Cervical cancer

Question 1

2 main HPV species and what they cause

Answer 1

16- SCC
18- Adenocarcinoma

Question 2

Risk factors of HPV infection x5

Answer 2

Early sex debut
Multiple sexual partner
Immunosuppression
High parity
Smoking
History of STIs

Question 3

Describe the oncogenes involved in HPV infection and what they suppress

Answer 3

E6- p53 tumor suppressor gene
E7- Rb retinoblastoma tumor suppressor gene

Question 4

Pathogenesis of HPV infection

Answer 4

HPV integrates into human genome>
1. Cell immortalization and rapid turn over of epithelial basal cells
2. Upregulation of E6 & E7

Question 5

Clinical features of CeCA x5

Answer 5

AUB
AVD
Dyspareunia
Lymphedema
Fistula formation

Question 6

State 2 fistulas formed in CECA

Answer 6

Vesicovaginal
Rectovaginal

Question 7

Investigations for CECA x4

Answer 7

Colposcopy - VIA, VILI
CYtology - Liquid based cytology, Pap smear
HPV DNA testing

Question 8

3 types of cervical biopsies

Answer 8

Punch biopsy
Cone biopsy
Endocervical curettage

Question 9

Indications of cervical biopsy x3

Answer 9

Suspicion of adenocarcinoma
Non pregnant women with inconclusive colposcopy
Positive screening test w/o visible lesion

Question 10

Treatment of CECA x3

Answer 10

Surgery
Chemotherapy
Radiotherapy

Question 11

Which stage of CECA gets pelvic exenteration

Answer 11

4A

Question 12

Which stage is trachelectomy done

Answer 12

1A1- 1B

Question 13

MOA of cisplatin and its 2 effects

Answer 13

Prevents replication of tumor cells
Nephrotoxicity, Peripheral neuropathy

Question 14

Which stage is hysterectomy done

Answer 14

1A1- 2A

Question 15

Organs of metastases, local(3) distant (4)

Answer 15

Distant- bones, lungs, liver, brain
Local- Bladder, Rectum, Vagina

Question 16

Prevention of CECA x4

Answer 16

VIA
Avoid smoking
HPV immunization
Safe sex/ abstinence

Question 17

Define screening

Answer 17

The presumptive recognition of unrecognized disease by means of tests and examinations that can be applied rapidly

Question 18

Define screening program

Answer 18

A comprehensive disease control activity based on identification and treatment of persons with unrecognized disease

Question 19

Define screening test

Answer 19

Specific technology used to identify persons with unrecognized disease

Question 20

Lymph nodes draining the cervix x4

Answer 20

External iliac
Internal iliac
Rectal
Sacral

Question 21

Blood vessels of the cervix

Answer 21

Uterine artery and veins

Question 22

Nerve supply to cervix and where it’s from

Answer 22

Uterovaginal nerve plexus from inferior hypogastric plexus