As above + paclitaxel / platin Mets on underside of diaphragm common |
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Vulval cancer
Appearance Which virus is associated |
Raised ulcer w/ rolled edges
HPV 6+11 (30% of cases) |