Path of Cervical Neoplasia

Question 1

Cervical Ectropion

Answer 1

Eversion of the endocervix where the columnar epithelium is exposed to the vaginal milieu

Question 2

JM is a 35 yo woman with one child and no significant PMHx. She is in clinic for routine check up and PAP smear. She reports spotting between menstrual periods. She has not had a PAP smear done in 2 yrs but the last test was negative. Examination reveals a 4mm soft tissue mass protruding from cervix. She does not smoke or drink EtoH, she is happily married, there is no Hx of cancer in her family. Which of the following is true about this finding?

A.Rare in girls who have not started menses
B.Condition is caused by inflammation
C.This condition can involve the ectocervix
D.Usually found in women over 20 years of age
E.All of the above

Answer 2

E.All of the above

Benign Cervical Dysplasia

Question 3

Endocervical polyp morph

Answer 3

• Loose fibromyxomatous stoma
• mucus-secreting glands
• squamous metaplasia
• “Nebothian Cysts”

Question 4

HPV Carcinogenesis

Answer 4

1. E6 protein debgradse p52 + BAX

2. E7 inactivatres CDKIa p21; Degrades RB-E2F

Question 5

Atypical SCs of undetermined significance

Answer 5

• Cervical cells showing “pulled-out” or streaming effect; pleomorphism
• HPV tst + Pap follow up 1 yr

Question 6

PAP screening reqs

Answer 6

• Start at 21
• Every 3 years 21-29
• every 5 w/ cyt + HPV test 30+

Question 7

Cervical CA Staging

Answer 7

0: CIS
I: Confined to ccervix
II: Beyond cervix
III: into pelvic wall
IV: Beyond true pelvis

Question 8

Cervical CA metastasis

Answer 8

Liver
Lungs
BM

Question 9

Which of the following is a complication most often responsible for the mortality seen in stage IV cervical cancer?

A.Uremia
B.Proteinuria
C.Sepsis
D.Volume depletion
E.Acidemia

Answer 9

A.Uremia