Cervical Cancer

Question 1

What HPV strain causes comon warts/verruca vulgaris

Answer 1

HPV 1, 2, 3, 4

Question 2

What HPV strain causes genital warts/condyloma acuminata

Answer 2

HPV 6/11

Question 3

HPV strain that cuase cervical cancer

Answer 3

HPV 16, 18, 31, 33, 45

Question 4

What strains does guardasil protect against

Answer 4

6, 11, 16, 18

Question 5

Who gets HPV

Answer 5

women 11-26
boys 11-12

**regular immunization given at 11 or 12

Question 6

Management for ASC-US

Answer 6

HPV DNA testing
(-) : repeart pap in 1 yr
(+) : colpo and cervical Bx

Question 7

2 types of cervical cancer

Answer 7

squamous cell carcinoma

atypical glandular cells

Question 8

What are the indications for a diagnostic cone bx?

Answer 8

Microinvarion < 3mm
endocervical cuttage positive 
discrepency of 2 steps (high grade pap, not confirmed on bx)
Inadequate culpo 
Adenocarcinoma in situ

Question 9

Diagnostic conde Bx complications

Answer 9

bleeding 
infection
cervical stenosis
incompetent cervix
PROM
Preterm labor

Question 10

What is CIN? MC timimg of developing CIN? MC location?

Answer 10

premalignant dz of cervical epithelium 2/2 HPV inf
during menses and after pregnancy
anterior lip of transformational zone, multifocal

Question 11

CIN I vs II vs III def

Answer 11

I: dysplasia in basal 1/3 of epithelium
II: dysplasia in basal 2/3 of epithelium
III dysplasia in >2/3 to full epithelium

Question 12

CIN I, II, III management

Answer 12

I: repeat pap q 6mo x 2 w/ LEEP if persistent for 2 yrs
II: LEEP
III: LEEP

Question 13

management when HGSIL on pap but normal on Bx

Answer 13

diagnostic cone bx

Question 14

Smx of cervical SCC

Answer 14

usualy smx, can present as post coital bleeding

Question 15

What is TNM criteria for the following stages + Tx
0
1a
1b
2a
2b
3a
3b
4a
4b

Answer 15

0 : carcinoma in situ | simple hysterectomy pr cold knife cone

1a : cervix only, 7mm or visible lesion | radical hystorectmy or radiation

2a : involves upper 2/3 vagina, no parametrium | ‘’
2b : involved upper 2/3 vagina, parametrium | chemoradiation (external and internal radition + cisplatin)

3a : involves lower 1/3 vagina, no pelvic wall | ‘’
3b : involves lower 1/3 vagina, pelvic wall | ‘’

4a : local met (bladder or rectum) | “
4b : distal met | ‘’