Cervical Disorders

Question 1

what is the name of the location where the inner lining meets the exterior surface of the cervix?

Answer 1

squamocolumnar junction (SCJ)

Question 2

what kind of cells makes up the inner lining of the cervix

Answer 2

columnar cells

Question 3

what kind of cells makes up the exterior surface of the cervix

Answer 3

squamous cells

Question 4

what is the clinical significance of the SCJ?

Answer 4

it’s where cervical cancer occurs

Question 5

what should you be thinking if the cervix is BRIGHT RED?

Answer 5

“ectropion” or “cervical ectopy” - the cervix basically everts

Question 6

is ectropion/cervical ectopy a normal finding?

Answer 6

yes, happens with age

Question 7

what is the “transformation zone,” and what structures is it made up of?

Answer 7

where neoplastic changes occur on the cervix

extends from “true” SCJ to “original” SCJ (like when there is ectropion)

Question 8

which condition is pearl-like and 1-3mm on the ectocervix

Answer 8

nabothian cyst

Question 9

are nabothian cysts malignant or benign

Answer 9

benign

Question 10

which condition is common over 20y, is from the endocervix, bleeds easily, and is 2-300mm?

Answer 10

cervical polyp

Question 11

are cervical polyps malignant or benign?

Answer 11

benign, but remove just to be sure

Question 12

how do you remove a cervical polyp?

Answer 12

grasp with ring forceps and twist

Question 13

which condition is characterized by purulent discharge +/- post-coital bleeding or urethritis?

Answer 13

acute cervicitis

Question 14

is acute cervicitis malignant or benign?

Answer 14

well it depends on how you look at it… it’s an STD so it needs to be treated but it’s not gonna kill ya

Question 15

which condition is characterized by leukorrhea, vulvar irritation, postcoital bleeding, and spotting, +/- dysmenorrhea, dyspareunia, low abd pain, low back pain, and urinary sx?

Answer 15

chronic cervicitis

Question 16

is chronic cervicitis malignant or benign?

Answer 16

benign!

Question 17

which condition is characterized by a narrowed endocervical canal?

Answer 17

cervical stenosis

Question 18

is cervical stenosis malignant or benign?

Answer 18

benign

Question 19

what causes cervical stenosis (4)?

Answer 19

congenital

low estrogen

neoplastic

post-surg

Question 20

what may cervical stenosis lead to?

Answer 20

may cause obstructed menstrual flow and infertility

Question 21

what is the most common type of cervical cancer, and what HPV strain causes it?

Answer 21

squamous cell - strain 16

Question 22

what is the 2nd most common type of cervical cancer, and what HPV strain causes it?

Answer 22

adenocarcinoma - strain 18

Question 23

true or false: the OLDER you get, the LESS likely you are to get cervical cancer.

Answer 23

TRUE! It takes about 20y to develop, so if you haven’t gotten by like 60 you probably won’t get it

Question 24

at what age do we stop screening for cervical cancer?

Answer 24

age 65

Question 25

which of the following is NOT a risk for cervical cancer?

a) early onset of sex
b) multiple/high-risk partners
c) hx of STIs
d) hx of pregnancy
e) hx of vag/vulvar cancer
f) immunosuppression
g) smoking

Answer 25

hx of pregnancy the rest are all risks

Question 26

Cervical cancer is usually asx, but what might you see on PE of the vag?

Answer 26

raised, friable lesions on the cervix

Question 27

how do you dx cervical cancer?

Answer 27

bx

Question 28

how do you treat early-stage cervical cancer? (3)

Answer 28

radical hysterectomy

fertility-sparing surgery

radiation +/- chemo

Question 29

what is the outlook of cervical cancer if there are mets or if it is recurrent?

Answer 29

less than 2y

Question 30

what ages do you give pap smears?

Answer 30

age 21-65

Question 31

how often do you do a screen pap if they have been normal ages 21-29?

Answer 31

every 3y

Question 32

what to you use to screen for ages 30-65y, and how often?

Answer 32

pap + HPV co-test every 5y

Question 33

if a person has no cervix, do you do a pap smear?

Answer 33

no silly