105. Cervical Smearing and Cancer Flashcards

1
Q

What age range of women are invited for a cervical smear?

A

Those aged between 20 and 60 years old

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2
Q

What factors may predispose to cervical cancer?

A
Earl sexual activity/Multiple partners
Vaginal or vulval warts
Previously abnormal result
OCP use
Heavy smoking
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3
Q

What does a severely dyskaryotic smear usually mean?

A

Cervical intra epithelial neoplasia

A pre cancerous neoplasia

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4
Q

Describe the appearance of a dyskaryotic histology slide?

A

Enlarged nuclei, darkly stained and have an irregular margin

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5
Q

What is the most common age group to get cervical cancer?

A

30-55

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6
Q

What causes 99.7% cases of cervical cancers?

A

Human Papilloma virus,

Strains 16&18 cause 70% of those cases

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7
Q

What is the role of cervical screening?

A

Aims to pick up Cervical intraepithelial neopalsias- a pre cancerous change

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8
Q

Where does the cervical cancer screening test sample from

A

The epithelium in the transition zone

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9
Q

What are the symptoms of cervical cancer

A

Intermenstrual bleeding
Vaginal discharge (bloodstained)
Post menopausal bleeding
Abnormal appearance of the cervix on examination

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10
Q

What must be ruled out in pre menopausal women before referring to gynae

A

Chlamydia

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11
Q

What further tests are done when cervical cancer is suspected

A

biopsy

radiological imaging and staging

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12
Q

What is the FIGO classification of cervical cancer?

A

Based on rectal and vaginal examination to stage the cancer

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13
Q

What are the treatment options for the various FIGO stages of cervical cancer

A

1a- Local excisions if fertility required. Hysterectomy
1b- 2a- radical hysteorectomy or chemotherapy
2-4- Chemo/radiotherapy

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14
Q

What chemotherapy options are given?

A

Cisplatin based chemo

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15
Q

When must radio/chemotherapy be considered

A

Greater than 1/3 stromal invasion
Lymphovascular space invasion
Tumour diameter>4cm

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16
Q

What may be a complication of cervical cancer?

A

Anaemia- bleeding and haemoglobin deficit

Radiation problems- bladder and bowel problems

Sexual problems- decreased orgasm, lost libido, change in sexual function

Lymphoedema

17
Q

What are the signs of lymphoedema?

A

Increased limb circumference
Patient reports altered sensation
Reduced flexibility
Palpable skin and subcutaneous changes

18
Q

How do you manage lymphoedema?

A

Compression
massage
good skin care
exercise