HPV

Question 1

High risk strains of HPV?

Answer 1

HPV 16 and 18

Question 2

Low risk strains of HPV?

Answer 2

HPV 6 and 11

Question 3

HPV incubation period?

Answer 3

3 weeks to 9 months
-still contagious during this time and so likely to acquire from an asymptomatic partner

Question 4

what strain of HPV typically causes genital warts and cervical cancer?

Answer 4

genital warts= low risk HPV= HPV 6 and 11
cervical cancer= high risk HPV= HPV 16 and 18

Question 5

What types of cancer does HPV commonly cause?

Answer 5

-Cervical (HPV is the most common cause)
-Oropharynx
-Anus
-Penis
-Vulva
-Vaginal

Question 6

How does HPV promote cancer?

Answer 6

-by inhibiting tumour suppressor genes p54 and pRb

Question 7

What vaccine is given for HPV and what strains does it cover?

Answer 7

2 doses of the Quadrivalent vaccine
-covers HPV 6, 11, 16 and 18

Question 8

who is given the HPV vaccine?

Answer 8

MSM <45
Girls and boys 12- 13

Question 9

how often are women with HIV screened for cervical cancer?

Answer 9

yearly

Question 10

Histology of genital warts?

Answer 10

Thickened papillomatous squmous epithelium with cytoplasmic vacuolation (Koilocytes)

KOYLOCYTE- type of epithelial cell that develops following a HPV infection

Question 11

Treatment for genital warts

Answer 11

-Topical Podophylotoxin
-Imiquimod (can take 3/4 months)
-Cryotherapy

Surgical:
-Electrocautery

Question 12

complications of genital warts?

Answer 12

-can progress to intra epithelial neoplasia

Question 13

what are some precancerous changes in the cervix?

Answer 13

-Cervical intraepithelial neoplasia
-Cervical glandular intraepithelial neoplasia (CGN)

Question 14

what is cervical intraepithelial neoplasia?

Answer 14

-a pre invasive stage of cervical cancer
-dysplasia of squamous cells at the transformation zone in the cervix

genital warts can go on to form cervical intraepithelial neoplasia

Question 15

what cells is the ectocervix lined by?

Answer 15

non keratinised stratified squamous epithelium

Question 16

what cells is the endocervix lined by?

Answer 16

mucous secreting glandular cells
-simple columnar epithelium

Question 17

what is the transformation zone of the cervix?

Answer 17

-area in the cervix where the endo/ ecto cervix meet
-there is an abrupt change from glandular/ columnar cells from the endocerxix to the non keratinised stratified squamous epithelium in the ectocervix
-this is where cancer is most likely to occur
-also where cervical smears are taken

Question 18

what is cervical glandular intraepithelial neoplasia?

Answer 18

-pre invasive form of endocervical adenocarcinoma

Question 19

is it easier to screen for cervical glandular intraepithelial neoplasia or cervical intraepithelial neoplasia?

Answer 19

easier to screen for cervical intraepithelial neoplasia
-screening less effective for CGIN

Question 20

how is cervical intraepithelial neoplasia diagnosed?

Answer 20

using Colposcopy

Question 21

Stage I cervical intraepithelial neoplasia?

Answer 21

-Mild dysplasia
-affecting 1/3 thickness of epithelial layer
-likely to return to normal without treatment

Question 22

Stage II cervical intraepithelial neoplasia?

Answer 22

-Moderate dysplasia
-2/3 thickness of epithelial layer
-likely to progress to cancer if untreated

Question 23

Stage III cervical intraepithelial neoplasia?

Answer 23

-severe dysplasia
-very likely to progress to cancer if untreated
-Cervical carcinoma in situ