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Erin Y3 - Reproduction > Cervical Neoplasia > Flashcards

Cervical Neoplasia Flashcards

1
Q

What is CIN?

A

Cervical intraepithelial neoplasia

Preinvasive phase of squamous cell cervical cancer

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2
Q

CIN1 (mild)

A

Basal 1/3 of epithelium occupied by abnormal cells

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3
Q

CIN2 (moderate)

A

Abnormal cells extend to middle 1/3 of epithelium

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4
Q

CIN3 (severe/carcinoma in situ)

A

Abnormal cells occupy full thickness of epithelium

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5
Q

What does kolicytosis indicate?

A

HPV infected epithelium

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6
Q

Time scale for progression from HPV to high grade CIN

A

6mnths-3yrs

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7
Q

Time scale for progression from high grade CIN to invasive cancer

A

5-20yrs

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8
Q

Risk factors for CIN

A 
More sexual partners
Non-use of barrier contraception
Younger age and first intercourse
Persistence of high risk HPV (16, 18)
Smoking
Immunosuppression
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9
Q

Treatment of CINII/III

A

Large loop excision of the transformational zone (LLETZ)

Ablation

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10
Q

Treatment of CINI

A

No treatment

Cervical screening in 12mnths to see if it’s gone away on its own

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11
Q

What is CGIN?

A

Cervical glandular intraepithelial neoplasia

Preinvasive phase of endocervical adenocarcinoma

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12
Q

Risk factors for CGIN

A

Later onset of sexual activity
Smoking
HPV (18)
Higher socioeconomic class

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13
Q

CIN/CGIN is harder to diagnose on smear

A

CGIN

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14
Q

What is the commonest type of cervical cancer?

A

Invasive squamous cell carcinoma

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15
Q

Presentation of cervical cancer

A 
Post-coital bleeding
Intermenstrual bleeding
Post-menopausal bleeding
Brownish or blood stained vaginal discharge
Contact bleeding due to friable epithelium
Pelvic pain
Haematuria/urinary infections
Ureteric obstruction/renal failure
Pelvic mass
Weight loss
Anaemia
Changes in bowel habit
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16
Q

Investigations for cervical cancer

A

Clinical examination
Colposcopy
MRI: particularly T2, better at depicting local disease
CT/PET: assess lymphatic spread

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17
Q

Spread of cervical cancer

A

Spread to adjacent structures via lymphatics: parametrium, upper vagina, pelvic sidewall, bladder, rectum
Pelvic and para-aortic node metastases

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18
Q

Stage 1 cervical cancer

A

Confined to the cervix

19
Q

Stage 1A cervical cancer

A

Microscopic

20
Q

Stage 1A1 cervical cancer

A

Depth up to 3mm, width up to 7mm

21
Q

Stage 1A2 cervical cancer

A

Depth up to 5mm, width up to 7mm

22
Q

Stage 1B cervical cancer

A

Visible lesion (or >1A2)

23
Q

Stage 2 cervical cancer

A

Spread to adjacent organs

24
Q

Stage 2A cervical cancer

A

Spread to upper 2/3 of the vagina

25
Stage 2B cervical cancer
Spread to upper 2/3 of the vagina + parametrial involvement
26
Stage 3 cervical cancer
Involvement of the pelvic wall
27
Stage 3A cervical cancer
Lower third of vagina
28
Stage 3B cervical cancer
Pelvic sidewall and/or hydronephrosis
29
Stage 4 cervical cancer
Distant metastases or involvement of rectum or bladder
30
Stage 4A cervical cancer
Bladder, rectum
31
Stage 4B cervical cancer
Beyond pelvis
32
Treatment for stage 1A cervical cancer
LLETZ or cone biopsy
33
Treatment for stage 1A2 cervical cancer
- Simple hysterectomy + pelvic lymphadenectomy | +ve nodes = + adjuvant radiotherapy
34
Treatment for stage 1B cervical cancer
Radical hysterectomy + pelvic lymphadenectomy or Chemotherapy (cisplatin, caroboplatin/paclitaxol) and radiotherapy
35
Treatment for stage 2-4 cervical cancer
Chemotherapy
36
Treatment for cervical cancer recurrence
Most are suitable for palliative care only
37
When are patients invited for cervical screening?
Women aged 25-49 invited every 3 years | Women aged 50-64 invited every 5 years
38
Patients with __ are screened annually
HIV | other certain groups of immunocompromised patients may have additional screening
39
Negative smear recall time and colposcopy referral
5yrs regardless of age | No colposcopy
40
HPV positive and negative cytology smear recall time and colposcopy referral
1yr | Colposcopy: only if 3 consecutive samples are virology positive
41
HPV positive and positive cytology (low grade, borderline) smear recall time and colposcopy referral
Colposcopy within 8wks
42
HPV positive and positive cytology (high grade) smear recall time and colposcopy referral
Colposcopy within 4wks
43
HPV positive and glandular abnormality smear recall time and colposcopy referral
Colposcopy within 2wks
44
Smear with suspicion of invasion recall time and colposcopy referral
Colposcopy immediately/within 2wks

Erin Y3 - Reproduction (9 decks)

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