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Women's Health > Cervical Disorders (Exam One) > Flashcards

Cervical Disorders (Exam One) Flashcards

1
Q

What is the area where the cells of the vagina (squamous cells) and the cells of the uterus ( columnar or glandular cells) meet?

A

Transformation zone

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2
Q

True / False - The SCJ (squamocolumnar junction) is static and remains in the same position from the cervix / vagina throughout the woman’s life

A

False- the SCJ moves as a result of hormonal and environmental influences (such as pregnancy)

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3
Q

Endocervix is lined with columnar cells and ectocervix are completely lined with squamous epithelium during what ?

A

Premenarchal sturcture

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4
Q

Post menarche SCJ is generally found where

A

Ectocervix - with increased eversion during pregnancy

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5
Q

post menopause the SCJ is often found where?

A

Within the endocervical canal

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6
Q

The naming system that Pap smears utilize

A

Bethesda System

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7
Q

Naming of cell types with Bethesda system ASC-USASC- HLSILHSIL

A

ASC-US: Atypical squamous cells of undetermined significanceASC-H- Atypical squamous cells in which High-grade lesions cannot be excludedLSIL- Low-grade squamous intraepithelial lesion(cellular change consistaent with CIN I ) HSIL - High-grade squamous intraepithelial lesion- Includes cellular changes consistent with CIN II and CIN III

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8
Q

How are Biopsied lesions of the cervix classified

A

with CIN nomenclature

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9
Q

CIN nomenclature Cervical Intraepithelial Neoplasia (CIN) CIN I CIN IICIN III Cancer in situ (CIS)

A

CIN I - Disordered growth of the lower third of the epithelial lining (mild dysplasia) CIN II- Abnormal maturation of the lower 2/3 of the epithelial thickness( Moderate dysplasia) CIN III- Involves more than 2/3 of the epithelial thickness (severe dysplasia) Cancer In Situ (CIS) - involves full thickness of the epithelium

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10
Q

what layer is broken through by abnormal cells to begin evading other tissue and create what we know as cancer

A

Basement membrane

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11
Q

Abnormal cells iwth mild changes at the surface

A

Low-grade changes

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12
Q

What is the Peak prevalence in women of Cervical Dysplasia

A

25-35 y.o. females

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13
Q

What are the two big factors that are included in Epidemiology of Cervical dysplasia

A

SES - socioeconomic status and geographic location

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14
Q

What are some risk factors for women for increased Cervical Dysplasia

A

Smoking, HPVHPV i fond in more than 80% of the CIN lesions Others: Multiple sexual partners, Genital neoplasia, HIV/AIDS, immunosuppression, multiparous, Long term oral contraceptive pill user, High-risk sexual partners, lower genital neoplasia, hx of exposure ot cervical neoplasia

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15
Q

HPV - currently _____ americans are currently infected

A

79 million

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16
Q

approximately _____ million people will become infected with HPV each year (in America)

A

14 million

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17
Q

women have what percentage chance of infection of HPV throughout lifetime

A

50-80% chance

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18
Q

Percentage of immunocompetent women that will resolve HPV infection within ____ years

A

90% 2 years

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19
Q

there are 130 types of HPV of which 30-40 will infect the ano-genital tissue Types ___, X5 will cause genital warts and low grade lesions

A

types 6 11424344

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20
Q

Which types (X13) of HPV are linked to CIN II and III and cancer

A

types16, 18, 31, 33, 39, 45, 51, 56, 58, 59, 68

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21
Q

what percentage is condom usage at decreasing spread of HPV . Why is this still insignificant to protect form HPV

A

60% effectiveThe condoms do not protect against labial-scrotal transmission

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22
Q

What are the prevention (medicine) tools for HPV

A

GardasilGardasil-9 and Cervarix

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23
Q

DDX for HPV

A

CervicitisPelvic Inflammatory DiseaseVaginitis TrichomoniasisHerpes LesionAbnormal Cells on Pap from surrounding tissue

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24
Q

Clinical features of Cervical Dysplasia

A

Often aysmptomatic visible cervical lesionFriable cervixbleeds easily-post coital bleeding

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25
Q

How do we evaluate Cervical Dysplasia

A

Obtain cervical cytology or biopsy Check for vaginal infections

26
Q

How do we diagnose cervical dysplasia

A

Cervical Cytology (Pap Smear)

27
Q

Recommendation for pap smears for women

A

once every 3 years for women 21-29 regardless of age of sexual debut, no HIV testing for this group. women 30 and up can be monitored by pap every 3 years or by pap and HPV testing every 5 years

28
Q

True or False- CIN I can spontaneously regress in a large number of pts, thus we continue monitoring with pap smears over time as first line management

A

True

29
Q

Tx of CIN II and CIN III should be treated in every pt. the therapy treatments of choice include what?

