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reproductive system > cervical > Flashcards

cervical Flashcards

1
Q

what virus and 4 types linked to cervical neoplasia

A

HPV 16, 18, 31, 33

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2
Q

2 HPV types linked to condylomata acuminata

A

HPV 6 and 11. mainly 11

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3
Q

early age sex, early childbearing, blacks, smoking, multiple sex partners, STD hx, low socialeconomic status

A

cofactors in cervical cancer

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4
Q

what part of cervix is 95% of cancer involved

A

transformation zone

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5
Q

what percentage of CIN-3 develop microinvasive and frankly invasive carcinoma

A

1/3

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6
Q

CIN age, CIS age, cervical cancer age

A

CIN 20s, CIS 25-35 y/o, cervical cancer after age 40

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7
Q

HPV 16, 18, 31, 33

A

virus and 4 types linked to cervical neoplasia

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8
Q

HPV 6 and 11

A

2 HPV types linked to condylomata acuminata; mainly 11

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9
Q

HPV most prevalent in squamous cell and adenocarcinoma

A

squamous: HPV 16
adenocarcinoma: HPV 18

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10
Q

gardasil vaccine protects against what types; ages of boys/girls

A

6, 11(90% of warts), 16, 18(70% cervical cancer). given up to age 26
boys 11-12 and girls 9-26; 3 injections over 6 months

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11
Q

which HPV causes 70% of cervical cancer

A

18

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12
Q

what decreases the risk of cervical/vaginal cancer

A

use of condoms or diaphragm

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13
Q

what is neoplasia

A

abnormal growth of cells

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14
Q

what is dysplasia

A

abnormal development of typically with an excess of immature cells

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15
Q

when to start screening

A

within 3 years of becoming sexually active OR reaching age 21

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16
Q

2 initial tests to get for cervical carcinoma

A

colposcopy with biopsy; and HPV DNA

17
Q

CIN-1, CIN-2, CIN-3, CIS definitions

what percentage of CIN-3 progress to CIS

A

CIN-1: mild cervical intraepithelial neoplasia
CIN-2: moderate cervical intraepithelial neoplasia
CIN-3: severe cervical intraepithelial neoplasia
CIS: carcinoma in situ
what percentage of CIN-3 progress to CIS: 1/3

18
Q

2 steps in the colposcopy

A
  • schiller test

- paint the cervix with Lugol’s iodine. Cells that do not stain should be biopsied

19
Q

3 aspects of the cervical biopsy

A
  • punch biopsy
  • endocervical curettage
  • conization for CIN-3 and CIS. Removing the entire transformation zone
20
Q

how to treat pre-invasive CIN

A

conization

21
Q

how to treat advanced cervical disease

A

hysterectomy with pelvic lymphadenopathy

22
Q

conization can lead to what

A

incompetent cervix than a LEEP

23
Q

common signs of cervical cancer

A

metrorrhagia, postcoital spotting, cervical ulceration

24
Q

what sign may appear after cancer invasion

A

bloody or purulent, malodorous, non-pruritic discharge

25
Q

cervical cancer screening
21-29 y.o
30-65 y.o
over 65 y.o

A

cervical cancer screening
21-29 y.o: every 3 years Pap smear(cytology)
30-65 y.o: every 3 years Pap smear or every 5 years perform co-testing with pap+HPV
over 65 y.o: stop screening if all tests are neg

26
Q 
definitions
ASC-US
ASC-H
LSIL
AGC
HSIL
A

ASC-US: atypical squamous cells of undetermined significance
ASC-H: atypical squamous cells
LSIL: low grade intraepithelial lesion
AGC: atypical glandular cells of undetermined significance
HSIL: high grade squamous intraepithelial lesion

27
Q

DES exposure risk for what

A

clear cell cancer

28
Q 
subtype for: 
benign with inflammation
CIN I
CIN II
CIN III
A

benign with inflammation: ASC-US and ASC-H
CIN I: LSIL
CIN II: HSIL
CIN III: HSIL

29
Q

4 common infectious cervicitis organisms; most common

A

**chlamydia, gonococcus, trichomonas, HSV

30
Q

mucopurulent cervicitis

A

chlamydia more common than gonococcus

31
Q

3 non infectious causes for cervicitis

A

trauma, radiation exposure, malignancy

32
Q

exam for cervicitis (3)

A

yellow green mucopurulent discharge, + cervical motion tenderness, friable cervix

33
Q

yellow green mucopurulent discharge, + cervical motion tenderness

A

cervicitis

34
Q

test for cervicitis

A

gram stain. chlamydia and gonorrhorea make up 40% of cases.

35
Q

cervicitis tx

A

chlamydia: azith 1 gm PO dose plus doxy 100mg po BID for 7 days
neisseria: ceftriazone 250mg IM plus azith 1 gm PO

36
Q

2 studies for cervical incompetence

A

bimanual physical exam and vaginal ultrasound

37
Q

cervical incompetence tx

A

surgical cerclage: using suture to reinforce cervix

38
Q

yellow green mucopurulent discharge, + cervical motion tenderness, friable cervix

A

cervicitis

reproductive system (11 decks)

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