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Oral Path 2, Exam 4 > HPV-Related Cancers > Flashcards

HPV-Related Cancers Flashcards

(61 cards)

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1
Q

True/False: All HPV types are sexually transmitted

A

False - HPV 6, 11 (squamous papilloma) and HPV 2 (non-genital warts) are not sexually transmitted

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2
Q

True/False: All HPV types are low risk for cancer

A

False - some types are low risk and some are high

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3
Q

Which HPV types are high risk for cancer?

A

HPV 16, 18

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4
Q

Which HPV types are sexually transmitted

A

HPV 6, 11

HPV 16, 18

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5
Q

Most common soft tissue mass arising from the soft palate

A

Squamous papilloma

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6
Q

Lesion that is exophytic with fingerlike projections giving a “cauliflower” or “wart-like” appearance

A

Squamous papilloma

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7
Q

Sessile

A

Base is the widest part of the lesion

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8
Q

Pedunculated

A

Base is narrower than the widest part of the lesion

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9
Q

Squamous papilloma has ___ (high/low) infectivity and ____ (high/low) virulence

A

Low, Low

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10
Q

What determines the color of squamous papilloma?

A

The amount of keratin

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11
Q

Treatment for squamous papilloma

A

Conservative excision

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12
Q

Prognosis for squamous papilloma

A

Recurrence is unlikely and spontaneous remission is possible

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13
Q

Dermatologic term for common wart

A

Verruca vulgaris

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14
Q

True/False: Verruca vulgaris is contagious

A

True

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15
Q

Verruca vulgaris is extremely common on the ___, especially the ____

A

Skin

Hand

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16
Q

Where are oral lesions of verruca vulgaris typically seen?

A

Vermilion border, labial mucosa, anterior tongue

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17
Q

Treatment for verruca vulgaris skin lesions

A

Topical therapies, surgery

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18
Q

Treatment for verruca vulgaris oral lesions

A

Surgery, laser, cryotherapy, electrosurgery

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19
Q

Prognosis for verruca vulgaris

A

May recur, spontaneous remission possible

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20
Q

Most common sexually transmitted infection in the US

A

HPV

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21
Q

HPV ___ and ___ are high risk and implicated in cancers

A

16 and 18

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22
Q

Low risk sexually transmitted infection

A

Condyloma acuminatum

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23
Q

Venereal warts

A

Condyloma acuminatum

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24
Q

Venereal warts are larger than ____ (~1 cm but up to 3cm) and there are often ____

A

Papillomas

Multiple

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25
Treatment for venereal warts
Excision, cryotherapy, laser, (topical agent for anogenital lesions)
26
Anogenital condylomata infected with HPV 16, 18 have a higher risk for...
Malignant transformation to SCC
27
45% of American adults have ____ HPV
Genital
28
What is an HPV infection?
HPV enters epithelial cells and infects the basal cells
29
What is an HPV infection?
Terminal differentiation of infected keratinocytes
30
What do mutations lead to?
Pre-cancerous and then cancerous transformation
31
Are most HPV infections symptomatic or asymptomaticc?
Asymptomatic
32
T/F: Over 90% of HPV infections are cleared by the body within 2-3 years
True
33
T/F: Some HPV infected cells never remain latent
False: Some remain latent for decades
34
HPV latent infections have ____ (high/low) replication, _____ (high/minimal) viral protein expression, lack of immune clearance, and persistent _____ up to 20 yrs.
Low Minimal Persistent
35
High-risk HPV types make what 4 proteins?
E6, E7, L1, L2
36
Which 2 proteins allow the cell to grow in an uncontrolled manner and avoid cell death
E6, E7
37
Which 2 proteins compromise the virus capsid (shell) required for virus transmission, spread and survival
L1, L2
38
Which 2 proteins are involved in early HPV protein production? Late?
Early - E6, E7 | Late - L1, L2
39
What cancer is the most highly caused by HPV? Second most?
Most - Anal cancer (95%) | 2nd most - Oropharyngeal and Cervical cancer (~70%)
40
How do you differentiate between oral and oropharyngeal cancer?
Based on anatomic location
41
Where are oral cancers located?
Anterior to the tonsillar pillars
42
T/F: HPV is a risk factor for Oral Squamous Cell Carcinoma
False - there is no evidence to support this
43
Where are oropharyngeal cancers located?
Base of the tongue, soft palate, palatine tonsils, and the pharyngeal wall
44
Both Oral and Oropharyngeal Squamous Cell Carcinoma have a ____ predilection
Male
45
What is the etiology of OSCC? What about OPSCC?
OSCC - Smoking, alcohol | OPSCC - More sexual partners (some HPV+)
46
Most patients with OPSCC have sexual partners with HPV. What form?
HPV16
47
Clinical presentation for OSCC? OPSCC?
OSCC - Leuko/Erythro/Erythroleukoplakia | OPSCC - Enlarged lymph node in neck, dysphagia, initially asymptomatic
48
Is the incidence of OSCC increasing or decreasing? OPSCC?
OSCC - Decreasing | OPSCC - Increasing
49
Which has a better survival rate? OSCC or OPSCC?
OPSCC
50
Why did the incidence of HPV+ oropharyngeal cancers increase, but the HPV- oropharyngeal cancers decreased (smoking)?
Increase in oral sexual behavior | Decrease in tobacco use
51
T/F: HPV-16 infection is not characterized by the presence of HPV-16 alone
True
52
What 2 other qualifications characterize an HPV-16 infection?
1. E6, E7 in the tumor cells expressed AND | 2. Serum presence of E6, E7 antibodies
53
Treatment for early HPV + OPSCC? Late?
Early: Platinum-based chemoradiotherapy and surgery Late: Surgery, chemotherapy, radiation
54
What is the prognosis for HPV + OPSCC?
Good - comorbidities have negative effects
55
From best to worst, rank the prognosis for HPV + and - in smokers and non-smokers
HPV+, non-smoker HPV+, smoker HPV-, non-smoker HPV-, smoker
56
Why is HPV testing important in oropharyngeal squamous cell carcinoma?
To ID patients that should have treatment de-escalated
57
HPV+ in OPSCC has a ___ (improved/worsened) survival, ___ (better/fewer) genetic alterations, and ___ (better/worse) response to therapy
Improved Fewer Better
58
2 things that vaccines prevent in both males and females?
1. Genital warts | 2. Epithelial dysplasia and anal cancer
59
T/F: Vaccines provide protection against diseases due to all HPV types
False
60
Do HPV vaccines protect patients that have already been exposed?
No
61
Are vaccines a treatment for genital warts or HPV-related cancer?
No

Oral Path 2, Exam 4 (6 decks)

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