40 Questions
What is the primary factor that determines the classification of SCC of the cervix?
The amount of keratin produced by the cells
Which of the following types of SCC is associated with a poor prognosis?
Poorly differentiated SCC
What is the primary source of oestrogens in the body?
Ovaries
What is the primary symptom presented by the 68-year-old woman in the case study?
Abnormal uterine bleeding
During which phase of the menstrual cycle does the endometrium show mitotic activity?
Proliferative phase
What is the purpose of ordering an MRI in the diagnosis of endometrial cancer?
To assess the extent of myometrial invasion
What is the characteristic feature of the early secretory phase endometrium?
Subnuclear vacuolation
What does the gross specimen from the hysterectomy show?
Cancer involving over 50% of the myometrium
Which of the following organs does not produce oestrogens?
Pituitary gland
What is the term for the process by which cancer cells resemble the cells of origin?
Differentiation
What is the grade of the endometrial cancer in the case study?
Well-differentiated
What is the corresponding phase of the ovary during the proliferative phase of the endometrium?
Follicular phase
What is the basis for grading endometrial cancer?
How closely the cancer cells resemble normal endometrium
What is a characteristic of poorly differentiated endometrial cancer?
It has a high rate of proliferation and propensity to invade blood vessels
What is the FIGO stage of the endometrial cancer in the case study?
Stage IB
What is the significance of poor differentiation in endometrial cancer?
It is associated with a higher propensity to invade blood vessels and lymphatics
What is the characteristic of the epithelium of the ectocervix?
Non-keratinising stratified squamous epithelium
What is the process called when the endocervical mucosa differentiates into squamous epithelium?
Metaplasia
What is the name of the procedure used to treat cervical intraepithelial neoplasia (CIN)?
LLETZ
What is the term for the area where the squamous epithelium of the ectocervix meets the columnar epithelium of the endocervix?
Squamocolumnar Junction
What is the type of cancer that can develop from the endocervical mucosa?
Adenocarcinoma
What is the term for the precancerous changes that can occur in the cervix?
Cervical Intraepithelial Neoplasia (CIN)
What is the name of the virus associated with cervical cancer and intraepithelial neoplasia?
Human Papillomavirus (HPV)
What is the term for the removal of the uterus as a treatment for early cervical cancer?
Hysterectomy
What is the main staging system used in Gynaecological cancers?
FIGO staging
What does the 'T' in TNM staging represent?
Tumour size or depth of invasion
What is the prognosis for a patient with a higher number of lymph nodes involved in cancer?
Poorer prognosis
What does the 'M' in TNM staging represent?
Metastasis to liver, lung, brain, bone
What is the difference between stage and grade in cancer?
DO NOT CONFUSE STAGE and GRADE
What is the significance of a higher T number in TNM staging?
Poorer prognosis
What is the purpose of staging in cancer?
To determine the prognosis of the cancer
Which of the following is NOT a site of metastasis in TNM staging?
Lymph nodes
What is the approximate five-year survival rate for patients with Stage T1 cancers?
95%
What is a common indication for hysterectomy in the post-partum period?
Post-partum haemorrhage (PPH)
What is the term for a placenta that is morbidly adherent and usually requires manual removal?
Placenta accreta
What is the usual site of Caesarean section?
Lower uterine segment
What is a common complication of abruptio placenta?
Post-partum haemorrhage (PPH)
What is the usual gestational age for detection of a gestational sac in the uterus?
6-7 weeks after LMP
What is the most common cause of post-partum haemorrhage (PPH)?
Uterine atony
What is the usual management of a ruptured ectopic pregnancy?
Laparoscopic surgery
Test your knowledge on the anatomy and pathology of the cervix, including cervical intraepithelial neoplasia, hysterectomy, and microscopic appearances of different epithelial types.
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