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NURSING 2005_Cervical Cancer_1 Slide PP Flashcards

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1
Q

Front

A

Back

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2
Q

<h1>Page 01</h1>

<br></br>What is the cervix?

A

A cylindrical shaped neck of tissue that joins the vagina with the uterus.

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3
Q

<h1>Page 01</h1>

<br></br>How long is the cervix?

A

About 2 - 3cm long.

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4
Q

<h1>Page 01</h1>

<br></br>What is the function of the cervix?

A

Facilitates the entry of sperm from the vagina into the uterus for fertilization.

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5
Q

<h1>Page 03</h1>

<br></br>What are the two regions of the cervix?

A

Endocervix and Ectocervix.

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6
Q

<h1>Page 03</h1>

<br></br>What type of epithelium is found in the endocervix?

A

Columnar epithelium.

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7
Q

<h1>Page 03</h1>

<br></br>What portion of the cervix projects into the vagina?

A

Ectocervix.

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8
Q

<h1>Page 03</h1>

<br></br>What type of epithelium is found in the ectocervix?

A

Stratified squamous epithelium.

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9
Q

<h1>Page 04</h1>

<br></br>What type of epithelium is found in the endocervix?

A

Simple columnar epithelium.

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10
Q

<h1>Page 05</h1>

<br></br>What type of epithelium is found in the Ectocervix?

A

Stratified squamous epithelium.

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11
Q

<h1>Page 06</h1>

<br></br>What is the Transformation Zone?

A

The area where the columnar epithelium (Endocervix) is being replaced by squamous epithelium (Ectocervix).

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12
Q

<h1>Page 06</h1>

<br></br>What is the site of the Squamocolumnar Junction?

A

The Transformation Zone.

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13
Q

<h1>Page 06</h1>

<br></br>What happens to the epithelium of the Ectocervix throughout a woman’s life?

A

It is continually replaced.

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14
Q

<h1>Page 06</h1>

<br></br>Where do most neoplastic changes arise?

A

In the Transformation Zone.

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15
Q

<h1>Page 07</h1>

<br></br>What is the name of the junction between the squamous epithelium and the columnar epithelium?

A

Squamocolumnar Junction.

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16
Q

<h1>Page 07</h1>

<br></br>Where is the location of the squamocolumnar junction on the cervix?

A

Variable.

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17
Q

<h1>Page 07</h1>

<br></br>What is the result of the continuous remodeling process of the squamocolumnar junction?

A

It results from uterine growth, cervical enlargement, and hormonal status.

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18
Q

<h1>Page 08</h1>

<br></br>What is the most common type of cervical cancer?

A

Squamous cell carcinoma.

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19
Q

<h1>Page 08</h1>

<br></br>What is the other type of cervical cancer apart from squamous cell carcinoma?

A

Adenocarcinoma.

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20
Q

<h1>Page 08</h1>

<br></br>What is the main cause of cervical cancer?

A

Human Papilloma Virus (HPV) infection.

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21
Q

<h1>Page 08</h1>

<br></br>What is the precursor to invasive cervical cancer?

A

Cervical Intraepithelial Neoplasia (CIN).

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22
Q

<h1>Page 08</h1>

<br></br>What are the risk factors for cervical cancer?

A

HPV infection, smoking, weakened immune system, and early sexual activity.

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23
Q

<h1>Page 08</h1>

<br></br>What is the recommended method for cervical cancer prevention?

A

Vaccination against HPV and regular cervical screening.

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24
Q

<h1>Page 08</h1>

<br></br>What are the common cervical screening methods?

A

Pap smear and HPV DNA test.

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25
Q

<h1>Page 09</h1>

<br></br>In 2020, where did cervical cancer rank among the most common cancers diagnosed in women worldwide?

A

3rd, after breast and lung cancer.

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26
Q

<h1>Page 09</h1>

<br></br>How many women worldwide were diagnosed with cervical cancer in 2020?

A

Approximately 604,127.

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27
Q

<h1>Page 09</h1>

<br></br>In 2020, where was the highest incidence of cervical cancer observed?

A

Eastern Africa, with an age-standardised incidence rate of 40.1 women per 100,000.

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28
Q

<h1>Page 10</h1>

<br></br>What was the incidence rate of cervical cancer in Australia?

A

5.6 women per 100,000.

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29
Q

<h1>Page 10</h1>

<br></br>Where does Australia rank in terms of cervical cancer incidence rate worldwide?

A

17th lowest, alongside New Zealand and Cyprus.

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30
Q

<h1>Page 10</h1>

<br></br>What was the mortality burden rate of cervical cancer in Australia?

A

1.5 women per 100,000.

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31
Q

<h1>Page 10</h1>

<br></br>Where does Australia rank in terms of cervical cancer mortality burden rate worldwide?

