cervix Flashcards
viral gene causing inactivation of the p53
E6
releases E2F from pRb driving cells into the cycle
E7
modifiers of HPV to progress to cervical CA
std, hiv, smoking, immunosuppression
latency incubation to cancer
15 years
associated with the development of squamous cell carcinoma of the cervix but not adenocarcinoma
smoking
bivalent cervarix
hpv 16, 18
quadrivalent gardasil
hpv 16, 18, 6, 11
nanovalent gardasil-9
hpv (16, 18, 6, 11) & 31, 33, 45, 52, 58
T or F
HPV vaccines do not work on existing infection or associated preinvasive or invasive disease, and it is therefore most effective if given prior to sexual debut and exposure to HPV.
true
HPV vaccine be given to both boys and girls at what age
age 11-12 (as early as 9 y/o)
Catch-up vaccination should be offered for females
13 to 26 years who have not been previously vaccinated
Pap smear: site where sample is taken
transformation zone
area where the squamous epithelium of the ectocervix meets the columnar epithelium of the endocervix
squamocolumnar junction
site where premalignant and malignant lesions develop
transformation zone
area involving old and new squamocolumnar junction
transformation zone
pap testing every 3 years
21-29
hpv co-testing with pap every 5 yrs or pap testing every 3 years
30-65
who have had three consecutive negative Pap tests or two consecutive negative HPV tests, provided they have had no history of high-grade dysplasia (CIN2/3) or cancer (CIN2+) in the past 20 years.
> 65 y/o screening not recommended
not had previous screening
should undergo Pap and HPV testing.
> 65 y/o
not recommended
for women who have had a hysterectomy with removal of the cervix and who do not have a history of CIN2+
HPV testing and Pap test not recommended
most common squamous abnormality
atypical squamous cells (ASC) of undetermined significance (ASC-US)
repeat cytology at 12 months or re ex HPV testing. If HPV testing is positive, colposcopy is performed.
If HPV testing is negative, return to routine screening
ASC-US
prebasal cell
no hormonal predominance / menopause
intermediate cell
inc progesterone
superficial cell
inc estrogen
koilocyte
binucleate with large, hyperchromatic nuclei with granular and clumped chromatin. irreg halo with sharp margin
