Pathology of the Cervix, Vulva and Vagina

Question 1

Which strains of HPV are responsible for the majority of cervical cancers in Scotland?

Answer 1

HPV 16 and 18

Question 2

12-13 year old girls in Scotland are vaccinated against which strains of HPV?

Answer 2

6, 11, 16 and 18

Question 3

The HPV vaccination programme in Scotland is now also going to be offered to boys. T/F?

Answer 3

True

Question 4

As well as cervical cancer, which cancer can be caused by HPV infection?

Answer 4

Oropharyngeal cancer

Question 5

Most HPV infection will progress to CIN or cancer. T/F?

Answer 5

False

Question 6

What factors other than HPV infection can influence the progression from CIN to cervical cancer?

Answer 6

Smoking

Question 7

What is meant by the term ‘dyskaryosis’?

Answer 7

Nuclear abnormality

Question 8

If CIN grade 2 or 3 is found on cervical screening, what is the next step?

Answer 8

Colposcopy

Question 9

CIN in the cervix will result in symptoms. T/F?

Answer 9

False - it is assymptomatic

Question 10

Women of what age are invited for cervical screening in Scotland?

Answer 10

25-65

Question 11

How often are women in Scotland invited for cervical screening?

Answer 11

Every three years between the ages of 25-50 and every five years for ages 50-65

Question 12

If there are borderline nuclear abnormalities on cervical screening then what is the next step?

Answer 12

Screening repeated after 6 months

Question 13

What grade of dyskaryosis is CIN 1 most likely to correspond to?

Answer 13

Low grade dyskaryosis

Question 14

What grade of dyskaryosis is CIN 2 most likely to correspond to?

Answer 14

Medium grade dyskaryosis

Question 15

What grade of dyskaryosis is CIN 3 most likely to correspond to?

Answer 15

High grade dyskaryosis

Question 16

What technique is used in cervical screening for HPV testing?

Answer 16

Liquid based cytology

Question 17

What substance is used to visualise the transformation zone of the cervix on colposcopy?

Answer 17

Acetic acid

Question 18

What are the potential symptoms of cervical cancer?

Answer 18

Post-coital bleeding
Intermenstrual bleeding
Irregular vaginal bleeding and pain

Question 19

Cervical cancer can be assymptomatic. T/F?

Answer 19

True

Question 20

Invasive squamous carcinoma of the cervix almost always develops from pre-existing CIN. T/F?

Answer 20

True

Question 21

All CIN will progress to squamous cancer. T/F?

Answer 21

False

Question 22

Which types of CIN are most likely to progress to cancer?

Answer 22

CIN 2 and 3

Question 23

What are the immediate complications of the treatment of cervical cancer?

Answer 23

Pain and haemorrhage

Question 24

What are the delayed complications of the treatment of cervical cancer?

Answer 24

Secondary haemorrhage
Infection
Cervical stenosis

Question 25

The treatment of cervical cancer can impact fertility. T/F?

Answer 25

False - treatment should not affect fertility

Question 26

Atrophic vaginitis is associated with a low oestrogen level. Thus, women of what age are most likely to have atrophic vaginitis?

Answer 26

Post-menopausal women

Question 27

What are the symptoms of atrophic vaginitis?

Answer 27

``` Discomfort Dyspareunia Bleeding Polyps Cysts ```

Question 28

Primary cancers of the vagina are common. T/F?

Answer 28

False - these are rare, however cancer of the cervix or vulva can involve the vagina

Question 29

Give examples of infections which can affect the vagina

Answer 29

``` Herpes simple virus Actinomyces Bacterial vaginosis Thrush Trichomanoas vaginalis ```

Question 30

Candidiasis (thrush) of the vulva is common. What can this be associated with?

Answer 30

Pregnancy | Diabetes

Question 31

Bartholin's vestibular gland cysts may become infected with abscess formation. T/F?

Answer 31

True

Question 32

What age of women are usually affected by vulvar cancer?

Answer 32

Vulvar cancer almost exclusively occurs in women less than 60 years old

Question 33

Vulvar cancer causes warty or basaxoid cancers. T/F?

Answer 33

True

Question 34

Vulvar cancers associated with dermatoses can occur in an older age group. T/F?

Answer 34

True

Question 35

Vulvar cancers associated with dermatoses is caused by HPV infection. T/F?

Answer 35

False

Question 36

What is the term for dysplasia of the vulva?

Answer 36

Vulva intra-epithelial neoplasia

Question 37

Lichen sclerosis is a non-infective inflammation is linked the vulval squamous carcinoma. T/F?

Answer 37

True

Question 38

The majority of vulval cancers are HPV dependent. T/F?

Answer 38

False - only about 20% of vulval cancers are HPV dependent