Disorders of the Cervix

Question 1

Nabothian Cysts

Answer 1

Mucous filled cyst on the surface of the cervix
Most often caused when stratified squamous epithelium of the ectocervix grows over the simple columnar epithelium of the endocervixAppear as firm bumps on the surface
Considered harmless and usually resolve on their own

Question 2

Major factors associated w/ development of High Grade Lesions and cervical Cancer are:

Answer 2

HPV subtype: 18 & 16 (involved in the bulk of cervical CAs
Persistence: age, duration, oncogenic subtypes
Environmental factors: cigarette smoking, infection w/ HIV, gonorrhea & chlamydia, herpes simplex virus 2, OCP

Question 3

Cervical Intraepithelial Neoplasia

Answer 3

CIN 1—low grade lesion: mild atypia, 1/3
CIN 2—high grade lesion: moderate atypia, 2/3
CIN 3—high grade lesion: severe atypia, >2/3

Question 4

Definition of an “Satisfactory” Pap

Answer 4

Proper amount of squamous cells
Proper labeling
Endocervical cells present!!!

Question 5

Pap Smear NOT Satisfactory if:

Answer 5

Scant cellularity
Not properly labeled
Cells obscured by blood or inflammation