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Reproductive system (inpt) > cervical CA > Flashcards

cervical CA Flashcards

1
Q

what HPV infx are linked to cervical neoplasia?

A

16, 18, 31, 33

    • 80% of cervical intraepithelial neoplasia (CIN) lesions and 90% of invasive cervical carcinomas show the presence of HPV
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2
Q

what are types 6 and 11 linked to?

A

condylomata acuminata

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3
Q

what are other RF that may cause the development of cervical intraepithemlia neoplasia lesions?

A

early age at first intercourse, early childbearing, mul sex partners, hx of STI, low socioeconomic status, AA, smoking

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4
Q

what part of the cervix may show/initiate cervical ca

A

transformation zone! involved in 95% of the cases

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5
Q

what is mild dysplasia?

A

CIN-1 and may progress to moderate (CIN2) severr (CIN3), and carinoma in situ; it can also stay the same or regress

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6
Q

how many pts w/ CIN 3 may develop microinvasive and invasive carcinoma?

A

1/3

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7
Q

what age group showl CIN

A

women in their 20s

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8
Q

what age group may solw CIS?

A

25-35 yo

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9
Q

cervical cancer age group?

A

> 40

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10
Q

Clinical Features of cervical dyplasia?

A

no sx, advanced or invasive may cause abnormal vag bleeding and vag discharge, tumor

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11
Q

what is the mean age of dx ?

A

47, but 39 in lower sE status groups

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12
Q

what other PE findings might you see?

A

enlargment of the cervix- endophytic spread: “barrel” shaped cervix

exophytic- friable, fungating lesion

  • ulceration: starts superficial, becomes deeper and encrotic as dz progresses
  • nodularity of uterosacral ligaments
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13
Q

types of cervical cancer

A

squamous cell carcinoma

adenocarcinoma, adenosquamous carcinoma

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14
Q

features of squamous cell?

A

HPV 16, most common

90% develop from intraepithelial layers

typically w/ in 1 cm of squamocolumnar junx

-large cell nonkeratinizeing

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15
Q

types of squmous cell

A

verrucous- HPV 6 (more slowley growing and locally invasive, looks like condyloma

-large cell keratinizing or small cell

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16
Q

ADenocarcinoma

A

HPV 18 most prevalent,

dervived from glandular elements

women under age 35

increased incidence over lasat several decades (screening and prevention of squmous lesions)

17
Q

where types of adenocarcinomas are there?

A

-mucinous, edometrioid, clear cell, serous

18
Q

what is clear cell related to?

A

utero DES (diethylstilbestrol) exposure- drug used to prevent miscarriage

19
Q

what is the worst type of cervical cancer?

A

neuroendocrine carcinoma!

most aggressive, survival is < 50% even in early stage, widespread hematogenous metastases are frequent

20
Q

dx of cervical cancer

A

, liquid-based specimen, and other cytologic screening techniques are highly effective and should begin within 3 years of becoming sexually active or reaching age 21 (whichever comes first). Annual pap smear reduces incidence of invasive cervical carcinoma by 95% (BUT – now new guidelines

21
Q

can you stop screening for cervical cancer after a hysterectomy?

A

yes!

22
Q

who must get an annual screening?

A

the immunocompromised!

23
Q

what if the results are abnormal?

A

o Biopsy of suspicious lesions is mandatory
o Colposcopy with biopsies is the most appropriate technique for histologic evaluation
o Conization is used when the results of colposcopy are unsatisfactory or endocervical curettage scrapings indicate severe disease

24
Q

BEthesda Criteria?

A

ASC-US, ASC-H, LSIL, HSIL

25
Q

ASC-US

A

atypical squamous cell of undetermined significance

26
Q

AS-H

A

atypical squamous cells, high grade lesion cannot be excluded

27
Q

LSIL

A

low-grade squamous intraepithelial lesion

28
Q

HSIL

A

 high-grade squamous intraepithelial lesion

29
Q

treament of CCA

A

mild lesions- may resolve spontaneously

-

30
Q

preinvasive neoplasia tx

A

electrocautery or cryocautery, laser therapy, conization, large-loop excision of transitional zone, or loop electrodiathermy excision procedure (LEEP

31
Q

severe abnormalilty tx?

A

o Hysterectomy and pelvic lymphadenectomy or radiation therapy i

32
Q

gardasil vaccine?

A

HPV associated with cervical cancer. CDC recommends all girls aged 11-12 years receive series of 3 injections over 6 months (but it is available to all women 9-26 years old). Prevent 4 types of HPV in those not previously exposed. May need boosters every 5 years

Reproductive system (inpt) (9 decks)

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