CYTOLOGY

Question 1

Risk factors for cervical dysplasia

Answer 1

Early onset of sexual activity
Multiple sexual partners
Tobacco
Oral contraceptives

Question 2

Age 65 and “adequate recent screening”

Answer 2

3 consecutive normal pap smears
No abnormal pap smears in last 10 years
No history of cervical or uterine cancer

Question 3

When to stop routine screening

Answer 3

Age 65 and “adequate recent screening”
Hysterectomy for benign disease
Hysterectomy for invasive cervical cancer

Question 4

Subdivided into:

Answer 4

Vaginal Portion( Portion vaginalis, Excocervix/Ectocervix

Supravaginal Portion ( Endocervix)

Question 5

Squamous Epithelium

Answer 5

Vagina and outer ectocervix

4 cell layers

Well-glycogenated (pink) unless atrophic

Composed of differentiating non keratinizing stratified squamous epithelium

Full maturation is estrogen dependent

Question 6

Columnar Epithelium

Answer 6

Upper and middle endo-cervical canal 
Single layer of columnar cells arranged in folds
Mucin producing (not true glands)

Question 7

Squamous Metaplasia

Progressive and stimulated by

Answer 7

Central ectocervix and proximal endocervical canal
Replacement of columnar cells by squamous epithelium

Acidic environment with onset of puberty
Estrogen causing eversion of endocervix

Question 8

Zone between original squamo-columnar junction and the “new” squamo-columnar junction

visually identify the transformation zone if present

Answer 8

Transformation Zone

Nabothian cysts

Question 9

Squamo-columnar Junction

Answer 9

Placement determined between 18-20 weeks gestation
Most often found on ectocervix
Can be found in vagina or vaginal fornices
Less apparent over time with maturation of epithelium

Question 10

“New” Squamo-columnar Junction

Answer 10

Border between squamous epithelium and columnar epithelium

Found on ecto-cervix or in endo-cervical canal

Majority of cervical cancers and precursor lesions arise in immature squamous metaplasia, i.e. the leading edge of the squamo-columnar junction

Question 11

At puberty & pregnancy the endocervical cells are pushed out to lie on the ectocervix

Answer 11

Ectropion / Erosion

Question 12

The endocervical cells are transformed into squamous cells through the process of squamous metaplasia

Answer 12

Metaplasia