Cervical Cancer

Question 1

most cervical cancers are what type

Answer 1

squamous cell carcinomas

Question 2

after squamous what is the most common type of cervical cancer

Answer 2

adenocarcinoma

Question 3

what are most squamous cancers of the cervix caused by

Answer 3

HPV-70% due to HPV 16 and 18

Question 4

which types of HPV are linked with cervical cancer

Answer 4

16 and 18

Question 5

what are the risk factors for cervical cancer

Answer 5

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

Question 6

how does cervical cancer tend to present

Answer 6

abnormal vaginal bleeding

Question 7

what does stage 1a cancer mean

Answer 7

it is microscopic

Question 8

stage 1b

Answer 8

visible lesion

Question 9

stage 2a

Answer 9

vaginal involvement

Question 10

stage 2b

Answer 10

parametrial involvement

Question 11

stage 3

Answer 11

lower vagina/pelvic sidewall

Question 12

stage 4

Answer 12

bladder/rectum or mets

Question 13

what is a nabothian cyst

Answer 13

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

Question 14

what are the symptoms of cervicitis

Answer 14

non specific acute/chronic inflammation

Question 15

what can silent cervictiits cause and why

Answer 15

infertility due to simultaneous silent fallopian tube damage

Question 16

what is follicular cervicitis

Answer 16

sub epithelial reactive lymphoid follicles present in cervix

Question 17

are cervical polyps premalignant

Answer 17

no

Question 18

what HPV type are genital warts

Answer 18

6 and 11

Question 19

describe the appearance of genital warts

Answer 19

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

Question 20

what is CIN

Answer 20

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

Question 21

what does koilocytosis indicate

Answer 21

HPV infection

Question 22

what is CIN 1

Answer 22

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

Question 23

what is CIN II

Answer 23

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

Question 24

CIN III

Answer 24

abnormal cells occupy full thickness of epithelium

mitoses often abnormal in upper 1/3

Question 25

what does invasive squamous carcinoma develop from

Answer 25

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

Question 26

what is CGIN

Answer 26

cervical glandular intraepithelial neoplasia

Question 27

what are the problems with CGIN

Answer 27

more difficult to diagnose on cervical smear than squamous

Question 28

CGIN is preinvasive phase of what

Answer 28

endocervical adenocarcinoma

Question 29

what is the prognosis of adenocarcinoma compared to squamous

Answer 29

worse

Question 30

what is the epidemiology of adenocarcinoma

Answer 30

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

Question 31

what else is also caused by HPV

Answer 31

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

Question 32

what is vulval intraepithelial neoplasia associated with

Answer 32

pagets disease

Question 33

what demographic tend to get vulvar intraepithelial neoplasia

Answer 33

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

Question 34

describe features of Vulvar invasive squamous carcinoma

Answer 34

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

Question 35

describe vulvar pagets disease

Answer 35

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