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Clin Med- Repro > Cervical Disorders Lecture > Flashcards

Cervical Disorders Lecture Flashcards

1
Q

nulliparous cervix

A

before vaginal delivery

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2
Q

multiparous cevix

A

after vaginal delivery

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3
Q

where the inner lining meets the exterior surface of the cervix

A

squamocolumnar junction

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4
Q

where does cervical cancer occur?

A

squamocolumnar junction (this is where you want to get your pap smear sample!)

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5
Q

What happens to the squamouscolumnar junction (SCJ) as a woman ages

A

it becomes closer to center/smaller

normal for younger women to have a reddish, ulcer looking area on cervix..this will get smaller with age

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6
Q

the transformation zone is where what changes occur?

A

premalignant and neoplastic

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7
Q

cervical dysplasia is…

A

precursor to cervical cancer

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8
Q

Yellowish translucent raised pearl-like lesions on ectocervix
1 mm to 3 cm
Few or multiple
Benign

A

Nabothian cysts

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9
Q
  • Small, pedunculated neoplasms
  • Originate from endocervix
  • Common
  • Especially in multigravidas over age 20
  • *Mostly benign

Can be easily removed if desired

A

Cervical polyps

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10
Q

**Asymptomatic or intermenstrual or postcoital bleeding/spotting

PE: red friable growth protruding from os
*Range of size: 2 mm to 3 cm

Remove by grasping w/ ring forceps then twist

A

Cervical polyps

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11
Q 
**Purulent vaginal discharge
Sometimes postcoital bleeding
May have urethritis symptoms as well
Variety of pathogens (usually infectious)
Gonorrhea
Chlamydia
Candida
Bacterial vaginosis
Trichomonas (“strawberry cervix” in 2% of cases)
Risk of PID if not treated
A

Acute cervicitis

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12
Q

Leukorrhea main symptom, noninfectious
Sometimes causes vulvar irritation
Postcoital or intermenstrual bleeding

Other symptoms:
Dysmenorrhea
Dyspareunia
Low abdominal pain
Low back pain
Urinary symptoms
A

Chronic cervicitis

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13
Q

Narrowing of the endocervical canal, usually at level of internal os

A

Cervical stenosis

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14
Q 
Causes:
Congenital
Hypoestrogenic state
Neoplastic
Post-surgical (eg, s/p LEEP)
  • Partial to full occlusion of the os
  • Obstruction of menstrual flow (can lead to amenorrhea)
A

Cervical stenosis

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15
Q

_____ is detected in 99.7% of cervical cancer cases

A

HPV

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16
Q

Most common histologic type of cervical cancers

A

squamous cell (69%)

adenocarcinoma is second

17
Q

african americans and hispanics have a higher risk of..

A

cervical cancer

18
Q

3rd most common GYN cancer diagnosis and death among GYN cancers

A

cervical cancer

19
Q 
Early onset sexual activity
Multiple sex partners
High risk sex partners
History of STIs
History of vulvar or vaginal squamous intraepithelial neoplasia or cancer
Immunosuppression
Smoking
A

Risk factors of Cervical CA

20
Q

Clinical manifestations:
early cervical CA frequently asymptomatic
irregular or heavy vaginal bleeding
postcoital bleeding

A

cervical cancer

21
Q

Cervical cancer usually originates at _______ _______ (@ SJC or junction between squamous epithelium of ectocervix and glandular epithelium of endocervical canal)

A

transformation zone

22
Q

radical hysterectomy
fertility-sparing surgery
radiation ± chemotherapy

A

Treatment for early stage cervical cancer

23
Q

Principal method for cervical cancer screening

A

Cervical cytology

24
Q

biggest HPV types we look at?

responsible for 70% of cervical cancer

A

16 and 18

25
Q

Which HPV is associated with higher rates of squamous cancers?

A

HPV 16

26
Q

Which HPV is associated with higher rates of adenocarcinoma (not as well screened for by Pap)

A

HPV 18

27
Q

Pap smears for ages 21-29 every….

A

3 years

28
Q

Age 30-35, Pap + HPV “co test” every….

A

5 years

29
Q

Start pap smears at age…

A

21 (continue until age 65)

30
Q

women 21-24 with abnormal pap…

A

can just repeat in 1 year

31
Q

Diagnostic procedure used to follow up some abnormal Pap results
Magnifies cervix
Staining to identify areas to be biopsied (acetic acid, iodine)

A

Colposcopy

32
Q

When you apply acetic acid, pre cancer changes appear

A

white

33
Q

treatment for highly abnormal cervical dysplasia

A

LEEP prodcedure

34
Q

21 yo pt with LSIL (low grade changes), what should you do…

A

recheck in a year..wait and watch
(low grade and young)

STILL VACCINATE!

Clin Med- Repro (11 decks)

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