Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Repro and Sexual Health > Pathology of cervix, vulva and vagina > Flashcards

Pathology of cervix, vulva and vagina Flashcards

1
Q

What are the different types of the cervix?

A

Ectocervix
Endocervix
Transitional Zone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What lines the ectocervix and endocervix respectively?

A

Ectocervix; squamous epithelium

Endocervix; glandular epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What makes up the epithelium of the cervix?

A 
Basement membrane 
Basal cells
Parabasal cells 
Intermediate cells 
Superficial cells 
Exfoliating cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the TZ zone of the cervix?

A

Squamo-columnar junction between ectocervix and endocervical epithelia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What will physiological things in life alters the position of the TZ?

A

Menarche
Pregnancy
Menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a cervical erosion?

A

Exposure of delicate endocervical epithelium to acid environment of vagina leads to physiological squamous metaplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a nabothian follicle?

A

Dilated endocervical glands which form a polypoid structure

Entirely benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is cervicitis?

A

Asymptomatic
Can lead to infertility due to simultaneous silent fallopian tube damage
Non-specific acute/ chronic inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is follicular cervicitis?

A

Sub epithelial reactive lymphoid follicles present in cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the different types of inflammatory pathology of the cervix?

A 
Cervicit
Follicular cervicitis
Chlamydia trachomatis
Herpes Simplex Viral Infection 
Cervical polyp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a cervical polyp?

A

Localised inflammatory outgrowth
Cause of bleeding if ulcerated
Not premalignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the neoplastic pathologies of the cervix?

A

Cervical Intraepithelial Neoplasia (CIN)

Cervical cancer; squamous or adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the high risk HPV strains?

A

16
18
(31,33,35,45,48)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are risk factors for CIN?

A

High risk HPV
Vulnerability of SC junction in early reproductive age
Smoking
Immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What increases the risk of vulnerability of SC junction in early reproductive age?

A

Age at first intercouse
Long term use of oral contraception
Non use of barrier contraception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does HPV cause cervical cancer?

A

Infects epithelial cells in the cervical mucosa

HPV DNA integrates into the cellular genome resulting in cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What strains of HPV cause genital warts?

A

6 and 11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a condyloma acuminatum?

A

Thickened papillomatous squamous epithelium with cytoplasmic vacuolation
Condyloma acuminata refers to anogenital warts caused by human papillomavirus (HPV). The most common strains of HPV that cause anogenital warts are 6 and 11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a koilocytosis?

A

A type of epithelial cell that develops following a human papillomavirus (HPV) infection. Koilocytes are structurally different from other epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why is a CIN not a cancer?

A

Not broken through the basal layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the appearance of CIN?

A

Infected epithelium remains flat, but may show koilocysosis which can be detected in cervical smears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe a CIN 3?

A

Squamous cell carcinoma in situ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the time lines for HPV and high grade CIN infection?

A

HPV infection can transform into high grade CIN in 6 months to 3 years
High grade CIN can transform to invasive cancer within 5-20 years

24
Q

What is CIN?

