Cervical Ca Flashcards
What’s the risk factors of cancer cervix?
- Sexual behavior:
- Early initiation of the sexual intercourse
- History of genital HPV infection or other STD; herpes and HIV
-Multiple sexual partners - Smoking.
- Low social economic conditions.
- Long term use OCP.
- Poor nutritional status. 
What’s the etiology for the cervical cancer?
HPV
What’s the type of HPV
بالمحاظره جدول
Cin
Pre invasive cervical legion that may progress to invasive carcinoma
Carcinoma in situ
Microscopic picture ( surface epithelium of the cervix show malignant , a change involves full thickness of the epithelium, but doesn’t invade the basement membrane ).
The signifcant features of CIN lesion are? 4
- Cellular immaturity
-Nuclear abnormalities
-Cellular disorganization - Increase mitotic figures
What’s the classification of CIN?
- CIN1. ( mild dysplasia. Lower 1/3. )
- CIN 2 ( moderate dysplasia lower 2/3)
- CIN. 3 ( severe dysplasia carcinoma in situ.)
How u Can diagnose CIN
Screening test.
Bethesda system results 5.
جدول سلايد ١٠
What’s the test you will do for the patient with a low-grade or she need to follow up
Colposcopy
When you will do the colposcopy?
- Abnormal pap test
- Has symptoms and signs.
What’s the complication of the radical hysterectomy acute
- Blood loss.
- Uretrovagina fistula.
- Vesicovagina fistula.
- Small bowel obstruction.
- Pulmonary embolus.
What’s the complication of the radical hysterectomy subacute
Bladder dysfunction
What’s the complication of the radical hysterectomy chronic
- Bladder hypotonia or atony
- Ureteral strictures
What’s the result of radical hysterectomy
Survival 85%
When we gonna give post operative radiotherapy
- Metastasis to the pelvic lymph node.
- Positive surgical margin.
Radiotherapy in cervical cancer
Extremely sensitive
When we give radiotherapy
For all patient
All the stages of the invasive cervical cancer
What’s the type of radiotherapy?
- External pelvic irradiation.( Teletherapy ): the use of various doses delivered to diferent proportions the patient pelvis ( 4000-6000 cGy)
- Intracavitary therapy ( brachytherapy ) : provided by inserting a hollow applicator into
the uterine cavity.
The sum of radiation doses required for central tumor control is (2000 – 3000 cGy )
What’s the complication of the radiotherapy
- Perforation of the uterus. ( due to insertion of uterine tendon, especially elderly
- Fever
- Acute: due to effect of ionizing radiation on epithelium ( intestine, and bladder ) leading to:
diarrhea, abdominal cramps, nausea( enteritis)
Frequent urination, hematuria ( cystitis)
small bowel complication ( small bowel fistula)
Urinary tract (vesicovaginal fistula)
Palliative therapy what’s the stage we gonna use it for ?
Stage 3 , 4
What’s the palliative therapy?
- Some suitable for extensive surgery.
- Some suitable for chemotherapy
- Good nursing care
- Analgesia-must be used in sufcient amount to —– pain ( Pethidine, Morphine).
- Antiemetic if necessary.
- IV drip and parenteral feeding.
- Urinary Catheterization.
- Other measures for symptom relief