Gynae - Cervical Flashcards
what are nabothian cysts?
fluid filled cysts on the cervix
what causes nabothian cysts?
columnar epithelium of the endocervix produces mucus
ectocervix can slightly cover and trap mucus
risk factors for nabothian cysts?
childbirth
trauma
infection
what causes a cervical ectropion?
columnar epithelium of the endocervix extends to the ectoverix
features of cervical ectropion?
post coital bleeding
dysparunia
increased discharge
risk factors for cervical ectropion?
young
COCP use
pregnancy
what is the TZ?
columnar -> stratified squamous
Tx for cervical ectropion?
nothing
if bleeding -> cautery with silver nitrate/cold coag
Tx for cervical ectropian?
nothing
if bleeding -> cautery with silver nitrate/cold coag
features of cervical cancer?
bleeding (post coital/post menopausal)
pain
haematuria
what is metaplasia?
change of one fully differentiated cell type to another
what is CIN?
pre invasive cancer of the TZ (not yet invaded basement membrane)
what does CIN turn to if left?
squamous cancer
what is CGIN? what does it turn into?
pre invasive cancer affecting glandular endo cervix (columnar)
adenocarcinoma
Ix for cervical cancer?
smear test
colposcopy + biopsy
PET/MRI/CT
what are the 3 levels of CIN and how are they Tx?
1 - basal 1/3rd abnormal (repeat smear in 1yr)
2 - abnormal to middle 1/3rd (ablate/LLETZ)
3 - full thickness (ablate/LLETZ)
staging of cervical cancer?
1 - confined
2 - spread to organs
3 - involving pelvic wall
3 - distant mets, rectum or bladder
Tx for cervical cancer?
LLETZ/cone biopsy
hysterectomy + lymphadenectomy
+ radio if positive nodes
if past cervix + chemo
what is the cervical cancer screening pathway?
HPV test
negative -> 5yrs
positive -> cytology
if negative, repeat in 1yr
if dykariosis, colposcopy
who gets cervical screening?
25-64yrs
how long do pregnant women wait until screening?
12 wks
who gets HPV vaccine?
11-13yrs M+F
how long does HPV infection take to turn into cancer?
5-20yrs
