Patho 1 and 2

Question 1

Formation of the transformation zone

Answer 1

During puberty the cervix changes shape
The lips of the cervix grow
The distal end of the endocervix opens
Endocervical mucosa becomes exposed to the vaginal environment

Question 2

what is squamous metaplasia

Answer 2

when the distal endocervical columnar epithelium is exposed to acidic vaginal environment
it is not suited to this, so undergoes adaptive changes called metaplasia
reserve cells in the area profilerate and mature to form squamous epithelium.

Question 3

define metaplasia

Answer 3

a transformation of cell type from one kind of mature differentiated cell type to another kind of mature differentiated cell type

Question 4

Histological features of the endometrium during the prolferative and secretory phases

Answer 4

proliferative  - before ovulation 
1-tubular glands 
2-specialised stroma 
3- blood vessels 
mitosis in glands 

secretory phase - 
1 - cork screw glands 
2 - specialised stroma 
3- blood vessels 
secretion in glands

Question 5

define neoplasia

Answer 5

new growth - abnormal uncoordinated and excessive cell growth
persists following withdrawal of stimuli and associated with genetic alterations

Question 6

behaviour of benign neoplasms

Answer 6

remain localised
doesnt invade surrounding tissues
generally grow slowly
good resemblance of parent tissue

Question 7

give an example of a benign neoplasm

Answer 7

LEIOMYOMA of the myometrium fibroid

benign neoplasm of smooth muscle
localised
slow growing

Question 8

consequences of benign neoplasms?

Answer 8

pressure on adjacent tissues (Bladder (frequency)
obstruct lumen of a hollow organ 
hormone production 
transformation into malignant neoplasm 
symptoms for the patient 

clinical problems - abnormal uterine bleeding and pain

Question 9

How do malignant neoplastic tissue look different to normal tissue/

Answer 9

loss of differentiation
loss of cellular cohesion
enlarged irregular dark nuclei
increased numbers of mitosis

Question 10

Consequences of malignant neoplasms?

Answer 10

Destruction of adjacent tissue
Metastasis
Blood loss from ulcerated surfaces
Obstruction of a hollow viscera
Production of hormones
Weight loss and debility
Anxiety and pain

Question 11

what is dysplasia?

Answer 11

the presence of cells of an abnormal type within a tissue, which may signify a stage preceding the development of cancer.

For some malignant neoplasms a ‘pre-malignant’ state is identified

There is an accumulation of cells which look somewhat like malignant cells but do not invade the basement membrane

Question 12

where does dysplasia occur?

Answer 12

often occurs in sites where there is metaplasia

squamous metaplasia of the cervical transformation zone
squamous metaplasia of the bronchial epithelium
glandular metaplasia of the distal oesophagus

Question 13

what is the difference between dysplasia and carcinoma?

Answer 13

invasion through the basement membrane

Question 14

What are the high risk types of HPV?

Answer 14

16 AND 18

Question 15

low risk types of HPV

Answer 15

6 AND 11

Question 16

Management

Answer 16

HPV Vaccination
Population based screening
Cervical sample cytology
Cervical sample HPV test
Colposcopy
Treatment of high grade dysplasia
Large Loop Excision of the Transformation Zone

Question 17

the incidence of cervical cancer has been declining

true or false?

Answer 17

true

Question 18

what is the birth cohort effect?

Answer 18

The separate peaks in cervical cancer incidence reflect a birth cohort effect
This happens when a group of people experience different circumstances to those born immediately before or after
An increase in cervical cancer incidence and mortality was seen in women reaching the age of sexual debut during WW1 and again in WW2
A birth cohort effect exists, believed to reflect the different exposure to HPV at the time women reached the age of sexual debut

HPV vaccination is creating new birth cohorts

Question 19

the incidence of endometrial cancer is rising - true or false

Answer 19

true