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Reproduction and sexual health > Cervical, vulval and vaginal pathology > Flashcards

Cervical, vulval and vaginal pathology Flashcards

1
Q

What type of epithelium lines the endocervix

A

simple columnar glandular epithelium

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2
Q

What type of epithelium lines the ectocervix and with which epithelium is it continuous with

A

Non-keratinising stratified squamous epithelium

continuous with vaginal epithelium

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3
Q

What is the squamo-columnar junction

A

where squamous and columnar epithelium meet

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4
Q

What is the transformation zone TZ

A

area between original SCJ and new SCJ

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5
Q

Why does the SCJ change at menarche

A

Metaplasia of columnar glandular epithelium to stratified squamous epithelium due to increase in oestrogen and development of vaginal bacterial flora

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6
Q

Metaplasia of cervical epithelium is a physiological process, true or false

A

TRUE

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7
Q

Nabothian cysts are pathological, true or false

A

FALSE, they are entirely benign

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8
Q

what are inflammatory causes of cervical pathology

A

cervicitis

cervical polyps

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9
Q

What does CIN stand for

A

Cervical Intraepithelial Neoplasia

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10
Q

Is CIN cancer?

A

No, it has not yet broken through the basement membrane

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11
Q

List risk factors for developing CIN/cancer

A

many sexual partners - at higher risk of contracting HPV 16+18
early age of 1st intercourse
long term use of oral contraceptives
not using barrier contraception
smoking
immunosuppression - HIV, chemo
not attending cervical screening programme

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12
Q

What are condyloma acuminatum more commonly known as and what causes them

A

Genital warts

HPV 6+11

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13
Q

What is koilocytosis

A

Halo cells seen in HPV infected cells - CIN

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14
Q

What is identified on cervical smear

A

Dyskaryosis

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15
Q

What is dyskaryosis

A

Abnormal nucleus

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16
Q

CIN is a pre-invasive stage of squamous cervical cancer, true or false

A

TRUE

17
Q

What is seen histologically in CIN

A

delay in differentiation - basal cells occupy more epithelium
nucelar abnormalities
excess mitotic activity
koilocytosis

18
Q

Define CIN I

A

abnormal cells occupy the basal 1/3rd of the cervical epithelium

19
Q

Define CIN II

A

abnormal cells extend to and occupy the middle 1/3rd of cervical epithelium

20
Q

Define CIN III

A

abnormal cells occupy the full thickness of cervical epithelium

21
Q

What is CIN III equivalent to

A

Carcinoma in situ (CIS)

22
Q

Symptoms of invasive squamous carcinoma

A 
asymptomatic - detected at screening 
abnormal bleeding - post coital, post menopausal, blood stained discharge, contact bleeding 
pelvic pain 
haematuria/UTIs
renal failure/ureteric obstruction
23
Q

How can invasive squamous carcinoma spread

A

local
lymphatic
haematogenous

24
Q

glandular lesions are more common than squamous lesions, true or false

A

FALSE, less common

25
Q

Where do glandular lesions originate from

A

endocervical epithelium

26
Q

What is the precursor for endo-cervical adenocarcinoma

A

Cervical Glandular Intraepithelial Neoplasia

CGIN

27
Q

Is CGIN/adenocarcinoma easier/harder to pick up ono cervical smear tests

A

Harder

28
Q

CGIN is usually associated with CIN, true or false

A

TRUE

29
Q

cervical adenocarcinoma has a better prognosis than squamous carcinoma, true or false

A

FALSE

30
Q

Risk factors for cervical adenocarcinoma

A

higher socioeconomic class
later onset of sexual activity
smoking
HPV (18)

31
Q

What are other HPV driven diseases

A

Vulval VIN
Vaginal VaIN
Anal AIN

32
Q

VIN can occur in conjunction with CIN and VaIN, true or false

A

TRUE

33
Q

in which age group is invasive vulvar squamous carcinoma seen

A

elderly women

34
Q

Vulvar invasive squamous carcinoma can arise from normal epithelium or VIN, true or false

A

TRUE

35
Q

what is the management of invasive vulvar squamous carcinoma

A

vulvectomy AND inguinal lymphadenectomy

36
Q

What us vulvar Paget’s disease

A

crusting rash with tumour cells in epidermis

37
Q

What underlying malignancy may be seen in vulvar Paget’s disease

A

tumour of sweat gland in skin

38
Q

What vaginal pathology may be seen

A

VaIN
squamous carcinoma
Melanoma

Reproduction and sexual health (46 decks)

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