Female Reproductive y3 — Past Paper OmpathStudy

Female rep y3 — Past Paper Questions & Answers Questions and answers 1. What is the adequately descriptive medical term for the lesion? (1 mark) Answer: Leukoplakia 2. List four (4) possible diagnoses for such vulval lesions (4 marks) Answer: Lichen sclerosus Squamous cell hyperplasia (Lichen simplex chronicus) Vulvar intraepithelial neoplasia (VIN) Invasive squamous cell carcinoma 3. What is the diagnosis? (1 mark) Answer: Cervical carcinoma (Squamous cell carcinoma of the cervix) 4. At what stage do you think the disease is and what is(are) the correlating finding(s)? (2 marks) Answer: Stage: FIGO Stage IIIB Correlating findings: Extension to the lower third of the vagina AND severe hydronephrosis (indicating extension to pelvic wall/ureteral obstruction). 5. List three (3) causes of the causative agent known to cause the condition. (3 marks) Answer: Multiple sexual partners Early age at first intercourse High-risk HPV types (e.g., HPV 16, 18) 6. Outline the pathogenesis of the disease (10 marks) Answer: Persistent infection of cervical basal cells at the squamocolumnar junction by high-risk Human Papillomavirus (HPV) types (e.g., HPV 16, 18). Integration of viral DNA into the host genome. Expression of viral oncogenes E6 and E7. E6 protein binds to and promotes degradation of the p53 tumor suppressor protein → loss of cell cycle control and apoptosis. E7 protein binds to and inactivates the retinoblastoma (Rb) tumor suppressor protein → uncontrolled cell proliferation. Accumulation of additional genetic mutations and chromosomal abnormalities. Progression through a spectrum of pre-invasive lesions: Low-grade Squamous Intraepithelial Lesion (LSIL) → High-grade Squamous Intraepithelial Lesion (HSIL). Breach of the basement membrane by HSIL cells → invasive squamous cell carcinoma. Local invasion into surrounding tissues and potential lymphatic or hematogenous metastasis. 7. List two screening tests for early detection of the disease (2 marks) Answer: Pap smear (cervical cytology) HPV DNA testing 8. List two types of vaccines available for the prevention of the disease (2 marks) Answer: Bivalent HPV vaccine (targets HPV 16, 18) Quadrivalent HPV vaccine (targets HPV 6, 11, 16, 18) Nonavalent HPV vaccine (targets HPV 6, 11, 16, 18, 31, 33, 45, 52, 58) 9. What do you think is the diagnosis? (2 marks) Answer: Endometrial serous carcinoma (or Uterine serous carcinoma) 10. Which immunohistochemistry (IHC) marker do you think was done to confirm diagnosis? (2 marks) Answer: p53 11. What is the genetic basis for the IHC result in 3(b) above? (2 marks) Answer: Mutation in the TP53 gene. This leads to aberrant p53 protein expression, typically either diffuse strong nuclear staining (overexpression) or complete absence of staining (null pattern), which is characteristic of high-grade serous carcinomas.