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Emma Repro > Cervix, Cervix Path > Flashcards

Cervix, Cervix Path Flashcards

1
Q

HPV is necessary or sufficient to cause cervical cancer and dysplasia?

A

necessary

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2
Q

HPV subtypes accounting for cancer

A

16, 18

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3
Q

in addition to cervical cancers, high-risk HPV causes

A
  • oropharyngeal cancer
  • anal cancer
  • vulvar and vaginal cancer
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4
Q

HPV transmission

A

skin-skin contact

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5
Q

HPV risk fx

A

STI risk fx
immunosuppression
smoking
young age

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6
Q

HPV natural history

A
  • vast majority of HPV infections are transient
  • asymptomatic
  • resolve spontaneously
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7
Q

HPV persistent infection

A
  • by same HPV type after 2 years

- leads to invasive cervical cancer through a stepwise sequence of progressive neoplasia

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8
Q

It takes __ years form initial infection to develop invasive cancer

A

10-25

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9
Q

cervical cancer screening guidelines

A

<21 y: none
21-29: pap q3yr
30-65: pap+HPV q 5 yr
>65 y or s/p hyst: no screening (no h/o CIN 2 or >20 in past 20 yr)

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10
Q

colposcopy

A

-magnification and illumination to aid in cervix/vagina/anogenital area

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11
Q

cervical cancer classification

A

CIN 1/2/3

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12
Q

CIN 1 recommendation

A

co-test in 1 year

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13
Q

CIN 2 recommendation

A

ev 6 mo colpo + pap, or treat

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14
Q

CIN 3 recommendation

A

treat

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15
Q

tx of CIN 2/3

A

excisional

  • cold-knife cone biopsy
  • LEEP
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16
Q

cold-knife cone biopsy

A

large area of tissue around cervix is excised for examinatino

17
Q

LEEP

A

uses electrical current to excise the distal cervix including the transformation zone

18
Q

Invasive cervical cancer

A
  • bleeding or brown discharge, often post-coital
  • back pain, weight loss are late manifestations
  • hx of inadequate screening
  • dx established by biopsy
19
Q

Invasive cervical cancer natural hx

A
  • once invasive, no regression
  • spreads by direct extension/growth
  • exophytic, cauliflower-like
  • stage on physical exam
20
Q

Invasive cervical cancer - early stage disease

tx

A

radical hysterectomy

chemoradiation therapy

21
Q

Invasive cervical cancer - advanced stage disease

A

chemoradiation therapy

22
Q

5-yr survival of stage Ia cervical cancer

A

95%

23
Q

HPV vaccine

A

L1 capsid HPV viral protein

reduces risk up to 97% for 7 types of high-risk HPV including HPV 16/18 and 6/11 (genital warts)

24
Q

carcinoma of the cervix usually begins at the junction of the

A

ectocervix and endocervix

25
Q

transition zone

A

between the original squamocolunar junction and the new sqamocolumnar junction

where cervical dysplasia occurs

26
Q

at puberty, cervix enlarges and ______ extends beyond the external os

A

endocervix

27
Q

HPV cytopathic effect

A

nuclear enlargement, hypERchromatism, membrane wrinkling

multinucleation

peri-nuclear cytoplasmic vacuolation (“halo”) –> KOLIOCYTES

28
Q

koliocytes

A

seen in HPV due to E4 disrupting keratin matrix –> peri-nuclear cytoplasmic vacuolation

29
Q

invasive adenocarcinoma histo

A

malignant glands invading stroma

pools of mucin from adenocarcinoma

30
Q

Bethesda system

A

describes pap findings

LSIL (Low grade squamous intraepithelial lesion)

or

HSIL (High grade squamous intraepithelial lesion

31
Q

vulval neoplasia

A

condyloma acuminatum

-due to HPV 6 and 11

32
Q

vulval carcinoma histo

A

keratin pearl

invasive nests of squamous cell carcinoma

33
Q

clear cell adenocarcinoma

A

-assoc w/ DES (diethylstilbestrol) exposure of the patient’s mother during pregnancy

tumors in young (avg 19)

34
Q

clear cell adenocarcinoma histo

A

malignant clear cells with glycogen

35
Q

embryonal rhabdomyosarcoma

A

sarcoma botryoides

a vaginal neoplasm

children, <5 years

small round blue cell tumor with rhabdomyoblasts

36
Q

grape-like tumor

A

embryonal rhabdomyosarcoma

Emma Repro (23 decks)

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