Cervical Cancer Flashcards
1
Q
cervix
A
- opening to vagina
- has wall of tissue surrounding this opening, which is where the malignancy arises
- malignancy advances and causes malignant cells to appear in the opening (making it smaller)
2
Q
cervical cancer
A
- caused by HPV
- can detect early; malignancy progresses early
3
Q
HPV
A
- human papilloma virus
- general mode of action of viruses: virus incorporates their genetic material into the host cell’s DNA -> forms viral particles -> viral particles released into cytoplasm -> lysis of cell -> mutations
4
Q
etiology and risks
A
- HPV infection (can develop without infection, but less common)
- hx of STDs
- smoking (organ specific carcinogens)
- high risk sexual practices
5
Q
strains of HPV
A
- there are over 100 strains of HPV, 40 are sexually transmitted
- 16 & 18 = strains responsible for HPV
- 6 & 11 = strains responsible for genital warts
6
Q
patho
A
- squamous cell origin
- 3 stages of progression:
- initial dysplasia (precancerous lesion)
- carcinoma in situ
- invasive stage
- time is takes to progress depends on individual, hx (several years between preCA and invasive stages)
- PAP smear (screening test): negative or positive
- mets through lymphatic system
7
Q
initial dysplasia (precancerous lesion)
A
- if caught in this stage, prognosis is really good
- change in histology -> warning sign for CA giving time to treat it before it progresses into CA
8
Q
carcinoma in situ
A
epithelial layer: superficial layer lining the cervix (develops if treatment doesn’t occur during precancerous stage)
9
Q
invasive stage
A
impacts deeper layers
10
Q
PAP smear
A
- take squamous cells from cervix and observe for changes in sqaumous cell growth
- not a test for HPV; is a test for changed histology
- smeared onto slide (dysplasia, metaplasia, and anaplasia can be viewed with a microscope)
- positive: CIN1, CIN2, CIN3
11
Q
CIN
A
- cervical intraepithelial neoplasia
- 1, 2, 3 = stage of progression of the neoplasm
- CIN 1 = mild dysplasia (LSIL)
- CIN 2 = moderate dysplasia (HSIL)
- CIN 3 = sever dysplasia and carcinoma in situ (HSIL)
12
Q
HSIL and LSIL
A
low grade/high grade squamous intraepithelial lesion
13
Q
diagnosis
A
- PAP smear
- colposcopy -> endoscopic examination of vagina and cervix (do this if PAP smear is positive)
14
Q
manifestations
A
- vaginal discharge
- metrorrhagia (bleeding between menses; late mnftn)
- increased frequent menses
- pelvic/back pain (late mfntn)
15
Q
treatment
A
- 100% curable if in situ
- early detection: excision
- invasive -> radiation or sx
- radical hysterectomy (remove uterus, cervix if more severe)
- cryosurgery
- LEEP
- laser
- conisation
- HPV vaccine (Gardasil)
