Disorders of the Cervix Flashcards
What is the most likely diagnosis for a women who comes in complaining of purulent discharge from her vagina, dysuria, and postcoital bleeding?
cervicitis
What type of findings on cervix suggest HSV?
diffuse vesicular lesions
What type of findings on cervix suggest trichomonas infection?
punctate hemorrhages (“strawberry spots”)
What is a sign of coexisting PID?
cervical motion tenderness
What antibiotic treatment should be used for gonorrhead and chlamydia?
ceftriaxone 250mg IM and zithromax 1g immediately
What is the antibiotic treatment for a patient who cannot tolerate zithromax for chlamydial infection?
doxy 100mg BID x 7 days
What is the antibiotic treatment for trichimonas?
metronidazole 500mg BID x 7 days
Benign, pedunculated growths of varying size that extend from the ectocervix or endocervical canal
cervical polyps
What is often found concurrently with cervical polyps?
endometrial hyperplasia
What should you do with all polyps once they’ve been removed?
send to pathology
Most common symptom for cervical polyps
postcoital bleeding
What do cervical polyps look like on physical exam?
pear-shaped growths protruding from cervix. usually smooth, soft, reddish purple to cherry red
What is the treatment for cervical polyps?
tie off and twist off at base with forceps
Mucous filled cyst on the surface of the cervix. caused when stratified squamous epithelium of the ectocervix grows over the simple columnar epithelium of the endocervix
Nabothian cysts
Treatment for symptomatic Nabothian cysts
removed by electrocautery or cryotherapy
central to the development of cervical neoplasia and can be detected in 99.7% of cervical cancer
HPV
Most common cell type of cervical cancer
squamous cell (69%)
Percentage of sexually active women who will have aqcuired a genital HPV infection by age 50
80%
How long does it usually take from time of HPV infection to presentation of cervical cancer?
15 years
What HPV subtypes are involved in the majority of cervical cancers?
18 and 16
Between what ages is invasive carcinoma encountered most frequently?
40-50 years
What subtypes of HPV does Gardasil cover?
6, 11, 16, and 18
What is the dosing schedule for Gardasil?
Administered over 6 month period. Second dose 2 months after 1st dose and third dose 6 months after the first dose
