Cervix Flashcards

1
Q

what is a cervical ectropion

A

physiological (normal) erosion of cervical erosion

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2
Q

what is the most common cancer in women <35

A

cervical cancer

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3
Q

how often do you get cervical smears aged 25-49

A

every 3 years

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4
Q

how often do you get cervical smears aged 50-65

A

every 5 years

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5
Q

where do you take sample cells from in cervical screening

A

transitional zone of cervix

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6
Q

which types of HPV causes genital warts

is it high or low risk

A

HPV 6 and 11

low risk

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7
Q

which types of HPV cause cervical cancer/CIN

is it high or low risk

A

HPV 16 and 18

high risk

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8
Q

why is screening still essential in those who have had HPV immunization

A

HPV immunization only protects against 70% of cervical cancers (HPV 16 and 18)

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9
Q

why does increased sexual activity increase risk of cervical cancer

A

NOT an STI

more likely to get changes in the transitional zone

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10
Q

risk factors for cervical cancer

A

smoking

increased sexual activity

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11
Q

does being infected by HPV 16/18 mean you will get cervical cancer

A

no, just increases your risk

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12
Q

what happens to tumour suppressor genes once you are infected with HPV 16/18

A

tumour suppressor genes are inhibited = allows tumour to grow

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13
Q

what does ANY HPV infection present with on cytology

A

koilocytosis - ie cant tell the difference between cervical cancer or genital wart

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14
Q

what happens to the squmocolumnar junction over time, what does this create

A

squamocolumnar junction moves over time

the zone between the old squamocolumnar junction and the new squamocolumnar junction = TRANSITION ZONE

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15
Q

clinical significance of the transition zone

A

susceptible to HPV infection

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16
Q

abnormally big nuclei
pleomorphism
viral inclusion bodies (in clusters)

A

koilocytosis

17
Q

what is CIN

A

cervical intraepithelial neoplasia

intraepithelial = squamous cell carcinoma in situ

18
Q

how much epithelium is involved in;

CIN 1
CIN 2
CIN 3

A

CIN 1 - bottom 1/3 of epithelium
CIN 2 - bottom 2/3 of epithelium
CIN 3 - full epithelial thickness

19
Q

does CIN 3 always cause cancer

A

no

but all cervical cancer comes from CIN 3

20
Q

if CIN1/2/3 doesn’t progress to cervical cancer, what happens

A

clear the virus and epithelium will go back to normal

21
Q

difference between CIN 3 and squamous cell carcinoma of cervix

A

squamous cell carcinoma = cells have broken through basement membrane

22
Q

how do you measure grading of tumour

A

differentiation - well, moderately, poorly

23
Q

well differentiated definition

A

looks similar to original epithelium

24
Q

poorly differentiated definition

A

looks nothing like original epithelium

25
Q

what is CGIN

A

cervical glandular intraepithelial neoplasia

26
Q

what is CGIN the precursor for

A

adenocarcinoma (glandular)

27
Q

which HPV causes adenocarcinoma/CGIN

A

HPV 18

28
Q

how does CIN/CGIN present

A

asymptomatic

29
Q

how does cervical cancer (adenocarcinoma or squamous cell carcinoma)

A

unusual vaginal discharge
irregular bleeding
dyspareunia - painful sex
pelvic pain

30
Q

diagnostic investigation for positive smear test or ?cervical cancer symptoms

A

biopsy!!!

31
Q

what does cytology after smear test tell you

A

if koilocytosis or not

if koilocytosis - you need to do biopsy to find out the exact cause eg CGIN, CIN1/2/3, cancer

32
Q

after diagnosis of cervical cancer from biopsy, what investigations do you want to do

A

PET CT for distant mets (staging)

MRI for local spread

33
Q

management of CIN 1

A

nothing
see back in 2 years
safety net about symptoms

34
Q

management of CIN 2/3/CGIN

A

loop excision (LLETZ)

35
Q

management of cervical cancer (squamous cell or adenocarcinoma) (3)

A

cervical excision/hysterectomy
loop excision (LLETTZ)
chemo - cisplatin

36
Q

squamous cell carcinoma of cervix precursor

A

CIN

37
Q

adenocarcinoma of cervix precursor

A

CGIN