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Women's Health Clin med > cervical cytology > Flashcards

cervical cytology Flashcards

1
Q

what is the second most common cancer in women in less developed regions

A

cervical cancer

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2
Q

What are the risk factors for cervical cancer

A

Early onset of sexual activity
multiple partners
long term use of OCP
nutrition deficiency
immunosuppression
lack of HPV vaccine***

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3
Q

Which women in developed countries are at highest risk for cervical cancer

A

those who are not adequately screened

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4
Q

What is the median age of cervical cancer diagnosis

A

50

*most frequently between 35-44

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5
Q

what is the median age at death for women diagnosed with cervical cancer

A

59

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6
Q

What are the 2 main types of cervical cancer

A

SCC
adenocarcinomas

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7
Q

Where does SCC occur in cervical cancer

A

arise in squamous epithelial cells of the cervix

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8
Q

Where of adenocarcinomas arise in cervical cancer

A

arise in glandular cells of the endocervix

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9
Q

Which type of cervical cancer is much harder to identify on Pap smears

A

adenocarcinomas

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10
Q

What is the best way to treat cervical cancer

A

prevention

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11
Q

Which gender is the HPV vaccine intended for

A

both males and females

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12
Q

Which gender is the main carrier of HPV for transmission

A

males

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13
Q

What is the purpose of screening tests like Pap smears for cervical cancer prevention

A

it helps identify premalignant lesions as well as invasive disease

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14
Q

What are the methods for screening for cervical cancer

A

Pap (cytology)
HPV testing for high risk

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15
Q

What area of the cervix is evaluated during cervical cancer screenings

A

Transformation zone between endo and ecto cervix

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16
Q

How long does HPV take to go away

A

generally 6-24 months without treatment

*especially if vaccinated

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17
Q

What are ablative therapy options

A

electrical loop excision (LEEP)
cryotherapy
cone biopsy

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18
Q

What are some cervical screening complications

A

cervical stenosis
infertility
cervical incompetence
PROM

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19
Q

What is the object of the cervical screening process

A

You want a representative cell sample
AKA: need cells from transformation zone and endocervical canal

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20
Q

What is the main cause of cervical cancer

A

HPV

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21
Q

Which cancers are cause from HPV

A

Cervical
anal
oropharyngeal

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22
Q

What are the main high risk types of HPV

A

16 and 18
*carcinogenic

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23
Q

What are the different types of HPV vaccines

A

Gardasil 9 ** (9-26y/o)

24
Q

When should HPV vaccine be given

A

ideally during recommended ages because its most effective

25
Q

Which patients should get 2 doses of the HPV vaccine

A

those who get their first dose before there 15th birthday

26
Q

Which patients should get 3 doses of the HPV vaccine

A

those who get their first done on or after their 15th birthday

27
Q

Which cells within the cervix are the most vulnerable to mutagens like HPV

A

Cells in the metaplasia

28
Q

What is included in an optimal cervical cancer screening

A

it includes the entire transformation zone

29
Q

What type of screening prep is required for HPV typing

A

liquid based cytology

*Not conventional pap

30
Q

What are the FDA approved liquid based cytology paps

A

thinprep
surepath

31
Q

What is NILM

A

negative for intraepithelial lesion of malignancy

32
Q

What are some cytology findings with Pap smears

A

atypical glandular cells
suspicion for invasive disease

33
Q

What are some histology finding with Pap smears

A

invasive carcinoma and the different grading

34
Q

What is SIL

A

Squamous intraepithelial lesion

*general term for abnormal growth of squamous cells on the surface of the cervix

35
Q

What are the two types of SIL

A

Low grade
high grade

36
Q

What is low grade SIL

A

early changes in size, shape, and number of cells from surface of the cervix

37
Q

What is high grade SIL

A

large number of precancerous cells

38
Q

What do atypical glandular cells always indicate the need for

A

colposcopy
endocervical curettage
AND
endometrial biopsy

39
Q

What is HPV co-testing

A

Adjunct testing with cytology

40
Q

What is HPV reflex testing

A

abnormal findings on cytology

41
Q

What are the different types of HPV testing

A
  1. test that detects the presence / absence of 13-14 HPV subtypes
  2. HPV genotyping and report presence/absence of 16 or 18
42
Q

What is HPV 18 associated with

A

cervical adenocarcinoma

43
Q

When should cervical cancer screenings be started

A

21 regardless of sexual activity

44
Q

What is the screening interval for 21-30 y/o

A

Cytology only
*q3 years if normal

45
Q

What is the screening interval from 30-65

A

Pap plus HPV
*q5 years if normal

46
Q

How does a supracervical hysterectomy change the cervical screening intervals

A

it doesn’t… stays the same

47
Q

When should cervical cancer screening be started

A

25y/o

48
Q

What is the preferred test for cervical cancer

A

HPV

49
Q

When can you stop cervical cancer screenings at 65

A

2 negative, consecutive co-tests

3 negative Pap tests in the last 10y

50
Q

If a patient is over 65 and reports having a new sexual partner, do you resume cervical cancer screenings

A

no
*risk is low and colposcopy is more difficult to preform

51
Q

What is an exception for continuing cervical screenings after 65

A

women exposed to DES in utero require years screening, even after TAH/TVH

52
Q

How long after a TAH/TVH for high grade lesions, should cervical screenings be preformed regardless of age

A

20 years

53
Q

If there is an abnormal cytology or positive HPV test, what is the gold standard for next step workup

A

Colposcopy

54
Q

What is LEEP used for and what is it

A

CIN 2,3
Excision of entire transformation zone with an electrified loop

55
Q

What is the purpose of a LEEP procedure

A

obtaining a diagnostic tissue sample to exclude or identify invasive disease

Women's Health Clin med (13 decks)

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