Cervical Cancer

Question 1

name four risk factors for cervical cancer

Answer 1

early age first sex
multiple sex partners
cigs
HIV
chronic steroid use

Question 2

what happens when someone usually gets HPV?

Answer 2

infection is cleared

Question 3

what is structure of HPV?

Answer 3

double stranded circular DNA virus

Question 4

what cells does HPV get into?

Answer 4

basal epithelial cells

Question 5

name the two high risk HPVs

Answer 5

16 18

Question 6

describe how HPV causes issues in cells?

Answer 6

E6 and E7 exons affect host regulatory proteins like Rb and p53

Question 7

in HPV cancer, where is viral genoma?

Answer 7

it is integrated into the human genome

Question 8

when do we start pap smear screening?

Answer 8

age 21

Question 9

a pap smear is a sample of what two things?

Answer 9

ecto and endo cervix

Question 10

the ectocervix is what type of epithelium?

Answer 10

stratified squamous

Question 11

what are the four epithelial layers of the ectocervix?

Answer 11

superficial intermediate parabasal and basal

Question 12

what is epithelium of the endocervix?

Answer 12

columnar mucinous epithelium

Question 13

name the cytologic features of low grade squamous intraepithelial lesions

Answer 13

perinuclear clearing with enlarged nuclei

Question 14

name the cytologic features of high grade squamous intraepithelial lesions

Answer 14

very enlarged nuclei with high nucleus to cytoplasm ratio

Question 15

what is seen sytologically with cervical adenocarcinoma?

Answer 15

nuclear enlargement
increased nuclear to cytoplasm ratio
nuclear elongation
rosette formation

Question 16

when do you start co testing? that means do HPV dna test and pap smear

Answer 16

at 30 years old

Question 17

what is next step if HPV is positive and have some form of abnormal cellularity?

Answer 17

colposcopy

Question 18

what do you apply during a colposcopy?

Answer 18

acetic acid

Question 19

low grade squamous cell (LSIL) involves what part of epithelium?

Answer 19

basal 1/3

Question 20

CIN 3 or HSIL, involves what part of the epithelium

?

Answer 20

entire thickness of the epithelium

Question 21

CIN 2 HSIL involves what part of the epithelium?

Answer 21

only about 1/2

Question 22

an HSIL on cytology can be what two things on histo?

Answer 22

CIN 2 or 3 or cancer

Question 23

an LSIL on cytology can be what on histo?

Answer 23

CIN 1 or CIN 2/3

Question 24

what are the two diagnostic cervical surgical techniques?

Answer 24

cold knife cone biopsy

loop electro diathermy excisional procedure (LEEP)

Question 25

what is rx for CIN 1?

Answer 25

1 yr follow up…may resolve

Question 26

what is rx for CIN 2?

Answer 26

treatment…but can just follow up if patient less than 25 and planning pregnancy

Question 27

what is rx for CIn 3?

Answer 27

rx immediately…can do ablation or diagnostic surgical techniques

Question 28

what is rx for adenocarcinoma in situ?

Answer 28

cold knife core biopsy

Question 29

what are the HPV vaccines called?

Answer 29

gardasil and cervarix

Question 30

which HPV vaccine is given in US?

Answer 30

gardasil

Question 31

what is structure of gardasil vaccine?

Answer 31

recombinant L1 capsid proteins

Question 32

what four HPV does gardasil protect from?

Answer 32

6,11,16,18