Cervix

Question 1

endocervical infection (cervicitis)

Answer 1

• classically asymptomatic and detected by pelvic examination and nucleic acid amplification testing.
• When symptomatic, it presents with a mucopurulent discharge or intermenstrual or post-coital spotting.
• Neisseria gonorrhoeae and Chlamydia trachomatis are the most common pathogens, and untreated infection can ascend to the upper genital tract, resulting in pelvic inflammatory disease (PID).

TX: azithromycin and ceftriaxone provides coverage of both organisms and prevents the progression of infection to the uterus and fallopian tube

+ PID cases can result in tubal factor infertility due to permanent scarring of the fallopian tubes from salpingitis.
- PID also increases the risk for future ectopic pregnancies.

Question 2

Cervical CA

Answer 2

• infection with human papillomavirus strains 16 and 18 predisposes to cervical dysplasia and malignant transformation
• High-grade cervical lesions require excision before they progress to cancer, but these procedures can cause cervical insufficiency and preterm labor.