Gynaecology

Question 1

which HPV strain is the most common identified in cervical cancer?

Answer 1

hpv 16 54%

hpv 18- 15%

Question 2

what % of CIN2will progress to CIN 3?

Answer 2

20%

Question 3

what % of CIN3 will progress to invasive cancer?

Answer 3

40%

Question 4

What is chromosome make up in complete molar pregnancy?

Answer 4

ALL genetic material comes from father

Complete molar - genetically diploid (46)

A complete mole is caused by a single sperm (90% of the time) 
or two (10% of the time) sperms combining with an egg which has lost its DNA.

The genotype is typically 46,XX (diploid) due to the subsequent mitosis of the fertilizing sperm but can also be 46,XY (diploid).

15% may need chemo for PTN

Question 5

Follow- up after molar pregnancy

Answer 5

Once hcg normalized- f/u hcg monthly 6/12

Avoid pregnancy while under f/u (6/12 from normal hcg)

Question 6

What metal tissue in complete and partial molar pregnancy?

Answer 6

Complete molar- no fetal tissue
Empty ovum fertilised by sperm

Partial molar- may have abnormal fetal tissue
2 sperm fertilise 1 ovum

Question 7

What is follow up after treatment for CIN

Answer 7

Women in follow up for treatment of CIN will be given a 3-year recall if HR-HPV negative 6 months after treatment, and will be referred to colposcopy if HR-HPV positive/any grade of cytology

Question 8

What is follow up for CGIN?

Answer 8

Women in follow up after adequate treatment for CGIN/SMILE will be given a 3-year recall if HR-HPV negative at both 6 and 18 months after treatment

Question 9

Women in follow up for cervical cancer?

Answer 9

Women in follow up for cervical cancer and CGIN/SMILE (without complete excision margins)
- screened annually with the HR-HPV test (instead of cytology) for 10 year

Question 10

What is follow up if HPV not detected on cytology?

Answer 10

HR-HPV not detected: return to normal recall (3 or 5 years)

Question 11

What is follow- up if smear detects HR HPV and cytology negative?

Answer 11

HR-HPV detected, cytology negative (no abnormal cells): recall 12 months

If then HR HPV negative- normal 3/5 yr recall

Question 12

What is follow up if smear detects HR HPV and cytology positive?

Answer 12

HR-HPV detected, cytology positive (abnormal cells found): refer for colposcopy

Question 13

What if HR HPV- smear inadequate?

Answer 13

Inadequate result: repeat in 3 months

Question 14

what % of untreated CIN 1 goes back to normal?

Answer 14

25-50%

Question 15

what % of untreated CIN 1 progresses?

Answer 15

20%

Question 16

what % of untreated CIN 2 progresses?

Answer 16

30%

Question 17

% of CIN3 that leads to ICC?

Answer 17

25-60% of CIN3