Cervical pathology

Question 1

Dysplasia and carcinoma in situ

Answer 1

Basal layer of squamo-columnar junction
Extends outward
Classified CIN 1, 2, or 3
Associated with HPV 16 (E6) and HPV 18 (E7)
- E6 blocks  p53
- E7 blocks RB

Question 2

Dysplasia and carcinoma in situ: risk factors

Answer 2

Multiple sexual partners (#1)
Smoking
Early sexual intercourse
HIV infection

Question 3

Invasiave carcinoma

Answer 3

Often SCC
Pap smear can catch cervical dysplasia (koilocytes) before progressing to invasive carcinoma

Lateral invasion can block ureters, causing renal failure.

Question 4

Endometritis: definition

Answer 4

Inflammation of the endometrium associated with retained product of conception following delivery/miscarriage, abortion, foreign body such as IUD.

Retained material promotes infection from vagina/GI

Question 5

Endometritis treatment

Answer 5

Gentamycin + clindamycin with or wihtout amp

Question 6

Endometriosis

Answer 6

Non neoplastic endometrial glands/stroma in abn location

Cyclinc bleeding (menstrual type) resulting in blood filled chocolate cysts.

In ovary or peritoneum

Question 7

Endometriosis: manifestation

Answer 7

Severe menstrual-related pain
Often results in painful intercourse and infertility
(due to retrograde menstrual flow)

Menorrhagia, dysmenorrhea, dyspareunia, infertility;
uterus is normal sized (vs. adenomyosis)

Question 8

Endometriosis: treatment

Answer 8

OCP, NSAIDs, leuprolide, danazol

Question 9

Endometriosis:

adenomyosis

Answer 9

Endometrium within the myometrium
Menorrhagia, dysmenorrhia, pelvic pain, uterus is ENLARGED (vs. endometriosis)

Treatment: hysterectomy