Cervical Cancer Flashcards

1
Q

most cervical cancers are what type

A

squamous cell carcinomas

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2
Q

after squamous what is the most common type of cervical cancer

A

adenocarcinoma

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3
Q

what are most squamous cancers of the cervix caused by

A

HPV-70% due to HPV 16 and 18

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4
Q

which types of HPV are linked with cervical cancer

A

16 and 18

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5
Q

what are the risk factors for cervical cancer

A

smoking
STI long term contraception use
age of first sexual intercourse
immunodeficiency

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6
Q

how does cervical cancer tend to present

A

abnormal vaginal bleeding

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7
Q

what does stage 1a cancer mean

A

it is microscopic

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8
Q

stage 1b

A

visible lesion

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9
Q

stage 2a

A

vaginal involvement

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10
Q

stage 2b

A

parametrial involvement

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11
Q

stage 3

A

lower vagina/pelvic sidewall

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12
Q

stage 4

A

bladder/rectum or mets

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13
Q

what is a nabothian cyst

A

a mucus cyst on surface of cervix, most often caused when stratified squamous epithelium of ECTOcervix grows over the simple cCOLUMNAR EPITHELIUM of the endocervix

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14
Q

what are the symptoms of cervicitis

A

non specific acute/chronic inflammation

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15
Q

what can silent cervictiits cause and why

A

infertility due to simultaneous silent fallopian tube damage

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16
Q

what is follicular cervicitis

A

sub epithelial reactive lymphoid follicles present in cervix

17
Q

are cervical polyps premalignant

A

no

18
Q

what HPV type are genital warts

A

6 and 11

19
Q

describe the appearance of genital warts

A

condyloma acuminatum-thickened papillomatous squamous epithelium with cytoplasmic vaculoation (koilocytosis)

20
Q

what is CIN

A

pre-invasive stage of cervical cancer, occurs at the transformation zone, can involve a large area, dysplasia of squamous cells, not visible by naked eye, asymptomatic

21
Q

what does koilocytosis indicate

A

HPV infection

22
Q

what is CIN 1

A

basal 1/3 of epithelium occupied by abnormal cells
radised numbers of mitotic figures in lower 1/3
surface cells quite mature but nuclei slightly abnormal

23
Q

what is CIN II

A

abnormal cells extend to middle 1/3
mitoses in middle 1/3
abnormal mitotic figures

24
Q

CIN III

A

abnormal cells occupy full thickness of epithelium

mitoses often abnormal in upper 1/3

25
Q

what does invasive squamous carcinoma develop from

A

pre-existing CIN, therefore most cases should be preventable by screening

26
Q

what is CGIN

A

cervical glandular intraepithelial neoplasia

27
Q

what are the problems with CGIN

A

more difficult to diagnose on cervical smear than squamous

28
Q

CGIN is preinvasive phase of what

A

endocervical adenocarcinoma

29
Q

what is the prognosis of adenocarcinoma compared to squamous

A

worse

30
Q

what is the epidemiology of adenocarcinoma

A

higher SE class, later onset of sexual activity, smoking, HPV particularly HPV 18

31
Q

what else is also caused by HPV

A

Vulvar intraepithelial neoplasia
vaginal intraepithelial neoplasia (VaIN)
Anal Intrepithelial neoplasia (AIN)

32
Q

what is vulval intraepithelial neoplasia associated with

A

pagets disease

33
Q

what demographic tend to get vulvar intraepithelial neoplasia

A

bimodal-young women (often multifocal, recurrent or persistent causing treatment problems), older women-greater risk of progression to invasive squamous carcinoma
three grades like CIN
often but not always HPV related

34
Q

describe features of Vulvar invasive squamous carcinoma

A

usually elderly women, ulcer or exophytic mass
most are well differentiated
spread to inguinal lymph nodes which is most important prognostic factor
surgical treatment-radical vulvectomy and inguinal lymphadenectomy

35
Q

describe vulvar pagets disease

A

crusting rash
tumour cells in epidermis, contain mucin
mostly no underlying cancer, tumour arises from sweat glands in skin