A

4th lowest, alongside Iraq and Iran.

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32
Q

<h1>Page 10</h1>

<br></br>What percentage of all cancer diagnoses in Australia was accounted for by cervical cancer?

A

0.46%.

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33
Q

<h1>Page 10</h1>

<br></br>What percentage of all cancer-related deaths in Australia was equated to cervical cancer?

A

0.68%.

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34
Q

<h1>Page 10</h1>

<br></br>Which cancer is the most common in the female reproductive tract in Australia?

A

Cervical cancer.

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35
Q

<h1>Page 11</h1>

<br></br>What is the biggest risk factor for cervical cancer?

A

Persistent infection with high-risk strains of Human Papilloma Virus (HPV).

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36
Q

<h1>Page 11</h1>

<br></br>In what percentage of cases of cervical cancer can HPV be detected?

A

90%.

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37
Q

<h1>Page 11</h1>

<br></br>What can be seen in colposcopic images related to cervical pathology?

A

Progression of cervical pathology.

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38
Q

<h1>Page 12</h1>

<br></br>What is a risk factor for cervical cancer related to socioeconomic status?

A

Limited access to health care and screening programs.

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39
Q

<h1>Page 12</h1>

<br></br>How does cigarette smoking contribute to the risk of cervical cancer?

A

It is a risk factor for cervical cancer.

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40
Q

<h1>Page 12</h1>

<br></br>What is the risk factor for cervical cancer associated with prolonged use of oral contraceptives?

A

Increased risk of cervical cancer.

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41
Q

<h1>Page 12</h1>

<br></br>What type of sexual partner is considered high-risk for cervical cancer?

A

A partner with multiple sexual partners or known HPV infection.

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42
Q

<h1>Page 12</h1>

<br></br>How does genetics play a role in the risk of cervical cancer?

A

Increased incidence within families.

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43
Q

<h1>Page 13</h1>

<br></br>What is the structure of the Human Papilloma Virus (HPV)?

A

It has a characteristic icosahedral viral outer shell (capsid) primarily comprised of star-shaped pentameric capsomeres.

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44
Q

<h1>Page 13</h1>

<br></br>What type of virus is the Human Papilloma Virus (HPV)?

A

A small, non-enveloped, double-stranded DNA virus.

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45
Q

<h1>Page 13</h1>

<br></br>How are capsomeres arranged in the Human Papilloma Virus (HPV) capsid?

A

Capsomeres self-assemble to form the capsid, which provides the viral DNA.

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46
Q

<h1>Page 14</h1>

<br></br>How many different types of HPV virus are there?

A

About 200.

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47
Q

<h1>Page 14</h1>

<br></br>What changes the way HPV virus interacts with tumour suppressor genes?

A

Slight changes in the proteins they produce.

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48
Q

<h1>Page 14</h1>

<br></br>Which HPV strains are responsible for warts and cold sores?

A

HPV6 & HPV11.

49
Q

<h1>Page 14</h1>

<br></br>How many strains of genital HPV are there?

A

About 50.

50
Q

<h1>Page 14</h1>

<br></br>How many strains of genital HPV are considered ‘high risk’?

A

Approximately 15 strains.

51
Q

<h1>Page 14</h1>

<br></br>Which HPV types are responsible for about 70% of cervical cancers?

A

Types 16 and 18.

52
Q

<h1>Page 15</h1>

<br></br>How is HPV contracted?

A

Through direct sexual contact with infected people.

53
Q

<h1>Page 15</h1>

<br></br>In what ways can HPV be spread during sexual contact?

A

Through vaginal, anal, and oral sex.

54
Q

<h1>Page 15</h1>

<br></br>Is HPV contagious?

A

Yes, HPV is contagious.

55
Q

<h1>Page 15</h1>

<br></br>Can people be infected with more than one type of HPV?

A

Yes, people can be infected with more than one type of HPV.

56
Q

<h1>Page 16</h1>

<br></br>How does HPV drive cervical cancer?

A

By utilizing the host’s cellular machinery and inserting viral proteins (E6 & E7) into the genome, which act as oncogenes to drive cell proliferation.

57
Q

<h1>Page 16</h1>

<br></br>What is the function of the E6 protein in HPV?

A

It binds to and inactivates p53 (tumour suppressor gene), leading to the loss of control of apoptosis.

58
Q

<h1>Page 16</h1>

<br></br>How does the inactivation of p53 by E6 protein contribute to cervical cancer?

A

It allows cells with damaged DNA to replicate rather than self-destruct.

59
Q

<h1>Page 17</h1>

<br></br>What is the function of E7 protein in HPV?

A

It binds to the Retinoblastoma (Rb) protein and inactivates it.

