Cervical Cancer

Question 1

Cervix?

Answer 1

opening to vagina

Question 2

Where does the malignancy in cervical cancer occur?

Answer 2

Around the wall of tissue surrounding the opening of the cervix

Question 3

What is the general mode of action of all viruses?

Answer 3

Virus incorporates their genetic material in the host cells DNA, forms viral particles, viral particles released into the cytoplasm -> lysis of cell -> mutations

Question 4

Etiology and risks of cervical cancer

Answer 4

• Human papilloma virus infection
• history of STIs
• multiple sexual partners
• smoking
• early age sex

Question 5

What is the histology of the cervix?

Answer 5

squamous cell origin

Question 6

What are the 3 stages of progression?

Answer 6

1. initial dysplasia
2. carcinoma in situ
3. later invasive stage

Question 7

Initial dysplasia?

Answer 7

Pre-cancerous lesion; if caught at this stage, prognosis is extremely good; change in histology -> warning sing for cancer, giving time to treat before it progresses into cancer

Question 8

Carcinoma in situ?

Answer 8

(epithelial layer): superficial layer lining the cervix (develops if tx does not occur in pre-cancerous stage)

Question 9

Later invasive stage?

Answer 9

Impacts deeper layers

Question 10

Screening test for cervical canceR?

Answer 10

Pap smear

Question 11

Explain the pap smear?

Answer 11

smeared onto a microscope (dysplasia, metaplasia, or anaplasia can be viewed). If its positive -> CIN1, CIN2, CIN3

Question 12

CIN?

Answer 12

Cervical intraepithelial neoplasia

Question 13

CIN1?

Answer 13

mild dsyplasia (LSIL)

Question 14

LSIL & HSIL

Answer 14

low-grade squamous intraepithelial lesion and high-grade squamous intraepithelial lesion

Question 15

CIN2?

Answer 15

moderate change (HSIL)

Question 16

CIN3?

Answer 16

severe dysplasia and carcinoma in situ (HSIL)

Question 17

Where does metastases occur?

Answer 17

through lymphatic system

Question 18

Diagnostics for cervical cancer?

Answer 18

• Pap smear
• HPV vaccine (Gardasil)
• Colposcopy

Question 19

How many strains are there of the HPV virus?

Answer 19

About 100 strains; ~40 are sexually transmitted.

Question 20

Which 4 strains are clinically significant?

Answer 20

stains 6 & 11 are responsible for 90% of genital warts

strains 16 & 18 are responsible for 70% of cervical cancer

Question 21

Manifestations of cervical cancer?

Answer 21

• vaginal discharge
• metorrhagia (bleeding b/w menses)
• more frequent menses
• pelvic/back pain

Question 22

Treatment for cervical cancer?

Answer 22

• early detection -> excision
• invasive stage -> radiation and surgery
• LEEP (loop electro-surgical excision procedure)
• Cryosurgery
• conization
• laser
• radical hysterectomy

Question 23

LEEP?

Answer 23

Loop electro-surgical excision procedure [CIN1 + CIN2]; electro-surgical -> high temperature applied with a loop-like instrument

Question 24

Cryosurgery?

Answer 24

cells exposed to extreme temperature will induce necrosis

Question 25

Conization?

Answer 25

surgical instrument used to remove a cone-shaped lesion from the Cervix