Lower GI Tract Malignancies

Question 1

HPV 16 and 18

Answer 1

account for majority of worldwide cervical cancer

Question 2

HPV 6 and 11 associated with.

Answer 2

external genital warts

Question 3

6 women RF for HPV infection

Answer 3

1. younger age
2. # of partners
3. early age of 1st sex experience
4. Male partner sex experience
5. smoking
6. uncircumcised male partner

Question 4

peak age group for men and women with HPV

Answer 4

women: age 20-24
men: age 25-29

Question 5

besides cervical what other cancers HPV associated with?

Answer 5

anal 70%
vulvar 50%
cutaneous squamous cell 90%

Question 6

HPV vaccination effective ages

Answer 6

9-26

Question 7

Gardasil vs Cervarix

Answer 7

Gardasil: 16,18 and 6,11

: 16, and 18

Question 8

VIN

Answer 8

vulvar intraepithelial neoplasia

Question 9

VAIN

Answer 9

vaginal intraepithelial neoplasia

Question 10

CIN

Answer 10

cervical intraepithelial neoplasia

Question 11

VIN average age

Answer 11

40-50

Question 12

CIN average age

Answer 12

30-40yr

Question 13

Cervical cancer pap smear false positive rate

Answer 13

20% due to misinterpretation or inadequate sample

Question 14

ASCUS

Answer 14

atypical squamous cells

HR HPV negative

Question 15

ASCUS-H

Answer 15

atypical squamous cells, possibly high grade dysplasia

Question 16

AGUS

Answer 16

atypical glandular cells

Question 17

LGSIL

Answer 17

low grade dysplasia

Question 18

HGSIL

Answer 18

high grade dysplasia

Question 19

what is Bethesda system

Answer 19

pap smear observation and evaluation with ASCUS H vs L

Question 20

RF for cervical CA

Answer 20

1. HPV infection
2. Young age at first coitus
3. smoking
4. multiple partners,
5. low SES
6. metropolitan areas
7. underdeveloped countries

Question 21

sx of cervical cancer

Answer 21

post coital spotting
vaginal discharge vaginal bleeding
pelvic pain radiating to leg
dysuria/hematuria/rectal bleeding

Question 22

PE findings of cervical cancer

Answer 22

1. friable cervix
2. necrotic ulceration
3. barrel shaped cervix

induration of vagina, firm mass in parametrium, nodal enlargement

Question 23

cervical ca is usually…

Answer 23

squamous

Question 24

w/ cervical ca dx.. if invasion is deeper than 3 mm

Answer 24

then there is risk of nodal metastasis and pelvic lymphadenectomy is added

Question 25

Trachelectomy includes

Answer 25

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

Question 26

tx for advanced cervical cancer

Answer 26

external radiation therapy 
intracavitary radiation 
interstitial radiation therapy 
sensitizing chemo (cisplatin low dose)

Question 27

what is fletcher applicator

Answer 27

for intracavitary radiation

inserted into the uterus and 2 ovoids which are put just in front of the cervix