Cervix Flashcards
what is the cervix
neck of uterus
what is the cervix divided into
exocervix and endocervix
epithelium of exocervix
nonkeratinizing squamous epithelium
epithelium of endocervix
single layer of columnar cells
what is the junction between exocervix and endocervix called
transformation zone
What is HPV, what’s its most popular target
sexually transmitted DNA virus
- cervix in the transformation zone
persistent infection of HPV leads to increase risk of what
cervical dysplasia ( cervical intraepithelial neoplasia ) CIN
What are high risk HPV types
16, 18, 31, 33
What are low risk HPV types
6, 11
high risk HPV produces what proteins which destroy what
E6 - destroys p 53
E7 - destroys Rb
histo for cervical intraepithelial neoplasia
koilocytic change
disordered cellular maturation
nuclear atypia
increased mitotic activity within endothelial
What are the different grades of cervical intraepithelial neoplasia, CIN
CIN I: less than 1/3 thickness of epithelium
CIN II: less than 2/3 thickness of epithelium
CIN III: slightly less than entire thickness
Carcinoma in situ: entire thickness
how does CIN progress
CIN 1 –> carcinoma in situ –> invasive squamous cell carcinoma
what is cervical carcinoma
invasive carcinoma arises from cervical epithelium
who usually gets cervical carcinoma
middle-aged women
clinical presentation for cervical carcinoma
vaginal bleeding: especially postcoital bleeding
cervical discharge
what is a key risk factor for cervical carcinoma
high-risk HPV infection
what are the most common subtypes of cervical carcinoma
squamous cell carcinoma
adenocarcinoma
how can cervical carcinoma impact other organs
- invade through anterior uterine wall into bladder
- block ureters
- hydronephrosis with postrenal failure
what is a common cause of death for cervical carcinoma
postrenal failure
what is gold standard for screening
pap smear
when does pap smear screening begin
21 years
performed every 3 years
process of pap smear
- cells are scraped from transformation zone using brush and analyzed under microscope
under microscope what is high-grade dysplasia characterized as
cells with hyperchromatic (dark) nuclei
high nuclear to cytoplasmic ratios
What happens when a patient comes back with an abnormal pap smear, what do you do next
confirmatory colposcopy and biopsy
what are limitations of pap smear
- inadequate sampling of transformation zone ( false negative)
- limited efficacy in screening for adenocarcinoma
HPV vaccines cover what strains
6,11,16,18
antibodies generated by HPV vaccine protect against what depending on the strain
6,11: condylomas
16,18: CIN and carcinoma
