Cervical Cancer Flashcards
Patient with cervical cancer – flank tenderness would indicate?
Metastatic obstruction of the ureter
Most common presenting symptom of invasive cervical cancer?
Abnormal vaginal bleeding
Risk factors for cervical cancer?
Notably, this is not a risk factor?
- early age of coitis or early childbearing (Early sex)
- Multiple sexual partners (Lots of sex)
- STIs, HPV, HIV (sex disease)
- Cigarette smoking (post sex)
- Low socioeconomic status
Family history is not a risk factor
Cervical intraepithelial neoplasia?
Preinvasive lesions of cervix with abnormal maturation, nuclear enlargement, and atypia
HPV – type of virus?
Circular, double-stranded DNA virus
Majority of cervical dysplasias/cancer arise where?
Squamocolumnar junction of the cervix
Ways to identify dysplastic lesions?
- Acetowhite change after addition of acetic acid
2. Vascular pattern changes punctations, corkscrew vessels, hairpin vessels)
Patient presents with cervical mass – next step?
Biopsy
Staging procedure for cervical cancer?
- Examination under anesthesia,
- IV pyelogram
- Chest radiograph
- Barium enema or proctoscopy
- Cystoscopy
Treatment of early versus advanced cervical cancer?
Radical hysterectomy or radiation
Versus
Radiotherapy (brachytherapy + teletherapy) + chemotherapy (cis-platinum)
Spread of cervical cancer? Can obstruct?
Through cardinal ligaments toward pelvic sidewalls; one or both ureters leading to hydronephrosis
Most common cause of death due to cervical cancer?
Bilateral ureteral obstruction
Cervical cytology is not recommended in women who have had? Exception?
Total hysterectomy for benign indications;
Annual Pap smear of vaginal cuff is still needed if hysterectomy is performed for cervical dysplasia
Patient with ASCUS, when to observe instead of immediate colposcopy?
Adolescents and pregnant patients
Advantages of hysterectomy over radiotherapy?
Preservation of sexual function and ovarian function (Vaginal agglutination is caused by radioactive implants, closing the vagina)
