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Case 12: Female Reproductive System > Cervical Cancer > Flashcards

Cervical Cancer Flashcards

1
Q

What is 8 risk factors for cervical cancer

A

HPV infection (16 & 18)
Long interval since last PAP smear
Immunosupression
Cigarette smoking
Oral contraceptive
Low SES
Multiple partners
STD infections

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2
Q

What is HPV & where does it make changes

A

A dsDNA virus that infects the skin & squamous mucosa & make changes to the basal epithelium at transitional zone

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3
Q

What is the 2 categories of HPV

A

High risk: 16 & 18
Low risk: 6 & 11

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4
Q

What 2 things does low risk HPV cause

A

Condylomata acuminata
Freelying episome

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5
Q

What does high risk HPV cause

A

Dysplasia

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6
Q

What is the outcomes of low risk HPV

A

Regression

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7
Q

What is the outcome of high risk HPV

A

CIN I/LSIL can regress or if it persist it can become CIN II/III & HSIL
CIN II/III & HSIL can regress but also alongside other factor become cervical cancer

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8
Q

What is the Bethesda grading system

A

Low grade squamous intraepithelial lesions (LSIL)
High grade squamous intraepithelila lesions (HSIL)
Invasive carcinoma once it crosses the basement membrane & replace underlying tissue

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9
Q

What is the FIGO staging system

A

Stage I: at the cervix
Stage II: beyond cervix
Stage III: irresectable
Stage IV: disseminated

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10
Q

What is FIGO stage I

A

Stage IA: only visible with a microscope & <5mm deep
Stage IB: more than 5mm deep

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11
Q

What is FIGO stage II

A

Stage IIA: upper 2/3 of the vagina
Stage IIB: parametrium

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12
Q

What is FIGO stage III

A

Stage IIIA: lower 1/3 of vagina
Stage IIIB: pelvic sidewall/non-functional kidneys & hydronephrosis

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13
Q

What is FIGO stage IV

A

Stage IVA: mucosa of bladder or rectum
Stage IVB: distant sites

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14
Q

What is the 2 screening protocols for cervical cancer

A

PAP smear/cytology screening
HPV high risk DNA testing

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15
Q

What is a PAP smear/cytology screening

A

Collecting cells from transitional zone via cervical brush

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16
Q

What is PAP smear/cytology screening interpretation

A

CIN I/LSIL: repeat after one year
CIN II/III/HSIL: colposcopy

17
Q

What is HPV high risk DNA testing

A

PCR for HPV DNA on site & are going to replace Pap smear

18
Q

For what is HPV high risk DNA testing sensitive

A

CIN II

19
Q

Who should go for HPV high risk DNA testing & when

A

Over 30 years old every 5 years

20
Q

What is primary prevention of cervical cancer

A

HPV vaccine

21
Q

How does the HPV vaccine work

A

1-3 shots over 6 months & protect against infection by creating neutralizing antibodies

22
Q

What is the 2 types of HPV vaccine

A

Cervarix 16 & 18
Gardasil 6, 11, 16 & 18

23
Q

What should be done when histological confirmed of invasive or precursor lesion

A

Colposcopy

24
Q

What is a colposcopy

A

Direct observation of cervix looking at the margins, color & blood vessel arrangement under magnification

25
Q

What is the 2 functions of a colposcopy

A

Determine if lesion present
Perform a biopsy

26
Q

What is the 2 types of biopsy

A

Hot wire loop (LLETZ)
Cold knife (cone biopsy)

27
Q

What is the 3 treatment options for cervical cancer

A

Surgery
Radiation
Chemotherapy

28
Q

What is the 3 types of cervical cancer

A

Squamous cell carcinoma
Adenocarcinoma
Small cell carcinoma

29
Q

Where does squamous cell carcinoma occur

A

At transitional zone

30
Q

Where does adenocarcinoma occur

A

Endocervical due to HPV infection

31
Q

What causes small cell carcinoma of the cervix

A

HPV 18

32
Q

What is the most common type of cervical cancer

A

Squamous cell carcinoma

33
Q

What is the most aggressive type of cervical cancer

A

Small cell carcinoma

34
Q

What is the 3 ways in which cervical cancer spread

A

Local: most common
Lymphatic: iliac nodes
Haematogenous: via vaginal plexus that is a link between systemic & portal circulation

35
Q

What is the 3 causes of death in cervical cancer w/ examples

A

Local: renal failure, haemorrhage & superadded infection
Systemic: blood borne metastases
Iatrogenic: pulmonary embolism after pelvic operation

Case 12: Female Reproductive System (10 decks)

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