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Year 2 Medicine > Pathology of the Female Reproductive Tract 2 > Flashcards

Pathology of the Female Reproductive Tract 2 Flashcards

1
Q

For some malignant neoplasms a ‘pre-malignant’ state is identified - What is this state termed?

A

Dysplasia

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2
Q

Dysplasia

A
  • 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
  • Dysplastic lesions may (but don’t always) progress to invasive malignancy
  • Recognising dysplastic lesions allows early treatment before invasion occurs
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3
Q

Define Dysplasia

A

disordered growth and differentiation characterised by increased proliferation (more mitoses), atypia of cells and decreased differentiation

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4
Q

Dysplastic lesions may (but don’t always) progress to invasive …

A

Dysplastic lesions may (but don’t always) progress to invasive malignancy

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5
Q

Recognising … lesions allows early treatment before invasion occurs

A

Recognising dysplastic lesions allows early treatment before invasion occurs

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6
Q

… on the left, … on the right

A

Stratified Squamous epithelium- left, dysplastic epihelium - right

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7
Q

Dysplasia has lots of different terminology for the same process - e.g for cervix:

A
  • Generic: Dysplasia
  • UK: Cervical intra-epithelial neoplasia (CIN)
  • US: Squamous intra-epithelial lesion (SIL)
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8
Q

Different degrees of dysplasia may be recognised microscopically

A
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9
Q

The … of dysplasia may predict the likelihood of developing invasive malignancy

A

The degree of dysplasia may predict the likelihood of developing invasive malignancy

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10
Q

Dysplasia often occurs in sites where there is …

A

Dysplasia often occurs in sites where there is metaplasia

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11
Q

Dysplasia often occurs in sites where there is metaplasia

  • squamous metaplasia of the cervical … zone
  • squamous metaplasia of the … epithelium
  • glandular metaplasia of the … oesophagus
A
  • squamous metaplasia of the cervical transformation zone
  • squamous metaplasia of the bronchial epithelium
  • glandular metaplasia of the distal oesophagus
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12
Q

Cells at the surface of … epithelium are different from those at the surface of normal epithelium

A

Cells at the surface of dysplastic epithelium are different from those at the surface of normal epithelium

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13
Q

What degree of dysplasia? (CIN I,II OR III)

A

CIN I

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14
Q

What degree of dysplasia? (CIN I,II OR III)

A

CIN II

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15
Q

What degree of dysplasia? (CIN I,II OR III)

A

CIN III

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16
Q

For CIN1, the risk of progression to CIN 3 is… and to Squamous cell carcinoma is…

A

11, to SCC is 1

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17
Q

For CIN2, the risk of progression to CIN 3 is… and to Squamous cell carcinoma is…

A

22, SCC 5

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18
Q

For CIN3, the risk of progression to Squamous cell carcinoma is…

A

40%

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19
Q

What is a PAP test?

A
  • Sampling cells from surface of the cervix
    • Pap tests detect abnormal cervical cells, including precancerous cervical lesions, as well as early cervical cancers.
20
Q

Normal constituents of a smear

  • What 3 cell types? (arrows)
A
  • Endocervical cells (top)
  • Squamous cells (middle)
  • Metaplastic cells (bottom)
21
Q

Normal surface cells have a … nucleus and lots of … (cervix)

A

Normal surface cells have a small nucleus and lots of cytoplasm

22
Q

Dysplastic cells have a higher ratio of … size to … volume, and the nuclei show the same features that we associate with … (Cervix)

A

Dysplastic cells have a higher ratio of nuclear size to cytoplasmic volume, and the nuclei show the same features that we associate with malignancy (Cervix)

23
Q

Normal or dysplastic cells? (Cervix)

A

dysplastic (large nucleus, small cytoplasm vol)

24
Q

The difference between dysplasia and carcinoma is invasion through the … …

A

The difference between dysplasia and carcinoma is invasion through the basement membrane

25
Q

… infection causes CIN and cervical cancer

A

HPV infection causes CIN and cervical cancer

26
Q

Human Papillomavirus

  • Human Papillomaviruses (HPVs) infect …
  • Confined to … site of infection without viraemia
  • Over … HPV types, some of which infect the anogenital mucosa
  • … stranded DNA virus 7.9Kbp
A
  • Human Papillomaviruses (HPVs) infect epithelium
  • Confined to local site of infection without viraemia
  • Over 130 HPV types, some of which infect the anogenital mucosa
  • Double stranded DNA virus 7.9Kbp
27
Q

HPVs may be grouped according to … association with …

A

HPVs may be grouped according to risk association with malignancy

28
Q

HPVs may be grouped according to risk association with malignancy

  • High Risk HPV
    • 16,18,31,33,35,39,45,51,52,56,58,59,68
  • Low Risk HPV
    • 6,11,40,42,43,44,54,61,72,81
A
  • High Risk HPV
    • 16,18,31,33,35,39,45,51,52,56,58,59,68
  • Low Risk HPV
    • 6,11,40,42,43,44,54,61,72,81
29
Q

Strategies to prevent cervical cancer

  • …. Vaccination
  • Population based …
    • Cervical sample … test
    • Cervical sample …
  • …scopy
  • Treatment of high grade …
  • Large Loop Excision of the … Zone
A
  • HPV Vaccination
  • Population based screening
    • Cervical sample HPV test
    • Cervical sample cytology
  • Colposcopy
  • Treatment of high grade dysplasia
  • Large Loop Excision of the Transformation Zone
30
Q

HPV positive oropharnygeal cancer increases: Cervical cancer prevented by screening

A
31
Q

Cervical cancer is predominantly a disease of the … world

A

Cervical cancer is predominantly a disease of the developing world

32
Q

Main 2 types of High Risk HPV …

A

16, 18

33
Q

Main 2 types of Low Risk HPV …

A

6,11

34
Q

… cancer is presently most common in North America and Europe

A

Endometrial cancer is presently most common in North America and Europe

35
Q

The incidence of cervical cancer has been … (in europe)

A

The incidence of cervical cancer has been declining (in europe)

36
Q

The reduction in incidence of cervical cancer has been paralleled by reduced …

A

The reduction in incidence of cervical cancer has been paralleled by reduced mortality

37
Q

Age specific mortality rates - cervical cancer

A
38
Q

What is a colposcopy?

A

Colposcopy is a medical diagnostic procedure to examine an illuminated, magnified view of the cervix as well as the vagina and vulva.

39
Q

The incidence and mortality of cervical cancer in the UK have …, particularly since the early 1980s

A

The incidence and mortality of cervical cancer in the UK have decreased, particularly since the early 1980s

40
Q
  • The incidence and mortality of cervical cancer in the UK have decreased, particularly since the early 1980s
  • In the UK this follows the introduction of the …
A
  • The incidence and mortality of cervical cancer in the UK have decreased, particularly since the early 1980s
  • In the UK this follows the introduction of the NHS cervical screening programme
41
Q

What is the birth cohort effect?

A

The birth cohort effect is defined as the variation in the prevalence of age-related maculopathy that arises from the different exposures of each birth cohort.

42
Q

Cervical Cancer - Birth Cohort Effect

A
  • The incidence and mortality of cervical cancer in the UK have decreased, particularly since the early 1980s
  • In the UK this follows the introduction of the NHS cervical screening programme
  • 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
43
Q

… vaccination is creating new birth cohorts

A

HPV vaccination is creating new birth cohorts

44
Q

Age standardised incidence rates of endometrial cancer (UK 1993-2016)

A
45
Q

Age specific incidence rates. - cervical cancer

  • 2 peaks represent …
A

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

Year 2 Medicine (162 decks)

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