Cancer

Question 1

Cervical Cancer

Answer 1

Infection with HPV (subtypes 16, 18, 31, 33, 35)
Two Types:
-Squamous Cell (more prevalent)
-Adenocarcinoma
develops from a preinvasive state termedcervical intraepithelial neoplasia(CIN).

Question 2

CIN 1

Answer 2

represents mild dysplasia

now classified as low-grade squamous intraepithelial lesions (LSILs)

Question 3

CIN 2/3

Answer 3

CINs 2 and 3 encompass moderate-to-severe dysplasia
classified as high-grade squamous intraepithelial lesions (HSILs) based on the Bethesda cervical cytology reporting system.
Most LSILs spontaneously resolve, whereas high-grade squamous intraepithelial lesions (HSILs) are more likely to progress to invasive cervical cancer.

Question 4

Routine cervical cancer screening guidelines

Answer 4

Initial Screening:
No earlier than 21 regardless of age of initiation of sexual activity
Women < 30
Screening with Pap test alone at intervals of every three years
No HPV testing as this population has higher rates of transient infections
Women >30
Pap test every three years
Co-testing (Pap test and HPV testing) every five years if both initial tests are negative (

Question 5

When to d/c cervical cancer screening?

Answer 5

women >65 years if they meet the following criteria:

• no increased risk
• adequate prior screening
• No history of high-grade dysplasia or worse.

Question 6

Negative Cytology for an intraepithelial lesion but has no endocervical/transformation zone component can be based on the results of high-risk human papillomavirus (HPV) testing

Answer 6

Unsatisfactory cytology (typically due to scant cellularity in the specimen) is based upon HPV testing

Question 7

Colposcopy

Answer 7

Done when there is an abnormal Pap smear

Question 8

HPV vaccines

Answer 8

Gardasil 
Females & males age 9-26
HPV 6, 11 benign warts
HPV 16, 18 (70% of cervical cancers)
Cervarix
Females age 10-25
HPV 16, 18

Question 9

Types of hyperplasia

Answer 9

Simple (cystic): inactive endometrium, no malignant potential: “Swiss cheese”
Complex (adenomatous): increased # of glands, gland crowding
Hyperplasia with atypia: irregular nuclei, may progress to malignancy

Question 10

Ovarian cancer risk factors

Answer 10

Nulliparity
BRCA1 or BRCA2 gene mutations
Family history
Advancing age

Question 11

Indications for genetic referral

Answer 11

Breast ca

Question 12

Molar pregnancy aka Gestational Trophoblastic Disease

Answer 12

noncancerous tumor that develops in the uterus as a result of a nonviable pregnancy. Two types are choriocarcinoma and persistent molar pregnancy

Question 13

Complete mole:

Partial mole:

Answer 13

46 XX derived from paternal chromosomes-haploid sperm fertilizes empty egg and doubles. No fetal tissue present
69 XXX or XXY:2 sperm fertilize one egg, fetus develops but does not survive

Question 14

staging

Answer 14

I: confined to uterus
II: outside of uterus; confined to genital structures
III: extends to lungs
IV: other distant metastases