Patho 1 and 2 Flashcards
Formation of the transformation zone
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
what is squamous metaplasia
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.
define metaplasia
a transformation of cell type from one kind of mature differentiated cell type to another kind of mature differentiated cell type
Histological features of the endometrium during the prolferative and secretory phases
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
define neoplasia
new growth - abnormal uncoordinated and excessive cell growth
persists following withdrawal of stimuli and associated with genetic alterations
behaviour of benign neoplasms
remain localised
doesnt invade surrounding tissues
generally grow slowly
good resemblance of parent tissue
give an example of a benign neoplasm
LEIOMYOMA of the myometrium fibroid
benign neoplasm of smooth muscle
localised
slow growing
consequences of benign neoplasms?
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
How do malignant neoplastic tissue look different to normal tissue/
loss of differentiation
loss of cellular cohesion
enlarged irregular dark nuclei
increased numbers of mitosis
Consequences of malignant neoplasms?
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
what is dysplasia?
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
where does dysplasia occur?
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
what is the difference between dysplasia and carcinoma?
invasion through the basement membrane
What are the high risk types of HPV?
16 AND 18
low risk types of HPV
6 AND 11
Management
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
the incidence of cervical cancer has been declining
true or false?
true
what is the birth cohort effect?
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
the incidence of endometrial cancer is rising - true or false
true