60
Q

<h1>Page 17</h1>

<br></br>What is the normal function of the Retinoblastoma (Rb) protein?

A

It stops cell division by binding to a transcription factor called E2F.

61
Q

<h1>Page 17</h1>

<br></br>What happens when E7 protein inactivates the Retinoblastoma (Rb) protein?

A

E2F encourages transcription of mRNA that encodes proteins which encourage DNA replication and division.

62
Q

<h1>Page 18</h1>

<br></br>What does CIN stand for?

A

Cervical Intraepithelial Neoplasia.

63
Q

<h1>Page 18</h1>

<br></br>What is the main cause of Cervical Intraepithelial Neoplasia?

A

Persistence of HPV infection.

64
Q

<h1>Page 18</h1>

<br></br>What percentage of patients with CIN 1 regress to normal in one year?

A

60%.

65
Q

<h1>Page 18</h1>

<br></br>What percentage of patients with CIN 1 regress to normal in two years?

A

90%.

66
Q

<h1>Page 18</h1>

<br></br>What is CIN 3 considered as?

A

Carcinoma in situ.

67
Q

<h1>Page 19</h1>

<br></br>What does LSIL stand for?

A

Low-grade squamous intraepithelial lesion.

68
Q

<h1>Page 19</h1>

<br></br>What is the likelihood of regression without treatment for LSIL?

A

Most regress without treatment.

69
Q

<h1>Page 19</h1>

<br></br>What is the recommended action for increased frequency of cervical screening for LSIL?

A

Increase frequency of cervical screen/pap smear.

70
Q

<h1>Page 19</h1>

<br></br>What does HSIL stand for?

A

High-grade squamous intraepithelial lesion.

71
Q

<h1>Page 19</h1>

<br></br>What is the chance of having an invasive cervical cancer for CIN 2 & CIN 3?

A

0.3% chance of having an invasive cervical cancer.

72
Q

<h1>Page 19</h1>

<br></br>What is the recommended action for HSIL?

A

Refer for colposcopy.

73
Q

<h1>Page 20</h1>

<br></br>What is the first event leading to cervical cancer?

A

Infection with HPV from sexual activity.

74
Q

<h1>Page 20</h1>

<br></br>What is the second event in the sequence leading to cervical cancer?

A

Viral persistence.

75
Q

<h1>Page 20</h1>

<br></br>What is the third event in the sequence leading to cervical cancer?

A

Progression to dysplastic change.

76
Q

<h1>Page 20</h1>

<br></br>What is the final event in the sequence leading to cervical cancer?

A

Development of invasive cervical cancer.

77
Q

<h1>Page 21</h1>

<br></br>What are the clinical manifestations of early stages of cervical cancer?

A

Often have no symptoms and can go undetected.

78
Q

<h1>Page 21</h1>

<br></br>What symptoms may be present in the late stage of cervical cancer?

A

Abnormal vaginal bleeding, bleeding after sexual intercourse, painful urination, pelvic or lower-back pain, bowel or urinary-related symptoms.

79
Q

<h1>Page 22</h1>

<br></br>What are the potential local spread locations of untreated cervical cancer?

A

Uterus, bladder, ureters, rectum, and peritoneum.

80
Q

<h1>Page 22</h1>

<br></br>Where can cervical cancer spread locally?

A

To pelvic nodes.

81
Q

<h1>Page 22</h1>

<br></br>Which distant sites can cervical cancer metastasize to?

A

Liver, lung, brain, and bone.

82
Q

<h1>Page 22</h1>

<br></br>What was the 5-year survival rate for cervical cancer in Australia from 2012-2016?

A

73.7%.

83
Q

<h1>Page 22</h1>

<br></br>What are the direct invasion locations of cervical cancer into the bladder and rectouterine space?

A

Bladder mucosa (red) and rectouterine space (white).

84
Q

<h1>Page 23</h1>

<br></br>What are examples of primary prevention for cervical cancer?

A

Promotion of health, vaccination, and making physical environments safe.

85
Q

<h1>Page 23</h1>

<br></br>What does secondary prevention for cervical cancer involve?

A

Early detection and prompt intervention to correct departures from good health or to treat the early signs of disease, e.g. cervical screening.

86
Q

<h1>Page 24</h1>

<br></br>What is Gardasil?

A

An HPV vaccine.

87
Q

<h1>Page 24</h1>

<br></br>What strains of HPV is Gardasil directed against?

A

Those known to cause cervical cancer and genital warts.

88
Q

<h1>Page 24</h1>

<br></br>Which types of HPV does Gardasil target?

A

Types 6, 11, 16, 18.

89
Q

<h1>Page 24</h1>

<br></br>Who led the initial research on Gardasil?

