Gynae - Cervical

Question 1

what are nabothian cysts?

Answer 1

fluid filled cysts on the cervix

Question 2

what causes nabothian cysts?

Answer 2

columnar epithelium of the endocervix produces mucus

ectocervix can slightly cover and trap mucus

Question 3

risk factors for nabothian cysts?

Answer 3

childbirth
trauma
infection

Question 4

what causes a cervical ectropion?

Answer 4

columnar epithelium of the endocervix extends to the ectoverix

Question 5

features of cervical ectropion?

Answer 5

post coital bleeding
dysparunia
increased discharge

Question 6

risk factors for cervical ectropion?

Answer 6

young
COCP use
pregnancy

Question 7

what is the TZ?

Answer 7

columnar -> stratified squamous

Question 8

Tx for cervical ectropion?

Answer 8

nothing

if bleeding -> cautery with silver nitrate/cold coag

Question 9

Tx for cervical ectropian?

Answer 9

nothing

if bleeding -> cautery with silver nitrate/cold coag

Question 10

features of cervical cancer?

Answer 10

bleeding (post coital/post menopausal)
pain
haematuria

Question 11

what is metaplasia?

Answer 11

change of one fully differentiated cell type to another

Question 12

what is CIN?

Answer 12

pre invasive cancer of the TZ (not yet invaded basement membrane)

Question 13

what does CIN turn to if left?

Answer 13

squamous cancer

Question 14

what is CGIN? what does it turn into?

Answer 14

pre invasive cancer affecting glandular endo cervix (columnar)

adenocarcinoma

Question 15

Ix for cervical cancer?

Answer 15

smear test
colposcopy + biopsy
PET/MRI/CT

Question 16

what are the 3 levels of CIN and how are they Tx?

Answer 16

1 - basal 1/3rd abnormal (repeat smear in 1yr)
2 - abnormal to middle 1/3rd (ablate/LLETZ)
3 - full thickness (ablate/LLETZ)

Question 17

staging of cervical cancer?

Answer 17

1 - confined
2 - spread to organs
3 - involving pelvic wall
3 - distant mets, rectum or bladder

Question 18

Tx for cervical cancer?

Answer 18

LLETZ/cone biopsy

hysterectomy + lymphadenectomy
+ radio if positive nodes

if past cervix + chemo

Question 19

what is the cervical cancer screening pathway?

Answer 19

HPV test

negative -> 5yrs
positive -> cytology

if negative, repeat in 1yr
if dykariosis, colposcopy

Question 20

who gets cervical screening?

Answer 20

25-64yrs

Question 21

how long do pregnant women wait until screening?

Answer 21

12 wks

Question 22

who gets HPV vaccine?

Answer 22

11-13yrs M+F

Question 23

how long does HPV infection take to turn into cancer?

Answer 23

5-20yrs