Cervical, vulval and vaginal pathology Flashcards
What type of epithelium lines the endocervix
simple columnar glandular epithelium
What type of epithelium lines the ectocervix and with which epithelium is it continuous with
Non-keratinising stratified squamous epithelium
continuous with vaginal epithelium
What is the squamo-columnar junction
where squamous and columnar epithelium meet
What is the transformation zone TZ
area between original SCJ and new SCJ
Why does the SCJ change at menarche
Metaplasia of columnar glandular epithelium to stratified squamous epithelium due to increase in oestrogen and development of vaginal bacterial flora
Metaplasia of cervical epithelium is a physiological process, true or false
TRUE
Nabothian cysts are pathological, true or false
FALSE, they are entirely benign
what are inflammatory causes of cervical pathology
cervicitis
cervical polyps
What does CIN stand for
Cervical Intraepithelial Neoplasia
Is CIN cancer?
No, it has not yet broken through the basement membrane
List risk factors for developing CIN/cancer
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
What are condyloma acuminatum more commonly known as and what causes them
Genital warts
HPV 6+11
What is koilocytosis
Halo cells seen in HPV infected cells - CIN
What is identified on cervical smear
Dyskaryosis
What is dyskaryosis
Abnormal nucleus
CIN is a pre-invasive stage of squamous cervical cancer, true or false
TRUE
What is seen histologically in CIN
delay in differentiation - basal cells occupy more epithelium
nucelar abnormalities
excess mitotic activity
koilocytosis
Define CIN I
abnormal cells occupy the basal 1/3rd of the cervical epithelium
Define CIN II
abnormal cells extend to and occupy the middle 1/3rd of cervical epithelium
Define CIN III
abnormal cells occupy the full thickness of cervical epithelium
What is CIN III equivalent to
Carcinoma in situ (CIS)
Symptoms of invasive squamous carcinoma
asymptomatic - detected at screening abnormal bleeding - post coital, post menopausal, blood stained discharge, contact bleeding pelvic pain haematuria/UTIs renal failure/ureteric obstruction
How can invasive squamous carcinoma spread
local
lymphatic
haematogenous
glandular lesions are more common than squamous lesions, true or false
FALSE, less common
Where do glandular lesions originate from
endocervical epithelium
What is the precursor for endo-cervical adenocarcinoma
Cervical Glandular Intraepithelial Neoplasia
CGIN
Is CGIN/adenocarcinoma easier/harder to pick up ono cervical smear tests
Harder
CGIN is usually associated with CIN, true or false
TRUE
cervical adenocarcinoma has a better prognosis than squamous carcinoma, true or false
FALSE
Risk factors for cervical adenocarcinoma
higher socioeconomic class
later onset of sexual activity
smoking
HPV (18)
What are other HPV driven diseases
Vulval VIN
Vaginal VaIN
Anal AIN
VIN can occur in conjunction with CIN and VaIN, true or false
TRUE
in which age group is invasive vulvar squamous carcinoma seen
elderly women
Vulvar invasive squamous carcinoma can arise from normal epithelium or VIN, true or false
TRUE
what is the management of invasive vulvar squamous carcinoma
vulvectomy AND inguinal lymphadenectomy
What us vulvar Paget’s disease
crusting rash with tumour cells in epidermis
What underlying malignancy may be seen in vulvar Paget’s disease
tumour of sweat gland in skin
What vaginal pathology may be seen
VaIN
squamous carcinoma
Melanoma