A 
Pre-invasive stage of cervical cancer 
Occurs in TZ 
Can involve large area
Dysplasia of squamous cell
Not visible by naked eye
Asymptomatic 
Detectable by cervical screening
25
What is the histology of CIN?
Delay in maturation/ differentiation; immature basal cells occupy more epithelium Nuclear abnormality; hyperchromasia, increased nucleocytoplasmic ratio, pleomorphism Excess mitotic activity; situated above basal layers, abnormal mitotic figures
26
How is CIN graded?
1 to 3
27
Describe CIN 1
Basal 1/3rd of epithelium occupied by abnormal cells Raised number of mitotic figures in lower 1/3rd Surface cells quite mature, but nuclei slightly abnormal
28
Describe CIN 2
Abnormal cells extend to middle 1/3rd Mitoses in middle 1/3rd Abnormal mitotic figures
29
Describe CIN 3
Abnormal cells occupy full thickness of epithelium | Mitosis, often abnormal in upper 1/3rd
30
What is the commonest form of cervical cancer?
Invasive squamous carcinoma
31
What will squamous carcinoma of the cervix arise from?
Pre-existing CIN therefore most cases should be preventable by screening
32
What is the staging system of invasive squamous carcinoma?
FIGO If lymph nodes involved; a lymphadenectomy will be done If tumour spread past cervix; radiochemo
33
What are the symptoms of invasive carcinoma?
Abnormal bleeding; post coital, post menopausal, brown or red stained vaginal discharge, contact bleeding Pelvic pain Haematuria/ urinary infections Ureteric obstruction/ renal failure
34
Where will squamous carcinoma of the cervix spread locally?
``` Uterine body Vagina Bladder Ureters Rectum ```
35
Where will squamous carcinoma of the cervix spread lymphatically?
Early to pelvic and para-aortic nodes
36
Where will squamous carcinoma of the cervix spread hematogenously?
Late; liver, lungs and bone
37
How is squamous carcinoma of the cervix graded?
Well differentiated Moderately differentiated Poorly differentiated Undifferentiated/ anaplastic
38
What is CGIN?
Cervical Glandular Intraepithelial Neoplasia Origin from endocervical epithelium Pre-invasive phase of endocervical adenocarcinoma
39
What is the epidemiology of endocervical adenocarcinoma?
``` 5-25% of cervical ca Increased incidence, particularly in young women Worse prognosis than squamous carcinoma Higher SE class Later onset of sexual activity Smoking HPV 18 incriminated ```
40
What are other HPV driven disease in the genital tract?
Vulvar intraepithelial neoplasia Vaginal intraepithelial neoplasia Anal intraepithelial neoplasia
41
What is dyskaryosis?
Abnormal nucleus found in a cervical smear sample
42
Who does vulvar intraepithelial neoplasia affect?
Bimodal; Young women; multifocal, recurrent, persistent Older women; greater risk of malignant transformation
43
What is VIN usually synchronous with?
CIN | VaIN
44
Who does vulvar invasive squamous carcinoma tend to affect?
Elderly women | Presents with an ulcer or exophytic mass
45
What is the most important prognostic factor for vulvar invasive squamous carcinoma?
Spread to inguinal lymph nodes
46
What is the treatment for vulvar invasive squamous carcinoma?
Radical vulvectomy | Inguinal lymphadenectomy
47
What is vulvar paget's disease?
Crusting rash Pinky balloon cells; mucinous cells involving epidermis Can spread along vulva, thigs, anus and vagina Tumour arises from sweat gland in skin
48
What infections can affect the vulva?
Candida; diabetics Vulvar warts (6 & q11) Bartholin's gland abscess
49
What are non-neoplastic epithelial disorders of the vulva?
Lichen sclerosis Lichen planus Psoriasis
50
Who can vulvar atrophy affect?
Post menopausal women; treat with topical oestrogen
51
What pathology can affect the vagina?
VaIN Squamous carcinoma Melanoma; appears as a polyp
52
What is the management of women with a borderline dyskaryosis at a cervical smear?
Lab perform a reflex high HPV test on cytology; If HPV +ve, woman referred for colposcopy within 6 weeks If HPV -ve; returned to routine screening
53
What is the management of women with high grade dyskaryosis/ suspected invasive cancer at a cervical smear?
Referred to colposcopy for app within 2 weeks
54
What is colposcopy?
Cervix is assessed in detail using colposcopy
55
What is the colposcopist looking for at colposcopy?
Abnormal changes in cervix which may indicate pre-cancerous changes (CIN)
56
How is CIN identified at colposcopy?
Acetic acid can be applied and abnormal areas turn white | If iodine applied; normal tissue stains dark brown and precancerous will not stain
57
What happens following an inadequate cervical cytology sample/
Repeat cervical cytology no less than 3 months after If 3 consecutive cervical cytology samples are inadequate, the woman should be referred to colposcopy for an app within 6 weeks

Repro and Sexual Health (77 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions