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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
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
HPV
Which HPV cause warts / cancer
Warts: HPV 6 + 11

Cancer: HPV 16 + 18
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
Cervical cancer
Location
100% in transformation zone
CIN 1
What structure and layer does it arise from
Deepest 1/3 epithelium
From basal layer
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
Ectropion
What is it
Symptoms, Mx
CSJ moved – columnar cells now on outside

Non-purulent discharge, PCB

Mx: ablation
Endometrial polyps
Demographic, symptoms
Which drugs predispose
♀ >40
HRT (∵ gives endometrial stimulation)

Tamoxifen: Partial oestrogen agonist
Endometrial stimulation
Polyp, hyperplasia, cancer
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
Leiomyosarcoma
Origin
Cell types present
Mx
2% fibroids convert to leiomyosarcoma

Spindle / rounded cells

Mx: TAH + BSO + R/T
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
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
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
Ovarian tumours
Serous cystadenoma
Benign/malignant, features, histology
Can be either benign / malignant

Thin serous fluid
Psammoma bodies
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
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
Ovarian tumours
Endometrioid cystadenoma
Benign/malignant, histology
Can be either benign / malignant

Difficult to differentiate from endometriosis
Ovarian tumours
Sex chord stromal
Benign/malignant, types
Can be either benign / malignant

Granulosa stroma cell

Androblastoma – sertoli leydig cell

Gynandroblastoma
Ovarian tumours
Granulosa cell
Benign/malignant
Malignant but confined to ovary
Ovarian tumours
Germ cell
Benign/malignant, types
Malignant

Dysgerminoma
Embryonal cell
Endodermal sinus (yolk sac)
Choriocarcinoma
teratoma
Mixed
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
Vulval cancer
Appearance
Which virus is associated
Raised ulcer w/ rolled edges

HPV 6+11 (30% of cases)