Cervix

Question 1

Why High Risk HPV is High Risk

Answer 1

Because produce E6 (destroys p53) and E7 (destroys Rb)

Question 2

HPV and Inflammation

Answer 2

Acute inflammation usually gets rid of virus, so persistent infection leads to increased risk of dysplasia. Also immunodeficiency is HUGE risk factor (along with smoking)

Question 3

CINs and Cervical Dysplasia

Answer 3

CIN 1, 2, and 3, and Carcinoma in situ based on thickness of epithelium involved (1/3, 2/3, almost full, full) and reversibility (CIN 1 most reversible, CIS not reversible)

Question 4

Cervical Carcinoma (definition, types, presentation, spread/cause of death)

Answer 4

CIS becomes squamos (most common) when invades BM. CIN/CIS does not progress to adeno. BOTH TYPES RELATED TO HPV
Presents with vaginal bleeding, especially postcoital
Often invade locally, especially anterior into bladder blocking ureters and causing hydronephrosis with postrenal failure

Question 5

Pap Smear Limitations

Answer 5

Still do colposcopy/bx after
False neg if don’t get transitional zone
DOES NOT DETECT ADENOCARCINOMA WELL

Question 6

HPV Quadrivalent Vax

Answer 6

Protects against 6, 11, 16, 18, so still need pap smears because of strain limitation