02a: Cervical

Question 1

Squamous cell carcinoma of cervix peAk incidence at what age?

Answer 1

40-45

Question 2

Cervical LSIL (low grade squamous intraepithelial lesion): what are the chances the lesion will regress, persist, and progress to HSIL?

Answer 2

Regress: 60%
Persist: 30%
Progress: 10%

Question 3

Cervical HSIL (high grade squamous intraepithelial lesion): what are the chances the lesion will regress, persist, and progress to carcinoma?

Answer 3

Regress: 30%
Persist: 60%
Progress: 10%

Question 4

T/F: in both malignant and benign HPV lesions, the virus integrates into host DNA.

Answer 4

False - integration important in malignancy

BUT in benign warts/paraneoplastic lesions, virus is free

Question 5

Which drugs/substances increase risk of cervical cancer?

Answer 5

Oral contraceptives and nicotine

Question 6

Pap smear: metabolically inactive cells are stained (X). Metaplastic squamous cells stained (Y)

Answer 6

X = pink
Y = blue green

Question 7

Women with normal pap and negative HPV DNA should be screened again every:

Answer 7

3 years

Question 8

Women with normal pap and positive high risk HPV DNA should be screened again every:

Answer 8

Rescreen again at 6-12 mo

Question 9

Cervical cancer staging: stage 0

Answer 9

CIN (cervical intraepithelial neoplasia) 3 (full thickness of epithelium)

Question 10

Cervical cancer staging: stage 1

Answer 10

Carcinoma (breached BM) confined to cervix

Question 11

Cervical cancer staging: stage 2

Answer 11

Tumor extends beyond cervix (not onto pelvic wall) and into vag but not lower 1/3

Question 12

Cervical cancer staging: stage 3

Answer 12

Involves pelvic wall or lower 1/3 of vag; regional node metastasis

Question 13

Cervical cancer staging: stage 4

Answer 13

Beyond true pelvis, mucosa of bladder/rectum and/or metastasis

Question 14

Bethesda System establish to report (X)

Answer 14

X = Pap smears

Question 15

Cervical cancer: 5y survival for stage III is (X). And stage IV is (Y)

Answer 15

X = Y = under 50%

Question 16

Cytopathology is study of (normal/abnormal) (X) cells in tissue fluid.

Answer 16

Both normal and abnormal

X = exfoliated (shed)

Question 17

Give examples of natural spontaneous exfoliation of tissue used in cytopathology

Answer 17

1. Skin, vag/cervix
2. Gland secretion (ex: nipple)
3. Sputum
4. Urine

Question 18

T/F: exudates and transudates can be evaluated by cytopathology

Answer 18

True (pleural, pericardial, peritoneal, joint, CSF)

Question 19

T/f: scraping cells from cervix, oral cavity, skin is considered natural spontaneous exfoliation for cytopathology

Answer 19

False - artificially enhanced exfoliation

Question 20

List disadvantages of cytopathology

Answer 20

1. Interpret of cell morphology based only on individual cell observation
2. Can’t always diagnose - may need histo confirmation
3. Doesn’t always determine size/type of lesion