Cervical CA

Question 1

What causes cervical carcinoma?

Answer 1

1. HPV

Question 2

How does HPV cause cervical carcinoma?

Answer 2

When the host factors are favourable then the HPV infection merges its DNA with the host DNA and causes dysplastic cells

Question 3

Which strains of HPV are carcinogenic?

Answer 3

HPV 16,18,31,33,35,39,45,51,56,58,66

Question 4

Which strains of HPV causes genital warts?

Answer 4

HPV 16, 18

Question 5

Which strain of HPV are non malignant?

Answer 5

6,11,42,43

Question 6

What are the risk factors for cervical cancer?

Answer 6

1. Smoking
2. Coital
   -early sexual debut
   -multiple sexual partners
   -chlamydia trachomatis
   ‘-promiscuity
3. Poor socio-economic background
   4.

Question 7

What are the premalignant lesions of cervical cancer?

Answer 7

Cervical intraepithelial

1. CIN 1- lower third of the epithelium is dysplastic
2. CIN 2-lower two thirds is dysplastic
3. CIN 3-the entire epithelium is dysplastic

Question 8

What is the primary prevention that we can do to prevent CERVICAL CA?

Answer 8

1. HPV vaccinations
2. Smoking education
3. Sexual health education

Question 9

How often do we do pap smears?

Answer 9

30,40,50 years in public but it is recommended that we do them every 3 years in women with 3 previous normal smears and every year for high risk women that are HIV positive

Question 10

What is a LLETZ?

Answer 10

Large loop excision of the transformation zone

Question 11

Why don’t we use the cone biopsy anymore lol avoid it in younger patients?

Answer 11

-It can cause infertility, cervical incompetence, or cervical stenosis

Question 12

What do we stain with on colposcopy?

Answer 12

1. Acetic acid(3-5%)-stains makes hypochromatic areas white

2. Lugols iodine-(stains glycogen brown)

Question 13

What is the Bethesda classification?

Answer 13

It is the cytological classification of premalignant lesions
ASCUS-atypical squamous cells of undetermined significance
LSIL-low grade squamous intraepithelial lesions
HSIL-high grade squamous intraepithelial lesions
ASGUS-atypical squamous-glandular cells of undetermined significance

Question 14

What are the causes of false positive pap smears?

Answer 14

1. Atrophy
2. Previous radiotherapy
3. Trichomoniasis
4. Lab errors

Question 15

What are the causes of false negatives?

Answer 15

1. Smear not taken at transformation zone
2. Too much keratinisation of the cervix
3. Too few cells on the slide
4. Smear covered with blood/pus cells

Question 16

What is the problem with adjuvant radiotherapy?

Answer 16

1. Sexual dysfunction
2. Fistuala formation
3. Vaginal stenosis
4. Bladder problems