Cervical, Vaginal And Vulval Pathologies Flashcards
DD of itch
candidiasis (albicans/non-albicans), trichomoniasis, public lice, scabies, vulval intra-epithelial neoplasia, atrophic vulvovaginitis, dermatitis (atopic ..)
What type of cells are captured on normal ectocervix epithelium by cervical smear?
Exfoliating cells
The ectocervix becomes endocervix at what point?
Transition zone - squamo-columnar junction
What is a physiological change in endocervical tissue that is associated with hormonal changes in puberty?
Squamous metaplasia over endocervical glands, pre puberty it is glandular epithelium however after puberty it changes to metaplastic squamous epithelium
List 2 types of inflammatory cervical pathologies
Cervicitis and cervical polyp
When can cervical polyps cause bleeding?
If ulcerated
How can cervicitis lead to infertility?
Is often asymptomatic so there can be simultaneous silent fallopian tube damage
List 4 causes of cervicitis
Follicular cervicitis,
Chlamydia trachomatis,
Herpes simplex viral infection,
Non-specific acute/chronic inflammation
What is follicular cervicitis?
Sub epithelial reactive lymphoid follicles present in cervix
List 5 risk factors for CIN/cervical cancer
Age of first intercourse, Long term use of oral contraceptives, Not using barrier contraceptives, Smoking increases risk x3, Immunosuppressed people
Human Papillomavirus infections can cause genital warts. What tissue is infected and what does it do to the tissue?
Infects squamous epithelium, causes tissue to form condyloma acuminatum
What are condyloma acuminatum?
Genital warts - thickened papillomatous squamous epithelium with koilocytosis
What is koilocytosis?
Cytoplasmic vacuolation - clear area around nucleus
What types of HPV cause genital warts?
Low risk HPV which are 6 and 11
HPV infection can cause Cervical intraepithelial neoplasia. What types of HPV cause CIN?
High risk HPV - types 16 and 18
How does CIN affect cervical tissue?
Infected epithelium remains flat but shows koilocytosis
Koilocytosis caused by HPV 16/18 can not be detected in cervical smears. True/false?
False - it can be detected
HPV infections can cause cervical cancer, what kind of cancer do they most commonly cause and how?
Invasive squamous carcinoma - virus is integrated into host DNA
What is found in biopsy of cervix with invasive squamous carcinoma?
Keratin band on surface and keratin bundles beneath
What is the timeline for HPV infection to develop into high grade CIN?
6 months to 3 years
What is the timeline for high grade CIN to develop into invasive carcinoma?
5 to 20 years
There is an 80% cumulative prevalence in a lifetime however most develop immunity. What increases risk of disease?
Persistence