CIS - HPV Flashcards
Patient comes in with increasing fatigue with increased sleep schedule.
Why is it pertinent to ask her about snoring/sore throat, swelling in legs, or depression
Snoring/sore throats —> sleep apnea
Swelling in legs = CHF
Depression —> sleep is a physical manifestation of depression
Dyspareunia
Pain with sexual intercourse
Why is it important to know that the patient is taking a garlic supplement
Garlic supplements are natural anticoagulants, and since the patient is having vaginal bleeding problems it’s important to know if she is on anticoagulation
Pap smear
- what position is the patient put in
Cells are scraped from the Cervical and examined under a microscope to check for disease
Lithotomy position
Dysplasi
the presence of cells of an abnormal type within a tissue, which may signify a stage preceding the development of cancer
When the pathology report reads high-grade squamous intraepithelial lesion, moderate dysphasia, and CIN II, what two things would you order
HPV reflex
Colposcopy
Colposcopy
Putting vinegar on abnormal cervix to look for abnormal cells
—> will turn white on contact with abnormal squamous cells
What did the severe dyslexia, CIN III/CA in situ show under the microscope
Increased nuclei
HPV characteristics
- size
- envelope yes/no
- type of DNA
Small
Non-enveloped
Circular ds-DNA
HPV types 1, 2, and 4 cause what
Common warts
HPV types 6 and 11 cause what
Condyloma acuminatum
Genital warts, men and women
Types 16 and 18 of HPV cause what
Cervical, penile, rectal, and oropharyngeal cancer
5 risk factors for HPV infection
Sexual activity Cigarette smoking Socioeconomic reasons Immunosuppressive History of STI
Transient infection of HPV
Results in HPV-infected cervix but not precancer or cancer
What two proteins make HPV 16 and 18 high risk
HPV E6
HPV E7
How does HPV E6 cause cancer
Inhibits p53
Increases telomerase expression
How does HPV E7 cause cancer
It inhibits p21, which causes increased CDK4/cyclin D concentration which inhibits RB-E2F complex, allowing E2F to be free and promote cell division
Also directly breaks up the RB-E2F complex
Normal symptoms of cervical cancer
Abnormal vaginal bleeding (post-coital, status post menopause, spotting)
Dyspareunia
Vaginal discharge
Two possible associated symptoms to cervical cancer
Lower back pain
Urinary symptoms
What is the recommended screening for ages 0-20
No screening
What is the screening recommendation for ages 21-29
Cytology (pap smear) every three years
Abnormal Pap tests may be followed up with HPV testing
What is the recommended screening for cervical cancer for ages 30-65
Cytology (pap smear) + HPV testing every 5 years
Or cytology every 3 years
What is the recommended screening for cervical cancer of people over the age of 65
No cervical cancer screening required IF the women has had regular screening in the previous 10 years and no serious precancers in the last 20 years
OR
Continue testing if an abnormality was found in the last 20 years
Gardasil
- how many vaccines
- protection from what
Two HPV vaccines