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Repro HK > Conditions of cervix, vulva and vagina > Flashcards

Conditions of cervix, vulva and vagina Flashcards

1
Q

epithelium of endocervix

A

columnar mucosal

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2
Q

epithelium of ectocervix

A

squamous

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3
Q

name of the area between ecto and endocervix

A

transition zone

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4
Q

what alter position of transition zone

A

menarche
pregnancy
menopause

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5
Q

what is the transition zone predisposed to

A

malignant change

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6
Q

what is cervical erosion

A

exposure of endocervical mucosal cells to acid environment of vagina causing squamous metaplasia

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7
Q

what are nabothian cysts

A

mucous retention cysts found on cervix - benign and physiological

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8
Q

infection of cervix

A

cervicitis

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9
Q

organisms causing cervicitis

A

chlamydia
herpes
gonococci

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10
Q

pathology of cervicitis

A

sub-epithelial reactive lymphoid follicles present in cervix

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11
Q

what can cervicitis lead to

A

fallopian tube damage

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12
Q

how does cervicitis usually present

A

usually asymptomatic may have discharge

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13
Q

what are cervical polyps

A

localised inflammatory outgrowth - may be ulcerated

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14
Q

cervical polyps are pre-malignant/benign

A

benign

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15
Q

presentation of cervical polyps

A

post-coital bleeding

discharge

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16
Q

management of cervical polyps

A

pre-menopause - nothing

post-menopause - TVS and hysteroscopy to exclude uterine polyps

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17
Q

what is the pre-invasive phase of cervical cancer

A

cervical intraepithelial neoplasia

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18
Q

what are the 2 high risk viruses associated with cervical disease

A

HPV 16 and 18

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19
Q

risk factors for CIN

A

many sexual partners (increased HPV exposure)
vulnerability of SC junction in early reproductive life
long term use of oral contraceptives
non-use of barrier methods
smoking
immunosuppression

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20
Q

what histological change is present in CIN

A

koilocytosis - presence of koilocytes (abnormal squamous cells)
immature basal cells
nuclear abnormalities
excess mitotic activity

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21
Q

how can koilocytes be detected

A

smear

22
Q

where does CIN occur

A

transition zone

23
Q

CNI histology

A

basal 1/3 of epithelium occupied by abnormal cells

24
Q

CNII histology

A

abnormal cells extend to middle 1/3

25
Q

CNIII histology

A

abnormal cells occupy full thickness of epithelium

26
Q

most common cervical cancer

A

squamous

27
Q

age group affected by squamous cervical cancer

A

younger women

28
Q

what does squamous carcinoma develop from

A

CIN (most cases are preventable by screening )

29
Q

stage 1A1

A

depth <3mm, width <7mm

30
Q

stage 1A2

A

depth <5mm, width <7mm

31
Q

stage 1B

A

confined to cefvix

32
Q

stage 2

A

spread to adjacent organs (vagina, uterus etc)

33
Q

stage 3

A

involvement with pelvic wall

34
Q

stage 4

A

distant metastases/bladder/bowel involvement

35
Q

presentation of cervical cancer

A 
none at early stages 
abnormal bleeding (post coital, post menopausal) 
brown/blood stained mucosal discharge 
contact bleeding 
pelvic pain 
haematuria
UTI
36
Q

what lymph nodes do cervical cancers spread to

A

pelvic

para-aortic

37
Q

lymph node spread is early/late

A

early

38
Q

haematogenous spread is early/late

A

late

39
Q

distant sites of metastasis

A

liver
lungs
bone

40
Q

pre-invasive form of endocervical adenocarcinoma

A

cervical glandular intraepithelial neoplasia

41
Q

what has worse prognosis, squamous or adenocarcinoma of cervix

A

adenocarcinoma

42
Q

what are other HPV associated neoplastic diseases

A

vulvar intraepithelial neoplasia (VIN)
vaginal intraepithelial neoplasia (VaIN)
anal intraepithelial neoplasia (AIN)

43
Q

VIN has greater risk of progression in younger/older women

A

older

44
Q

who gets vulvar invasive squamous carcinoma

A

elderly women

45
Q

how does vulvar carcinoma present

A

ulcer

exophytic mass

46
Q

where does vulvar carcinoma spread to

A

inguinal lymph nodes

47
Q

treatment for vulval cancer

A

radical vulvectomy

inguinal lymphadenectomy

48
Q

crusting vulvar rash

A

vulvar paget’s disease

49
Q

what is pagets disease of vulva

A

tumour cells in epidermis (containing mucin)

tumour arising from sweat gland in skin

50
Q

who gets vaginal cancer

A

elderly

Repro HK (37 decks)

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