Cervical Disorders

Question 1

alkaline pH causes overgrowth of microbes causing cervicitis. What could cause this alkaline pH?

Answer 1

bleeding, intercourse, abx use

Question 2

cervicitis affects what cells of cervix?

Answer 2

primarily the columnar epithelial cells of the endocervical glands

Question 3

causes of cervicitis

Answer 3

trichomonas, gonorrhea, chlamydia, mycoplasma

Question 4

Red edematous cervix with mucopurulent exudate is symptom of

Answer 4

cervicitis

Question 5

patient presents with complaint of irregular vaginal bleeding. a growth protrudes through cerival ox. Is soft and mucoid. dx and tx?

Answer 5

endocervical polyp. simple curettage or surgical excision

Question 6

HPV types a/w cervical cancers

Answer 6

16 and 18

Question 7

HPV 16 and 18 account for what percent of cervical cancers

Answer 7

16 accounts for 60%, 18 accounts for 10%

Question 8

single most important factor in cervical oncogenesis

Answer 8

high oncogenic risk

Question 9

HPV type based on

Answer 9

DNA sequence

Question 10

HPV subgroup based on

Answer 10

high and low oncogenic risk

Question 11

why are OCP’s a risk factor for cervical cancer?

Answer 11

cause hormonal change that change pH

Question 12

HPV cellular effect causing cervical neoplasm

Answer 12

infects IMMATURE basal cells of squamous epithelium (damage to surface epithelium must occur that allows access to immature cells)

Question 13

differentiate between CIN I, II, and II based on HPV associations and which are precancerous or not

Answer 13

CIN I-a/w HPV 6 and 11. Not precursor to cervical cancer.

CIN II and III- a/w HPV 16, 18, 31, 33 45. pre-cancerous

Question 14

hallmark of HPV infection

Answer 14

koilocytes

Question 15

CIN I

Answer 15

neoplastic basaloid cells in lower one third of epithelium have mild dysplasia

Question 16

CIN II

Answer 16

neoplastic basaloid cells in up to lower 2/3 of epithelium have moderate dysplasia

Question 17

CIN III

Answer 17

neoplastic basaloid cells have severe dysplasia in more than 2/3 of epithelium

Question 18

HSIL vs. LSIL a/w HPV

Answer 18

LSIL 80% or more a/w HPV. HSIL all a/w HPV

Question 19

progression of LSIL indirectly to carcinoma

Answer 19

60% of LSIL regress, 30% persist, 10% progress to HSIL. of that 10%, 30% regress, 60% persist, and 10% develop into carcinoma

Question 20

80% of cervical cancers are

Answer 20

Squamous CC

Question 21

precursor of cervical cancer

Answer 21

HSIL

Question 22

second most common cervical cancer

Answer 22

cervical adenocarcinoma (15%)

Question 23

5 year survival for cervical cancer caught EARLY vs. LATE

Answer 23

early- 80%, late 5% (has mets to rectum or bladder by then)

Question 24

carcinoma in situ most likely occurs at what site

Answer 24

squamous-columnar junction