Path - Cervix

Question 1

microscopic appearance of chronic cervicitis

Answer 1

lymphocyte rich infiltrate

when germinal centers form, described as follicular cervicitis

Question 2

what is the most common cervical cyst?

Answer 2

Nabothian cyst

Question 3

histology of exocervic and endocervix and what is the junction between them called?

Answer 3

exo: non-keratinizing squamous
endo: single layer of columnar cells
transformation zone

Question 4

how does high risk HPV lead to increased risk of cervical cancer?

Answer 4

produce E6 and E7 proteins that result in destruction of p53 and Rb, respectively
E7 also inhibits p21 and p27 - cyclin dependent kinase inhibitors
E6 also upregulates telomerase

Question 5

how to differentiate between CIN I, II, III, and carcinoma in situ

Answer 5

I - < 1/3 thickness of epithelium (LSIL)
II - < 2/3 thickness
III - slightly less than entire thickness of epithelium
CIS - entire thickness

Question 6

what are the typical fates of LSIL vs HSIL?

Answer 6

LSIL - 60% regress, 30% persist, only 10% go to HSIL

HSIL - 30% regress, 60% regress, 10% go to carcinoma

Question 7

typical presentation of cervical carcinoma, some key risk factors

Answer 7

vaginal bleeding (especially postcoital) or cervical discharge in MIDDLE AGED women (40-50)
high risk HPV, smoking, immunodeficiency (AIDS defining)

Question 8

where do advanced cervical tumors often invade through and what is an outcome of this?

Answer 8

anterior uterine wall into bladder –> block ureters –> hydronephrosis with postrenal failure (common COD)

Question 9

on PAP smear, what are high grade dysplasia cells characterized by?

Answer 9

hyperchromatic (Dark) nuclei and high nuclear to cytoplasmic ratio

Question 10

what does the quadrivalent HPV vaccine cover?

Answer 10

HPV types 6, 11, 16, 18