Cervical Dysplasia Flashcards
t or f: squamous cell carcinoma of the cervix is non-existent in women who have had no sexual contact
TRUE
what is the yearly exam done to assess for cervical dysplasia?
papanicolaou smear
approximately what percent of cervical dysplasia is related to HPV?
80%
t or f: all cervical dysplasia will eventually progress to CA
FALSE: some may progress to CA, some may remain the same, some may regress to normal
t or f: there is a genetic component to cervical dysplasia
TRUE - genetic disposition is a risk factor for cervical dysplasia
t or f: young women whose mothers took DES during pregnancy are at increased risk for cervical dysplasia
TRUE
what are the two HPV types that cause a majority of cervical cancer?
16 and 18
what is the name of the border between the squamous lining of the vagina and the columnar cells of the uterus?
squamocolumnar junction (remember this is located on the cervix)
what is the difference between location of the squamocolumnar junction in nulliparous women vs. pregnant women?
in nulliparous the SCJ is typically at the external os; in pregnant women it tends to migrate out and is visible to the naked eye
the area near the ectocervix where columnar cells undergo metaplasia and become squamous cells is referred to as what?
the transformation zone (TZ)
what areas of the cervix must be biopsied to rule out cancer of the cervix?
TZ must be biopsied
t or f: the adolescent cervix is more susceptible to carcinogenic stimuli than the elderly
TRUE
what are the basic guidelines for pap smears?
start at age 21 and done every 3 years; at age 30 done every 5 years (if done with HPV co-testing) otherwise every 3 years
what are two signs on cytologic analysis that points towards cervical dysplasia?
clumping of chromatin and decreased cytoplasm resulting in higher nucleus to cytoplasm ratio
how do neoplastic cells appear under colposcopy when acetic acid is applied?
the acid dehydrates the cell and causes precipitation of nucleic proteins - neoplastic cells appear whiter b/c of higher nucleus/cytoplasm ratio
what is the one circumstance underwhich a colposcopy would be rendered inadequate?
if the transformation zone is not fully visualized
t or f: cervical biopsy is contraindicated in pregnancy
FALSE (endo cervical curretage IS however contraindicated)
what are some contraindications to cervical biopsy?
PID and cervcitis
what is the next step after biopsy results or ECC is positive for CIN II or III?
cone biopsy or LEEP ( loop electrosurgical excision procedure )
from where is the specimen taken for cone biopsy?
cone shaped piece of the endocervical canal is taken
desrcibe the LEEP?
a small wire loop with an electric current is used to excise the TZ and endocervix
what is the one drawback for evaluation of biopsy margins with LEEP? (THINK …)
it can be difficult due to thermal artifact
please describe how to properly dispense the gardasil vaccine.
3 doses of 0.5mL IM at 0 2 and 6 months
against which types of HPV does the gardasil vaccine protect against?
6.11.16.18
