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Infection > Lecture 8.2: Viral Infections and Cancers > Flashcards

Lecture 8.2: Viral Infections and Cancers Flashcards

1
Q

What is an Oncogene?

A

Genetic material that carries the ability to induce cancer

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2
Q

What is Human Papillomavirus (HPV)?

A

• HPV is the most common sexually transmitted infection (STI)

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3
Q

How common is HPV?

A

80% of sexually active unvaccinated men and women get the virus at some point in their life

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4
Q

How to Test for HPV?

A
  • Males –Only visual exam*

* Females –Visual exam and detection through smears

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5
Q

How is HPV Transmitted?

A
  • More likely transmitted through direct contact

* With infected skin (i.e. wart is present)

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6
Q

What are Condylomata acuminata?

A

Benign anogenital warts most often caused by HPV types 6 and 11, as are laryngeal and oropharyngeal warts

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7
Q

What is the incubation period of warts?

A

1-6 months

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8
Q

Features of Visible Anogenital Warts (7)

A
  • Soft
  • Moist
  • Minute pink or gray polyps
  • Enlarge
  • May become pedunculated
  • Have rough surfaces
  • May occur in clusters
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9
Q

Where do anogenital warts occur in men?

A
  • Foreskin
  • Coronal Sulcus
  • Within the Urethral Meatus
  • Penile Shaft
  • Anus & Rectum
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10
Q

Where do anogenital warts occur in women?

A
  • Vulva
  • Vaginal Wall
  • Cervix
  • Perineum
  • Urethra
  • Anal Region
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11
Q

What types of HPV cause flat endocervical or anal warts that are difficult to see and diagnose clinically?

A

16 and 18

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12
Q

If untreated what can Condylomata acuminata lead to? (4)

A
  • Transmission to sex partners and newborns
  • Warts may grow and spread if left untreated
  • May cause cervical cancer
  • Block openings from anus, vagina and urethra
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13
Q

What HPV Types appear to cause Cervical Cancer?

A

HPV Type 16, 18, 31, 33, 35, or 39

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14
Q

What HPV Types most likely to cause cancer?

A
  • HPV 16 and 18
  • High Risk
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15
Q

Which HPV Types associated with benign warts?

A
  • HPV 6 and 11
  • Low Risk
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16
Q

Which cancer is HPV 16 most commonly linked to?

A

HPV16 is commonest in squamous cell carcinoma

17
Q

Which cancer is HPV 18 most commonly linked to?

A

HPV18 is more associated with adenocarcinoma

18
Q

Risk Factors for Cervical Cancer (6)

A
  • Younger age at first intercourse
  • A high lifetime number of sex partners
  • Oral Contraceptives
  • STIs
  • Cigarette smoking
  • Immunodeficiency
19
Q

Symptoms of Cervical Cancer (8)

A
  • Often Asymptomatic
  • Irregular Vaginal Bleeding
  • Pain during intercourse
  • Foul-smelling Vaginal Discharge
  • Pelvic Pain
  • Obstructive Uropathy
  • Back Pain
  • Leg Swelling (due to venous or lymphatic obstruction)
  • Pelvic examination may detect an exophytic necrotic tumor in the cervix
20
Q

What is CIN (Cervical Intra-Epithelial Neoplasia)?

A

It is a term that describes abnormal changes of the cells that line the cervix

21
Q

How is CIN (Cervical Intra-Epithelial Neoplasia) Graded?

A

1: Mild cervical dysplasia
2: Moderate dysplasia
3: Severe dysplasia and carcinoma in situ

CIN 1: Low Risk.
CIN 2 & 3: High Risk

22
Q

Can CIN 3 Regress?

A
  • CIN 3 is unlikely to regress spontaneously
  • If untreated, over time it may penetrate the basement membrane
  • Thus becoming invasive carcinoma
23
Q

Mechanism of Action of HPV

A

1) Normal viral mode of infection
2) Viral DNA integrates with Host DNA
3) Alterations in genes can lead to carcinogenesis

24
Q

What are the 3 different types of gene alterations HPV infection cause that may lead to carcinogenesis?

A

1) Loss of function of a tumour suppression gene
2) Enhanced expression of an oncogene
3) Interchromosomal rearrangements leading to altered gene expression in
involved regions

25
Q

What does HPV E6 Protein do in the host cell?

A

Inhibits human p53 tumour suppressor protein

26
Q

What does HPV E7 Protein do in the host cell?

A
  • Anti-apoptotic effect through mutations in the p53 protein
  • Rb
27
Q

How is Diagnosis of Cervical Cancer carried out?

A
  • A sample of cells is taken from the cervix for analysis
  • A speculum is used to open the woman’s vagina
  • Spatula to sweep around the cervix
28
Q

What is the use of Cervical Screening?

A

A method of preventing cancer by detecting and treating early abnormalities which, if left untreated, could lead to cancer in a woman’s cervix

29
Q

Histology of Determining Grade of Neoplasm: Low Grade

A
  • If it’s well differentiated and resembles the parent normal tissue low grade
  • This implies that it will grow slowly
30
Q

Histology of Determining Grade of Neoplasm: High Grade

A
  • If it’s more poorly differentiated and doesn’t resemble the normal tissue
  • The implication is that it will grow more quickly than one of low grade
31
Q

What is a Koilocyte?

A
  • A squamous epithelial cell that has undergone a number of structural changes
  • These occur as a result of infection of the cell by HPV
32
Q

What is Loop Electrosurgical Excision Procedure (LEEP)?

A
  • A procedure to remove abnormal cells from your cervix or vagina
  • Loop is heated by an electric current to make it similar to a surgical knife
  • This then removes abnormal cells and tissues from the cervix or vagina
  • Medicine is applied to reduce bleeding
33
Q

What percentage of oral cancers are HPV related?

A

25-35%

34
Q

What is the most common demographic in HPV-related oral cancers?

A

Most common in heterosexual men in their 40s and 50s

35
Q

What percentage of anal cancers are linked to HPV?

A

90%

36
Q

What percentage of anal cancers are linked to HPV? HPV Type?

A

90%

70% are HPV16

37
Q

Risk Factors for Developing Anal Cancer (7)

A
  • Being over age 50
  • Having another type of cancer
  • Having a weakened immune system
  • Regularly experiencing anal abnormalities
  • Having multiple sex partners
  • Engaging in receptive anal sexual activity
  • Smoking

Infection (21 decks)

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