Disorders Of The Cervix

Question 1

What are nabothian follicles?

Answer 1

Small, mucus-filled cysts on the ectocervix, actually columnar glands in the transformation zone that got sealed over

Question 2

What symptoms can nabotjian follicles cause?

Answer 2

Pelvic pain, heavy feeling, irregular menses

Question 3

Causes of cervical ectropion

Answer 3

Puberty, pregnancy, pill

Question 4

Symptoms of cervical ectropion

Answer 4

IMB, PCB

Question 5

When to follow up for cervicitis?

Answer 5

On day 7 with speculum. No need routine follow-up unless STI identified/symptoms of PID. if PID, assess antibiotic response after 7 days

Question 6

What is the schedule for the National Cervical Screening Program in Aussie?

Answer 6

5 yearly HPV test for those aged 25-75

First cervical screening test is at 26/2 years after last Pap test

Question 7

What to do if HPV detected?

Answer 7

Immediate Reflex LBC.
If not 16/18:
- unsatisfactory: retest in 6-12 weeks
- negative/pLSIL/LSIL: repeat HPV test in 12 months and if HPV undetected go back to routine. if HPV detected (any type) do reflex LBC and refer for colposcopy.
If 16/18: ANY LBC result/unsatisfactory must refer for colposcopy

Question 8

How is the HPV Vaccine given in Aussie?

Answer 8

First dose at 15 or under

Second dose at any age, but recommended interval is at least 612 months.

Question 9

What kind of vaccine is the HPV vaccine and what does it protect against?

Answer 9

9 Valent

6,11,16,18,31,33,45,52,58

Question 10

What are the investigations for suspected cervical cancer

Answer 10

Bedside: Pap smear, LBC, HPV, urinalysis and culture
Colposcopy and biopsy: note location of SCJ, TZ, abnormal BV, ace to white areas
Cone biopsy
CT scan for FIGO staging

Question 11

How to manage cervical ectropion

Answer 11

• change from estrogen-based contraceptive
• can do cervical dilation and cautery
• take cervical and vaginal swab TRO STI and cancer