A

Cryotherapy, LEEP, or Cold Knife conization

30
Q

When treating CIN II and CIN III we must act quickly and treat all pts even with pregnancy. Increased risk for complications in pregnant women are low and considered minuscule (TRUE or FALSE)

A

FALSE- treatment for pregnant women should be done postpartum

31
Q

How many years does it take if HPV infection is not cleared for CIN II or CIN III to form

A

Approximately 3-5 years

32
Q

It takes how many years to progress to cervical cancer from HPV infection that remains active and for lesions that are not treated

A

10 - 20 years in addition to the 3-5 years that it took to become CIN II or III (total of 13- 25 years ) of HPV infection onset

33
Q

What is a Colposcopy

A

The Colposcope Uses magnification (5-15X) and light, in combination with aqueous acetic acid, and sometimes iodine to allow abnormal cells to be seen more easily

34
Q

Biopsies are obtained utilizing what proceedure

A

Colposcopy

35
Q

what is the chemical utilized for cryosurgery / how does it work

A

Nitrous Oxide, or Carbon DIoxide

Super-cools a probe; cover lesion until blanching occurs at least 7mm from the pobe’s edge on all sides. This ensures freezing beyond extent of lesion

Appropriate technique for Cryosurgery is Freeze → thaw → freeze

36
Q

What procedure is abriviated by (LEEP)

A

Loop Electrosurgical Excision Procedure

37
Q

how is LEEP conducted

A

-small fine wire loop that excises tissue with assistance of an electrosurgical generator

38
Q

How is the procedure Cold Knife Conization conducted

A

Excision of a cone-shaped section of the cervix with a scalpel. Done under local or general anesthesia

39
Q

What age is Cervical Cancer most prevalent in

A

women over the age of 40

40
Q

what percentage fo women infected with HPV will have persistant infection causing an increase in risk of CIN II , III, and/or Cervical cancer

A

10%

41
Q

estimated new cases of invasive cervical cancer anually

A

12,700

42
Q

Estimated deaths annually of new cases of cervical cancer in US

A

4290 deaths

43
Q

Mortality rate of Cervical cancer in developing countries

A

50%

44
Q

What has provided a 75% decrease in cervical cancer cases

A

Mass Screening programs, Treatment, and prevention

45
Q

what percentage of cases of cervical cancer can be cured if caught in early stages

A

greater than 95%

46
Q

What is a Colposcopy

A

The Colposcope Uses magnification (5-15X) and light, in combination with aqueous acetic acid, and sometimes iodine to allow abnormal cells to be seen more easily

47
Q

Biopsies are obtained utilizing what proceedure

A

Colposcopy

48
Q

what is the chemical utilized for cryosurgery / how does it work

A

Nitrous Oxide, or Carbon DIoxide

Super-cools a probe; cover lesion until blanching occurs at least 7mm from the pobe’s edge on all sides. This ensures freezing beyond extent of lesion

Appropriate technique for Cryosurgery is Freeze → thaw → freeze

49
Q

What procedure is abriviated by (LEEP)

A

Loop Electrosurgical Excision Procedure

50
Q

how is LEEP conducted

A

-small fine wire loop that excises tissue with assistance of an electrosurgical generator

51
Q

How is the procedure Cold Knife Conization conducted

A

Excision of a cone-shaped section of the cervix with a scalpel. Done under local or general anesthesia

52
Q

What age is Cervical Cancer most prevalent in

A

women over the age of 40

53
Q

what percentage fo women infected with HPV will have persistant infection causing an increase in risk of CIN II , III, and/or Cervical cancer

A

10%

54
Q

estimated new cases of invasive cervical cancer anually

A

12,700

55
Q

Estimated deaths annually of new cases of cervical cancer in US

A

4290 deaths

56
Q

Mortality rate of Cervical cancer in developing countries

A

50%

57
Q

What has provided a 75% decrease in cervical cancer cases

A

Mass Screening programs, Treatment, and prevention

58
Q

what percentage of cases of cervical cancer can be cured if caught in early stages

A

greater than 95%

59
Q

Risk factors of Cervical Cancer

A 
Smoking (2-4 x greater) 
Immunosuppression
HiV infections 
Hx of STI's 
High Parity 
Oral Contraceptive Use
60
Q

Symptoms of ______ include: Anemia, abnormal vaginal bleeding, Post-coital bleeding, Blood stained discharge, Pelvic pain (often unilateral), Urine or feces leaking from vagina(indication of a fistula formation)

A

Cervical Cancer

61
Q

How to diagnosis Cervical Cancer

A

Biopsy

Clinical staging by exam, and evaluation of the bladder, ureters, and rectum via imaging

Women's Health (4 decks)

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