Pathology Of The Cervix, Vulva And Vagina Flashcards
1
Q
List the epithelia types in the gynaecological system
A
- endocervix: glandular mucosa (columnar epithelia)
- ectocervix: squamous
- physiological squamous metaplasia occurs in transition zone
2
Q
What is the purpose of cervical screening?
A
Designed to pick up precancerous changes in cervical smears (dyskaryosis = CIN) so patients can be referred for colposcopy (examination and biopsy of the cervix) and treatment
3
Q
Define dyskaryosis
A
- nuclear enlargement
- dense hyperchromasia
- coarse chromatin clumping
4
Q
Describe the possible outcomes and plans of action of cervical smear results
A
- negative = repeat in 3 years
- borderline = repeat in 6 months (if 3 = refer for colposcopy)
- dyskaryosis = refer for colposcopy
- shows feature of invasion = urgent referral
5
Q
What is koilocytosis?
A
- area of space around the nuclei
- abnormal nuclei
- marker of HPV infection
6
Q
What is cGIN?
A
- endocervical glandular epithelium premalignant change
- malignant change = adenocarcinoma
- HPV associated
7
Q
What are the symptoms of cervical cancer?
A
- post-coital bleeding
- intermenstrual bleeding
- irregular vaginal bleeding
- pain
- none
8
Q
What are the risk factors for cervical cancer?
A
- HPV
- age of first sexual intercourse (early)
- number of sexual partners
- smoking
- OCP
- immunosuppression
- circumcision in males protective
9
Q
What is the treatment for cervical cancer?
A
- dependent on clinical stage
- early = surgical through LETZ, or simple/radical hysterectomy
- advanced = chemo/radiotherapy
10
Q
What increases the risk of vulval inflammation?
A
Skin conditions that affect hair-bearing skin like psoriasis or eczema
11
Q
Describe invasive squamous cell carcinoma of the vulva
A
- most common type of vulval cancer
- associated with a precancerous stage VIN
- can be associated with CIN/invasive cervical cancer
- can be warty/basaloid
12
Q
Describe vulval cancer associated with dermatoses
A
- most well differentiated and keratinising
- not associated with HPV/VIN
- usually adjacent squamous hyperplasia and/or lichen sclerosus atrophicus (can be preceded by leukoplakia)
