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REPRO II Exam 1 > Cervical Pathology I > Flashcards

Cervical Pathology I Flashcards

1
Q

transformation zone

A

of cervix - susceptible to HPV infection, dysplasias, cancer

puberty and pregnancy - eversion** - exposure of endocervical canal

adult - squamous metaplasia** of exposed endocervical canal - creates the transformation zone

post-menopause - inversion** - transformation zone into the endocervical canal again

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2
Q

eversion

A

puberty and pregnancy

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3
Q

squamous metaplasia

A

adult - forms transformation zone

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4
Q

inversion

A

post-menopause

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5
Q

lugals

A

iodine
-turns healthy tissue brown

cervix exam

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6
Q

colored lights

A

to examine cervix

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7
Q

acetic acid

A

to examine cervix

white HPV infection

acetyl white lesion

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8
Q

transition zone

A

cervix-endocervix

SCJ - squamocolumnar junction

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9
Q

chronic cervicitis

A

changing microbiome

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10
Q

at puberty with flora

A

estrogen > formation of glycogen > lactobacilli > lactic acid and peroxide

loss of acidosis - loss of flora and overgrowth of bacteria - cervicitis

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11
Q

all infections

A

may cause changes in squamous mucosa of cervix which may result in atypia on pap smear

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12
Q

ASCUS

A

atypical squamous cells of uncertain significance

problem for path and clinician

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13
Q

asymptomatic women, PID, ectopic

A

chlamydia

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14
Q

newborn chlamydia

A

conjunctivitis
pneumonia
blindness

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15
Q

NAAT

A

nucleic acid amplification test

dx of chlamydia

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16
Q

chlamydia over time

A

more chronic
-may scar fallopian tube

site of ectopic pregnancy**

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17
Q

chronic follicular cervicitis

A

chlamydia trachomatis infection

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18
Q

herpes on cervix

A

blisters/ulcers

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19
Q

multinucleated cells with intranuclear ground glass viral inclusions

A

herpes

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20
Q

gonococcus

A

neisseria gonorrhoeae

gram negative diplococci

thayer martin

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21
Q

lesion

A

any abnormal finding

shorthand - something of interest

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22
Q

polyp

A

any mass causing elevation on epithelial surface

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23
Q

sessile

A

broad based polyp

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24
Q

pednuculated

A

polyp with stalk

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25
Q

polyp >5cm

A

may be called tumor

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26
Q

thayer martin

A

chocolate agar with antibiotics

grows neisseria gonorrhoeae

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27
Q

tx of endocervical polyp

A

polypectomy

can extrude from endocervical canal

28
Q

endocervical gland full of mucus

A

nabothian cyst

very common - often cause no problems

29
Q

leading cause of cancer death in third world

A

cervical neoplasms

30
Q

high risk HPV

A

16 - 60% of cervical cancers

18 - 10%

31
Q

risk for HPV

A 
young first intercourse
multiple partners
immunosuppression
BCPs
smoking
32
Q

HBV

A

causes hepatocellular carcinoma by inserting into hepatic DNA

33
Q

HPV life cycle

A

can only infect immature squamous cells

can only replicate in maturing squamous cells

34
Q

proteins of HPV

A

E6

E7

35
Q

E6

A

HPV product

binds to p53 and inactivates it

36
Q

E7

A

HPV product

binds to Rb protein

  • prevents binding to E2F
  • free E2F binds promoter genes - like c-myc
37
Q

episome

A

cytoplasmic form of HPV

38
Q

high grade HPV and cancer

A

inserts into DNA - leading to presence of E6 and E7

39
Q

other locations of HPV squamous cancer

A

oropharynx, anus, penis, vulva, vagina

40
Q

p53

A

involved in causing G1 arrest for DNA repair
-G1 to S transition

guardian of genome

LOF p53 - DNA unrepaired

41
Q

hyperP Rb

A

no inhibition of E2F - cancer

42
Q

hypoP Rb

A

inhibition of E2F - no transcription

43
Q

CIN

A

cervical intraepithelial neoplasm

44
Q

CIN I

A

mild dysplasia
low grade squamous intraepithelial lesion (LSIL)

95% go away

minimal nuclear enlargement above lower third

45
Q

CIN II

A

moderate dysplasia
high grade SIL

half way nuclear enlargement

46
Q

CIN III

A

severe dysplasia
high grade SIL

full thickness nuclear enlargement

47
Q

HSIL

A

need excised

for CIN II and CIN III

48
Q

koilocytic atypia

A

hallmark of HPV

low grade and high grade

but if this only - low grade

49
Q

Ki 67

A

marker of cell proliferation

should only be on basal layer of cell

if extends higher - expansion of proliferation zone

50
Q

p16

A

cell cycle regulator
-cyclin kinase inhibitor

high levels - but cell still proliferates - bc p16 target (Rb) is inactivated by E7

51
Q

HSIL to cancer

A

10 years - so takes a long time

52
Q

Tx of cervical dysplasia

A

abnormal pap - follow up coloscopy and cervical biopsy

also removal of dysplastic tissue

53
Q

cervical cancer screening recommendations

A

age 21 to 65

54
Q

cone bx

A

area of tissue around cervix is removed and examined

55
Q

majority of cervical cancers

A

SCC - 80%
15% - adenocarcinoma
5% - adenosquamous carcinoma and small cell

56
Q

peak age of invasive cervical cancer

A

age 45

57
Q

bleeding after sex

A

with cervical cancer

58
Q

T2

A

extends beyond cervix

59
Q

death in cervical cancer

A

invasion of local structures

-obstruction of ureters - renal failure**

60
Q

tx of cervical cancer

A

radical hysterectomy

61
Q

keratin pearl

A

SCC of cervix

62
Q

stage 1

A

confined to cervix

63
Q

pap smear

A

10% false negative rate

average lab - misses one every 2 years

combined with HPV DNA test - 99.5% sensitive

no HPV DNA testing in women <30 - high rate of infection

64
Q

tx with abnormal pap

A

follow up colposcopic exam

  • removal of tissue if high grade
  • watchful expectantly low grade
65
Q

HPV vaccine

A

new vaccine covers 6, 11, 16, 18, 31, 33, 45, 52, 58
-called 9v

now vaccinating males

REPRO II Exam 1 (14 decks)

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