Cervical Screening

Question 1

Human Papillomavirus

Answer 1

DNA tumor virus, associated with cervical disease, over 100 virus types with various manifestations, most common STD in U.S.

Question 2

Uterine Cervix

Answer 2

meets at the squamo-columnar junction of squamous epithelium and columnar epithelium

Question 3

Squamous metaplasia

Answer 3

process of chance from columnar to squamous cells

Question 4

transformation zone

Answer 4

area between old and new squamo-columnar junction, area of rapid cell division, HPV causes cervical cancer here

Question 5

Pap test

Answer 5

invented in 1940s, cytological study for detecting cancer, worldwide, can detect 95% of all cervical cancers and precancer, dramatically reduces cervical cancer death rates

Question 6

Pap test technique

Answer 6

take sample from squamo-columnar junction, perform prior to digital vaginal examination, perform prior to endocervical sampling, moisten speculum, remove excess discharge with cotton tip, 1 or 2 glass slides, begin with exocervix then endocervix

Question 7

cervical cancer screening

Answer 7

begin at age 21, every 3 years for 21-29 yr old, every 5 years for 30-65 yr old

Question 8

when to do pap test

Answer 8

mid cycle, avoid intercourse, vaginal meds, and douching for 24-48 hours prior to test

Question 9

Follow up for abnormal cervical cytology

Answer 9

reflex HPV DNA testing, colposcopy, endocervical sampling

Question 10

management for abnormal cervical cytology

Answer 10

cryosurgery, laser ablation, conization (cold knife, laser, LEEP)

Question 11

Genital HPV

Answer 11

around 40 strains infect genital tract, types 16 and 18 cause 70% of all cervical cancers

Question 12

High risk HPV

Answer 12

produces no symptoms, detected by DNA testing, primary cause of cervical neoplasia, persistant infection associated with cervical cancer

Question 13

HPV DNA testing

Answer 13

performed on vaginal/cervical cell sample, assesses for 1 or more potentially cancer causing HPV types, recommended for women over 30, ThinPrep Pap or BD SurePath Pap

Question 14

HPV infection manifestations

Answer 14

abnormal pap results, external genital warts, cervical lesions

Question 15

HPV risk factors

Answer 15

smoking, more than 3 partners, new sex partner, drug use, intercourse while drunk

Question 16

Teaching to reduce risk

Answer 16

diet, avoid chemical/environmental hazards, sex health awareness, HPV vaccine

Question 17

Gardasil

Answer 17

HPV vaccine for females and males 9-26

Question 18

Cervarix

Answer 18

HPV vaccine for females age 10-25

Question 19

Treatment of external cervical warts

Answer 19

goal is to destroy visible lesion and reduce symptoms, provider-administered meds, surgical

Question 20

Cervical cancer

Answer 20

80-90% are squamous cell carcinoma, can be adenocarcinoma, typically slow growing and begin as dysplasia

Question 21

Dysplasia

Answer 21

pre cancerous condition detected by pap test that is 100% curable

Question 22

Cervical cancer risk factors

Answer 22

HPV, immunosuppression, smoking, alcohol, poor nutrition, STDs, early pregnancy, multiple partners, inadequate cervical screening, family hx

Question 23

Cervical cancer symptoms

Answer 23

continuous discharge, bleeding, heavier longer periods, loss of weight and appetite, fatigue, pelvic pain, back pain, leg pain

Question 24

Cervical cancer treatment

Answer 24

dependent upon stage, may include surgery, radiation, chemo, biological therapy

Question 25

Cervical cancer surgery

Answer 25

with invasive disease, combined with radiation, options range from conization to radical hysterectomy

Question 26

Cervical cancer radiation

Answer 26

external therapy, internal therapy (brachytherapy), or combined

Question 27

External beam radiation

Answer 27

targets entire pelvis, generally administered 5x/wk for 5-6 wks

Question 28

Internal Implant radiation

Answer 28

placement of radioactive material as close to tumor as possible, performed in hospital (1-3 day stay), pt is radioactive, causes sterility

Question 29

Chemo

Answer 29

used for metastatic or recurrent cancer, oral or IV, may be combined, side effects include N/V, oral lesions, change in appetite, vag sores, hair loss, fatigue, anemia, infertility, pain

Question 30

biological therapy

Answer 30

intended to repair, stimulate, or enhance immune system responses, interferon is most common drug therapy, outpatient basis, side effects- flu like symptoms, rash, anorexia, bruising