A

Professor Ian Fraser at University of Queensland.

90
Q

<h1>Page 24</h1>

<br></br>Which country was the first to adopt a national, publicly funded HPV vaccination program?

A

Australia.

91
Q

<h1>Page 25</h1>

<br></br>What is the purpose of the National HPV Vaccination Program?

A

To prevent women from being infected with high-risk HPV types 16 and 18.

92
Q

<h1>Page 25</h1>

<br></br>When did the National HPV Vaccination Program begin for females?

A

In 2007.

93
Q

<h1>Page 25</h1>

<br></br>When was the National HPV Vaccination Program extended to males?

A

In 2013.

94
Q

<h1>Page 25</h1>

<br></br>At what age is the HPV vaccination free in school for children?

A

Aged 12-13 years.

95
Q

<h1>Page 25</h1>

<br></br>What percentage of cervical cancers in women are caused by HPV types 16 and 18?

A

70%.

96
Q

<h1>Page 25</h1>

<br></br>What percentage of all HPV related cancers in men are caused by HPV types 16 and 18?

A

90%.

97
Q

<h1>Page 25</h1>

<br></br>What is the purpose of the updated vaccine called Gardasil 9?

A

To provide fully vaccinated females with protection against 90% of cervical cancers.

98
Q

<h1>Page 25</h1>

<br></br>Which virus like particles does Gardasil 9 protect against?

A

HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58.

99
Q

<h1>Page 25</h1>

<br></br>What is the primary prevention method associated with Gardasil?

A

Gardasil is a primary prevention method.

100
Q

<h1>Page 26</h1>

<br></br>What has replaced the Pap Smear as the screening method of choice in Australia?

A

The National Cervical Screening Program.

101
Q

<h1>Page 26</h1>

<br></br>What does the Cervical screen identify?

A

The presence of HPV infection.

102
Q

<h1>Page 26</h1>

<br></br>What is the cause of at least 90% of cervical cancers?

A

HPV infection.

103
Q

<h1>Page 26</h1>

<br></br>What did the Pap smear identify?

A

Cytological changes that may be associated with dysplasia.

104
Q

<h1>Page 27</h1>

<br></br>What is the expected impact of changes to the National Cervical Screening Program and HPV vaccination?

A

Expected to reduce the number of women diagnosed with cervical cancer by at least 15%.

105
Q

<h1>Page 27</h1>

<br></br>When was the ‘Global strategy to accelerate the elimination of cervical cancer as a public health problem’ launched?

A

In 2020 by the World Health Organisation (WHO).

106
Q

<h1>Page 27</h1>

<br></br>What makes the elimination of cervical cancer theoretically possible?

A

The vaccine and the cervical screen.

107
Q

<h1>Page 27</h1>

<br></br>What type of prevention is cervical screening considered?

A

Secondary Prevention.

108
Q

<h1>Page 29</h1>

<br></br>What is the recommended occurrence for the new cervical screening scheme?

A

Five-yearly test for women aged 25-74.

109
Q

<h1>Page 29</h1>

<br></br>What is the recommended occurrence for the old Pap smear scheme?

A

Two-yearly test for women aged 18-20+ who have ever been sexually active.

110
Q

<h1>Page 29</h1>

<br></br>What is the collection method for both the new cervical screening scheme and the old Pap smear scheme?

A

Speculum insertion → cervical swab → results sent to lab.

111
Q

<h1>Page 29</h1>

<br></br>What is the method of action for the new cervical screening scheme?

A

Determines whether the DNA from the HPV virus are present on epithelial cells.

112
Q

<h1>Page 29</h1>

<br></br>What is the method of action for the old Pap smear scheme?

A

Detects abnormal cells in the cervix → cervical dysplasia.

113
Q

<h1>Page 30</h1>

<br></br>What is the current barrier to widespread use of cervical screening methods?

A

The high cost of cervical screening.

114
Q

<h1>Page 30</h1>

<br></br>What is the status of Medicare (or equivalent) in all countries?

A

Not all countries have Medicare or equivalent.

115
Q

<h1>Page 30</h1>

<br></br>According to WHO, what is the situation in many countries regarding cervical screening?

A

Many countries do not have any form of cervical screening.

116
Q

<h1>Page 30</h1>

<br></br>How is cervical screening conducted in countries with screening programs?

A

It is often opportunistic rather than organization population-based.

117
Q

<h1>Page 30</h1>

<br></br>What type of cervical screening is undertaken in many countries of lower socio-economic status?

A

Visual inspections only.

118
Q

<h1>Page 30</h1>

<br></br>What may drive improvements in cervical screening, according to WHO?

A

WHO’s 2030 targets, e.g. addition of cervical screening to healthcare plans.

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