cervical cancer

Question 1

majority of cervical cancers?

Answer 1

squamous cell carcinoma

Question 2

SCC involves infection with HPV?

Answer 2

16 and 18

Question 3

risk factors for getting infection?

Answer 3

80%

Question 4

risk factors for getting infection?

Answer 4

high parity 
smoking
regular unprotected sex
early age of sexual activity 
immunosuppression 
prolonged use of contraceptive pill

Question 5

consequences of infection?

Answer 5

infection without any cellular changes and development of immunity
persistence of infection, uptake of viral DNA into cells and changes to epithelial cells known as DYSKARIOSIS

Question 6

persistence of infection, uptake of viral DNA into cells and changes to epithelial cells known as

Answer 6

DYSKARIOSIS

Question 7

precursor lesion of invasive carcinoma?

Answer 7

CIN

Question 8

how is dyskariosis diagnosed?

Answer 8

cytology

Question 9

how is CIN diagnosed?

Answer 9

it is a histological diagnosis made on biopsy

Question 10

CIN 1 risk of progeression to cancer?

Answer 10

1%

Question 11

CIN II risk of cancer?

Answer 11

5%

Question 12

CIN III risk progression of cancer?

Answer 12

12%

Question 13

what is glandular intraepithelial neoplasia?

Answer 13

precursor lesion for invasive adenocarcinoma

Question 14

GIN involves which epithelium?

Answer 14

columnar epithelium of the endocervix

Question 15

age range of the screening programme of smear test?

Answer 15

25 - 64

Question 16

what age do you get a smear test every 3 years.

Answer 16

25-49

Question 17

when do you get a smear every 5 years?

Answer 17

50-64

Question 18

what is the purpose of the screening programme?

Answer 18

to obtain cervical cells for cytology

Question 19

if cytology is inflammatory what do you do

Answer 19

repeat in 3 months

Question 20

if cytology borderline?

Answer 20

repeat in 6 months

Question 21

mild dyskaryosis?

Answer 21

repeat in 6 months

Question 22

when do you refer for colposcopy?

Answer 22

moderate and severe dyskaryosis and glandular abnormalities

Question 23

what does colposcopy involve?

Answer 23

Involves looking up close at the cervix with speculum and microscope

Question 24

two stains use in colposcopy?

Answer 24

acetic acid (goes white) and iodine (goes brown)

Question 25

how do you get CIN from colposcopy?

Answer 25

eye ball from stains

Question 26

what does every patient get at colposcopy?

Answer 26

biopsy

Question 27

if CIN 2 or 3 what do you do?

Answer 27

cold coagulation or LLETZ

Question 28

how do you get an exact CIN diagnosis/

Answer 28

from biopsy

Question 29

age of patients who get cervical canceR

Answer 29

25-44

Question 30

presentation /

Answer 30

post/intermenstrual bleeding, pelvic pain, blood stained discharge, weight loss, bowel and bladder disturbance

Question 31

staging for cervical cancer?

Answer 31

MRI

Question 32

staging?

Answer 32

1 confined to cervix
2 out of cervix - in vagina (not lower third ) and extends to pelvic side wall
3 stage 3 involves lower third vagina and extends to pelvic side wall
• Stage 4: tumour involves the bladder or rectum and/or extends beyond the pelvis.

Question 33

management ?

Answer 33

o 1a1 (microscopic disease) cone biopsy, which will preserve fertility.
o 1a2 – 2a: radical hysterectomy with bilateral pelvic node dissection.
• Stage 2b – 4
Radiothaerapy +/- chemotherapy

Question 34

how do you prevent cervical canceR?

Answer 34

HPV vaccination

Question 35

what strains does this cover?

Answer 35

6,11,16,18

Question 36

what age of girls is this given to ?

Answer 36

11-13