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Reproduction > Pathology of the Cervix, Vulva and Vagina > Flashcards

Pathology of the Cervix, Vulva and Vagina Flashcards

1
Q

What are the cell layers of the normal ectocervix?

A

exfoliating; superficial; intermediate; parabasal; basal; basement membrane

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2
Q

What type of epithlium is ectocervical?

A

squamous

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3
Q

What type of epithelium is the endocervical epithelia?

A

columnar

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4
Q

What does the position of TZ change in response to?

A

menarche; pregnnayc; menopause

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5
Q

What si the transformation zone?

A

squamou-columnar junction between ectocervical and endocevical epithelia

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6
Q

What is a cervical erosion?

A

exposure of delicate endocervical epithelium to acid environemnt of vagina leads to physiologyical squamous metaplasia

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7
Q

Why can cervicitis lead to infertility?

A

pt is often asymptomatic and can often have simultaneous silent fallopian tube damage

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8
Q

What folllicular cervicitis?

A

sub epithelial reactive lymphoid follicles present in cervix

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9
Q

What are hte cases of cervicitis?

A

chlamydia and HSV

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10
Q

What is a cervical polyp?

A

localised inflammatory outgrowth

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11
Q

What is the prognosis of a cervical polyp?

A

not premalignant

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12
Q

When can cervical polyps cause bleeding?

A

if ulcerate

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13
Q

What are the types of cervical caner?

A

squamous carcinoma; adenocarcinoma

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14
Q

What are hte risk factors for CIN and cervical cancer?

A

high risk HPV (16 and 18)- many partenrs increases this risk; vulnerability of SC junction in early repro life; smoking; immunosuppression

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15
Q

What can cahnge the vulnerability of the SC junction in early repro life?

A

age at first intercourse; long term use of COP’;non-use of barrier contraception

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16
Q

What types of HPV cause genital warts?

A

6 and 11

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17
Q

What other name are genital warts known by?

A

condyloma acuminatum

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18
Q

Dscribe the histopathology of genital warts?

A

thickened papillomatous squamous peithlium with cytoplasmic vaculoation====koilocytosis

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19
Q

What is seen on histopathology with cervical intraepithelial neoplasia?

A

infection epithelium reamins flat but may show koilocytosis which can be detected in cervical smears

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20
Q

What causes invasive squamous carcinoma?

A

virus has integrated into host DNA

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21
Q

How long does it take HPV infection to become a high grade CIN?

A

6 months - 3years

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22
Q

How long does it take a high grade CIN to become an invasive cancer?

A

5-20 years

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23
Q

What is the cumulative prevalence of HPV infection?

A

80%

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24
Q

What is CIN?

A

pre-invasive stage of cervical cancer

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25
Q

Where does cervical intraepithelial neoplasia?

A

transformtion zone

26
Q

what factors are invovled in grading CIN on histology?

A

delay in maturation/differentiation; nuclear abnormalities; excess mitotic activity

27
Q

What is seen with a delay in maturation.differentiation?

A

immature basal cells occupying more of epithelium

28
Q

What nuclear abnormalties are seen in CIN?

A

hyperchomasia; increased nucleocytoplasmic ratio; pleomorphism

29
Q

What is excess mitotic activity?

A

situated above basal layers; abnormal mitotic forms

30
Q

What is CIN 1 defined as?

A

basal 1/3rd of epithlium occupied by abnormal cells; surface cells uite mature but nuclei slightly abnormal

31
Q

What is CIN2 defined as?

A

abnormal cells extend to middle 1/3rd

32
Q

What is CIN3 deinfed as?

A

abnormal cells occupy full thickenss of epithlium

33
Q

What isthe most common type of cervical cancer?

A

invasive squmous carcinoma

34
Q

What does invasive squmoua carinoma develop from?

A

pre-existing CIN

35
Q

What is stage 1A1 of invasive squamous carcinoma of cervix ?

A

depth upto 3mm; width upto 7mm

36
Q

What is stage 1A2 of invasive squamous carinoma of cervix?

A

depth upto 5mm, width upto 7mm

37
Q

What is stage 1B of invasive squmous carcinoma of hte cervix?

A

confined to cervix

38
Q

Waht is stage 2 of invasive squmous carcinoma of hte cervix?

A

spread to adjacent organs

39
Q

What is stage 3 of invasive squmous carcinoma of hte cervix?

A

involvemtn fo pelvic wall

40
Q

What is stage 4 of invasive squmous carcinoma of hte cervix?

A

distant mets or involvemtn of rectum or bladder

41
Q

What are the symtpoms of invasive carinoma of the ervix?

A

abnormal bleeding; pelvic pain; haematuria/UTIs; ureteric obstruction/renal failure

42
Q

What type of abnormal bleeding can you get with cervical cancer?

A

post-coital; post-menopausal; brownish or blood stained vaginal discharge; contact bleeding-friable epithelium

43
Q

What is the local spread of squmous cervical carcinoma?

A

uterine body; vagina; bladder; uretersl rectum

44
Q

What is the early spread of squmous carcinoma of the cervix?

A

lymphatic–pelvic and para-aortic nodes

45
Q

What is hte late spread of cervical squmous carcinoma?

A

haematogenous

46
Q

What does cervical glandular intraepithelial neoplasia originate from?

A

endocervical epithelium

47
Q

What is CGIN the preinvasive phase for?

A

endocervical adenocarcinoma

48
Q

What is the prognosis of adenocarinoma vs squmous carinoma of the cervix?

A

worse compared to squamosu

49
Q

What are the RF for adenocarincoma of the cervix?

A

higher SE class; later onset of sexual activity; smoking; esp. HPV 18

50
Q

What are the other pelvic HPV driven disease?

A

vulvar intraepithelial neoplasia; vaginal intraepithelial neoplasia; anal intraepithelial neoplasia

51
Q

What is vulval intraepithelial neoplasia like in young women?

A

often multifocal, recurrent or persisten causing treatment problems

52
Q

what is vulvar intraepithelial neoplasia like in old women?

A

greater risk of pgression to invasive squamous carcinoma

53
Q

What nodes does vulvar invasive squamous carcinoma ten to spread to?

A

inguinal lymph ndoes

54
Q

What is the most important prognostic factor in vulvar invasive squmous carcinoma?

A

spread to inguinal nodes

55
Q

Who gets vulvar invasive squmoua carcinoma?

A

elderly women

56
Q

What is the appearnace of vulvar squmoua carcinoma?

A

ulcer or exophytic mass

57
Q

What does vulvar squmous carcinoma arise from?

A

normal epithelium or VIN

58
Q

What is seen with vulvar Paget’s disease?

A

crusting rash

59
Q

What is found within the vulvar Paget’s disease?

A

mucin

60
Q

What does the tumour in vulvar pagets disease arise from?

A

sweat gland in skin

61
Q

What may be foudn if a patient has vaginal intraepithelaila neoplasia?

A

also have cervical and vulval lesions

62
Q

How may melanomain the vagina appear?

A

polyp

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