1: Gynaecological Cancers: Benign Cervical Disease

Question 1

What is a cervical ectropion

Answer 1

Eversion of the endocervix, exposing columnar epithelium

Question 2

What commonly causes cervical ectropion

Answer 2

Increased oestrogen

Question 3

When are cervical ectropions more common

Answer 3

Adolescence (Puberty)
COCP
Pregnancy

Question 4

What is an overall RF for cervical ectropion

Answer 4

Increased oestrogen

Question 5

What are risk factors for cervical ectropion

Answer 5

COCP
Menstruation
Pregnancy
Adolescence

Question 6

When is a cervical ectropion rare and other differential diagnosis should be considered

Answer 6

If post-menopausal women

Question 7

What are common symptoms of cervical ectropion

Answer 7

Asymptomatic. Or:

• Post-coital bleed
• IM bleed
• Increase in non-purulent discharge

Question 8

How will cervical ectropion appear on exam

Answer 8

Red area of cervix

Question 9

What is the cervix made of

Answer 9

Endocervix and Ectocervix

Question 10

What is the endocervix

Answer 10

Lines inner portion of cervix

Question 11

What type of epithelium is the endocervix

Answer 11

Columnar epithelium

Question 12

What is the ectocervix

Answer 12

Lines portion of the cervix in vagina

Question 13

What does the ectocervix contain

Answer 13

Stratified squamous epithelium

Question 14

Explain pathophysiology of cervical ectropion

Answer 14

Ectocervix undergoes metaplasia triggered by oestrogen to form endocervix, which contains columnar epithelium.

Question 15

Why will some women with cervical ectropion experience increase in discharge

Answer 15

As columnar epithelium contains mucinous glands.

Question 16

Why does post-coital bleeding occur in cervical ectropion

Answer 16

As intercourse can disrupt blood vessels of the columnar epithelium.

Question 17

How is cervical ectropion diagnosed

Answer 17

Clinically

Question 18

Explain management of cervical ectropion

Answer 18

Does not require management, unless symptomatic

Question 19

What is first line for cervical ectropion

Answer 19

COCP

Question 20

What is second-line for cervical ectropion

Answer 20

Ablation

Question 21

What are cervical polyps

Answer 21

Benign growths inner surface cervix

Question 22

What is peak incidence of cervical polyps

Answer 22

50-60

Question 23

What is a risk factor for cervical polyps

Answer 23

Multiparous

Question 24

How do cervical polyps usually present

Answer 24

Asymptomatic

Question 25

If symptomatic, how may cervical polyps present

Answer 25

Abnormal uterine bleeding:

• Intermenstrual
• Post-coital

Question 26

What causes cervical polyps

Answer 26

Focal hyperplasia of endocervix

Question 27

What is thought to cause cervical polyps

Answer 27

Chronic inflammation

Question 28

How can cervical polyps only be definitively diagnosed

Answer 28

Histology on removal

Question 29

What is associated with cervical polyps

Answer 29

Endometrial polyps. Therefore TV-US for women

Question 30

What is risk of polyps transforming to malignancy and what does this mean

Answer 30

0.5%. All polyps should be removed when identified

Question 31

How are small cervical polyps removed

Answer 31

Polpectomy forceps

Question 32

How are large cervical polyps removed

Answer 32

Diathermy loop excision