Lower GI Tract Malignancies Flashcards
HPV 16 and 18
account for majority of worldwide cervical cancer
HPV 6 and 11 associated with.
external genital warts
6 women RF for HPV infection
- younger age
- # of partners
- early age of 1st sex experience
- Male partner sex experience
- smoking
- uncircumcised male partner
peak age group for men and women with HPV
women: age 20-24
men: age 25-29
besides cervical what other cancers HPV associated with?
anal 70%
vulvar 50%
cutaneous squamous cell 90%
HPV vaccination effective ages
9-26
Gardasil vs Cervarix
Gardasil: 16,18 and 6,11
: 16, and 18
VIN
vulvar intraepithelial neoplasia
VAIN
vaginal intraepithelial neoplasia
CIN
cervical intraepithelial neoplasia
VIN average age
40-50
CIN average age
30-40yr
Cervical cancer pap smear false positive rate
20% due to misinterpretation or inadequate sample
ASCUS
atypical squamous cells
HR HPV negative
ASCUS-H
atypical squamous cells, possibly high grade dysplasia
AGUS
atypical glandular cells
LGSIL
low grade dysplasia
HGSIL
high grade dysplasia
what is Bethesda system
pap smear observation and evaluation with ASCUS H vs L
RF for cervical CA
- HPV infection
- Young age at first coitus
- smoking
- multiple partners,
- low SES
- metropolitan areas
- underdeveloped countries
sx of cervical cancer
post coital spotting
vaginal discharge vaginal bleeding
pelvic pain radiating to leg
dysuria/hematuria/rectal bleeding
PE findings of cervical cancer
- friable cervix
- necrotic ulceration
- barrel shaped cervix
induration of vagina, firm mass in parametrium, nodal enlargement
cervical ca is usually…
squamous
w/ cervical ca dx.. if invasion is deeper than 3 mm
then there is risk of nodal metastasis and pelvic lymphadenectomy is added
Trachelectomy includes
removal of the cervix and para cervical tissues while uterine fundus remains intact
for women who want to remain fertile and their tumor is small
tx for advanced cervical cancer
external radiation therapy intracavitary radiation interstitial radiation therapy sensitizing chemo (cisplatin low dose)
what is fletcher applicator
for intracavitary radiation
inserted into the uterus and 2 ovoids which are put just in front of the cervix
