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Clin Med II - Exam 5 > Dobbs - Cervical Cancer Screening > Flashcards

Dobbs - Cervical Cancer Screening Flashcards

1
Q

is cervical ca curable

A

yes → 95% of early cases

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2
Q

90% of invasive cervical carcinomas show

A

presence of HPV

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3
Q

lifetime cumulative risk of acquiring HPV in sexually active persons

A

50-80

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4
Q

which types of hpv cause cervical ca

A

16

18

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5
Q

hpv 6 and 11 are associated w.

A

condyloma acuminata

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6
Q

2 high risk factors for cervical neoplasia

A

immunosuppression → HIV, transplant, other

DES exposure

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7
Q

spectrum of hpv (5)

A

condyloma

mild dysplasia → CIN 1

moderate dysplasia → CIN 2

severe dysplasia → CIN 3

cervical ca, carcinoma in situ (CIS)

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8
Q

where columnar endocervical cells transform into squamous epithelial ectocervical cells

A

transformation zone

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9
Q

concerning findings w. transformation zone

A

friable

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10
Q

disordered growth of epithelial lining of cervix

A

CIN (cervical intraepithelial neoplasia)

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11
Q

mild dysplasia, disordered growth of lower ⅓ of epithelial lining

A

CIN 1

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12
Q

moderate dysplasia, abnormal maturation of lower ⅔ of lining

A

CIN 2

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13
Q

severe dysplasia, encompasses more than ⅔ of epithelial thickness

A

CIN 3

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14
Q

full thickness of cervix

A

CIS (carcinoma in situ)

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15
Q

beyond cervix to uterus to pelvic walls/vagina to lymph nodes to bladder/rectum to distant sites

A

cervical ca

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16
Q

cervical ca is very rare in pt’s <

A

40 yo

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17
Q

common sites of metastasis for cervical ca (2)

A

lung

bones

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18
Q

sx of cervical ca (5)

A

post coital bleeding

abnormal bleeding

friable

vaginal d.c (watery, mucoid, purulent, malodorous)

+/- visualized tumor

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19
Q

mc type of cervical ca

A

squamous cell → 80%

20
Q

less common form of cervical ca

A

adenocarcinoma → 20%

21
Q

is a PAP smear a diagnostic test

A

no! → just detects premalignant/malignant cell changes

22
Q

sampling of cervical cells from transformation zone

A

pap smear

23
Q

junction of endocervix and ectocervix

A

transformation zone

24
Q

bethesda classification

A
  1. satisfactory vs unsatisfactory
  2. NILM (negative for intraepithelial lesion or malignancy)
  3. squamous cell
  4. glandular cell
25
Q

examples of “unsatisfactory” finding

A

blood

inflammation

bacteria

lubricant

26
Q

squamous classifications range from __

to __

A

atypical squamous cells (ASC) → squamous cell carcinoma

27
Q

glandular cell classification ranges from __

to __

A

atypical glandular cells → adenocarcinoma

28
Q

cervical ca screening guidelines are based on (2)

A

presence of cervix

no s/s of cervical ca

29
Q

do the cervical screening guidelines take into account sexual hx or hpv vaccination status

A

no!

30
Q

cervical screening guidelines for pt’s under 21 yo

A

no screening

31
Q

consequences of screening adolescents

A

anxiety

cost

overuse of follow-up procedures → additional testing → unnecessary tx

32
Q

tx for CIN1 increases risk for

A

preterm birth

low birthweight

preterm premature rupture of membranes (PPROM)

33
Q

cervical screening guidelines for 21-29 yo

A

pap smear alone q 3 years

OR

primary hrHPV testing starting at 25 every 5 years in average risk pt’s 25-29 yo

34
Q

cervical ca screening guidelines for 30-65 yo

A

any one of:

cytology alone q 3 years

FDA-approved primary hrHPV testing alone q 5 years

cotesting q 5 years

35
Q

what is cotesting

A

hrHPV testing

PLUS

cytology

36
Q

cervical ca screening guidelines for > 65 yo

A

no screening after adequate negative prior screenings in last 10 years

no screening w. hysterectomy w. removal of cervix and no hx of high-grade cervical precancerous lesions or cervical ca

37
Q

repeat HPV testing or cotesting is recommended for pt w. minor screening abnormalities indicating HPV infxn w. low risk of underlying C1N 3 at

A

1 year

38
Q

for pregnant women 25 yo and older, expedited tx is recommended when

A

HPV infx w. low risk of underlying CIN 3+ > 60%

39
Q

__ tx is preferred to

__ tx for histologic HSIL

A

excisional preferred over ablative

40
Q

continued surveillance w. HPV testing or cotesting at __ intervals for

__ years is recommended post-tx of histologic HSIL

A

3

25

41
Q

when is cytology recommended for surveillance of HPV

A

when other testing is not available

42
Q

tx for CIN 2 or CIN 3

A

LEEP (loop electrosurgical excision procedure)

outpatient

43
Q

what tx requires hospitalization

A

cone bx

44
Q

HPV 11

A

condyloma

45
Q

who is gardasil approved for

A

9-45 yo

all girls and boys

46
Q

a 34 yo w. G2P2 presents vaginal d.c, dysuria, dypareunia - what test is not recommended

a. chlamydia
b. gonorrhea
c. pap
d. urine
e. wet prep

A

PAP

Clin Med II - Exam 5 (23 decks)

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