cervical pathology

Question 1

what cells are present in cervical ectropion

Answer 1

more columnar epithelial in transformation zone

Question 2

RF ectropion

Answer 2

elevated oestrogen - ovulating, pregnant, COCP, menstruating women

Question 3

causes postcoital bleeding

Answer 3

ectropion (most common) // cervicitis eg chlamydia // cancer // polyp // trauma

Question 4

mx ectropion

Answer 4

speculum + cautery if problematic

Question 5

which HPV subtypes are carcinogenic

Answer 5

16,18,33

Question 6

which HPV is assoc with warts

Answer 6

6 + 11

Question 7

what effect does HPV have on endocervical cells

Answer 7

develop into koilocytes

Question 8

histology changes seen with HPV

Answer 8

enlarged nucleus // irregular nuclear membrane // stained darkr // perinuclear halo

Question 9

which age group gets HPV tests every 3 years

Answer 9

25-49 (scotland every 5 years)

Question 10

which age group gets HPV screening every 5 years

Answer 10

60-64

Question 11

if pregnant when is cervical screening done

Answer 11

3 monts post partum

Question 12

who is at risk of cervical cancer

Answer 12

sexually active, multiple partners, long term COCP, smoking

Question 13

when is the best time to take a cervical smear

Answer 13

mid cycle

Question 14

which cervical screening tests are cytologically examined

Answer 14

HPV +ive ones

Question 15

if a HPV test is negative what action is taken

Answer 15

return to normal recall (unless previous CIN, CGIN, etc)

Question 16

what abnormal changes can be seen on cytology

Answer 16

borderline changes, low grade dyskaryosis, carcinoma, neoplasm

Question 17

further mx if cervical cytology is abnormal

Answer 17

colposcopy

Question 18

what happens if cervical cytology is normal after +ive smear

Answer 18

repeat in 12 months

Question 19

if the repeat HPV+ive but cytologically normal test is now -ive after 12 months what happens

Answer 19

return to normal call

Question 20

if the repeat HPV+ive but cytologically normal test is still +ive after 12 months what happens

Answer 20

repeat test in 12 months

Question 21

if the 2nd repeat HPV+ive but cytologically normal test is now -ive after 24 months what happens

Answer 21

return to normal recall

Question 22

if the 2nd repeat HPV+ive but cytologically normal test is still +ive after 24 months what happens

Answer 22

colposcopy

Question 23

what happens if smear is inadequate

Answer 23

repeat within 3 months, if 2 consecutive –> colposcopy

Question 24

how is CIN diagnosed (CIS)

Answer 24

cervical smear

Question 25

mx CIN

Answer 25

large loop excision tranzformation zone

Question 26

most common age cervical cancer

Answer 26

25-29 (uo to 45)

Question 27

RF cervical cancer

Answer 27

HPV 16,18,33 // HIV // smoking // early intercourse, multuple partners // lots of kids // COCP // low SE

Question 28

types of cervical cancer

Answer 28

SCC (80%), adenocarcinoma (20%)

Question 29

what staging is used for cervical cancer

Answer 29

FIGO

Question 30

1A and 1B stage

Answer 30

1A - confined to cervix, not vissible and <7mm // 1B - confined to cervix, visible and larger >7mm

Question 31

stage II cervical cancer

Answer 31

II = beyond cervix but not pelvic wall (uterus or upper 2/3 vagina)

Question 32

stage III cervical cancer

Answer 32

beyond cervix and pelvic wall (pelvic wall or lower 1/3 vagina)

Question 33

stage IV cervical cancer

Answer 33

rectum or bladder

Question 34

mx stage CIN and 1A cervical tumour

Answer 34

LLETZ or cone biopsy

Question 35

mx cervical cancer 1B–> 2A

Answer 35

radical hysterectomy + lymph + chemo + radio

Question 36

mx cervical cancer III + IV

Answer 36

chemo + radio (IV maybe palliative)

Question 37

most common chemo agent in cervical cancer

Answer 37

cisplatin

Question 38

complication of cervical cancer surgery

Answer 38

bleeding, infection // cone biospy or trachelectomy –> preterm birth // hysterectomy –> ureteral fistula

Question 39

complications radio

Answer 39

diarrhoea, vaginal bleeding, burns, pee problems // ovarian failure, fibrosis