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3. Conditions: Gynaecology > Cervical Cancer > Flashcards

Cervical Cancer Flashcards

1
Q

Strongest risk factor for cervical cancer?

A

HPV 16 & 18 infection

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2
Q

What cells cause cervical cancer?

A

Squamous cell = 80%

Adenocarcinoma = 20%

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3
Q

Where does squamous cell carcinoma arise from in cervical cancer?

A

Vaginal cervix

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4
Q

Where does adenocarcinoma arise from in cervical cancer?

A

Endocervix

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5
Q

What is the pathology of HPV infection?

A

Turns on oncoproteins E6/E7

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6
Q

What do oncoproteins E6/E7 lead to?

A

Cervical intra-epithelial neoplasia

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7
Q

Which part of the cervix is most susceptible to malignant change?

A

Squamo-columnar junction

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8
Q

What are the peak ages of cervical cancer?

A

30 - 39

> 70

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9
Q

What other risk factors account for the 3% of non HPV cervical cancer?

A

Multiple partners

Early first intercourse

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10
Q

Typical presentation?

A

” 68 y/o presents with weight loss, fatigue and pelvic pain. Vaginal exam shows an exophytic mass. “

Typically, cervical cancer is found by an abnormal smear and has an asymptomatic presentation.

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11
Q

DDx of abnormal smear?

A

Cervical ectropian

Nabothian cyst

Cervical polyp

Cervicitis

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12
Q

What is a cervical ectropian?

A

Natural descent of the cervix due to hormones. Cervix appears red

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13
Q

Investigation?

A

Speculum exam
- Often bleeds when prodded –> post-coital bleeding

Colposcopy

Biopsy

MRI pelvis

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14
Q

What may be elicited by colposcopy?

A

Dense acetic acid uptake

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15
Q

What is acetic acid used for normally in colposcopy?

A

Washing away mucus

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16
Q

What staging is used for cervical cancer?

A

FIGO staging

17
Q

Stage 1 FIGO for cervical?

A

Cancer in situ
A - invisible - diagnosed by biopsy
B - visible but very small

18
Q

Stage 2 FIGO for cervical?

A

Cancer invades past cervix but not to pelvic sidewall

19
Q

Stage 3 FIGO for cervical?

A

Tumour fixed to pelvic wall
A - involves vagina
B - traverse to internal pelvic wall

20
Q

Stage 4 FIGO for cervical?

A

A - local spread

B - distant spread

21
Q

Treatment of carcinoma in situ?

A

LLETZ

- Large loop excision of transitional zone

22
Q

Stage 2 treatment?

A

Hysterectomy

23
Q

Stage 3 treatment?

A

Chemo
- Cisplatin

Radiotherapy

24
Q

Stage 4 treatment?

A

Palliative chemo

  • Paclitaxel
  • Cisplatin

3. Conditions: Gynaecology (24 decks)

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