Pathology - Vulva, Cervix and Vagina Flashcards

1
Q

what two cells are normally seen on a cervical smear?

A

cervical squamous cells

endocervical cells

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2
Q

what is cervicitis?

A

inflammation of the cervix

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3
Q

how does cervicitis often present?

A

often asymptomatic

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4
Q

how can cervicitis cause infertility?

A

causes silent Fallopian tube damage

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5
Q

what is a cervical polyp?

A

localised inflammatory outgrowth in the cervix

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6
Q

when can cervical polyps bleed?

A

if they become ulcerated

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7
Q

what is CIN?

A

cervical intraepithelial neoplasia

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8
Q

how long does it take for HPV infection to cause high grade CIN?

A

6 months - three years

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9
Q

how long does it take for high grade CIN to progress to invasive cancer?

A

5-20 years

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10
Q

what is the pre-invasive stage of cervical cancer called?

A

CIN

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11
Q

where does CIN occur?

A

the transformation zone of the cervix

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12
Q

what is the pathological process behind CIN?

A

dysplasia of cervical squamous cells

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13
Q

how does CIN present?

A

asymptomatic

detected on smear testing

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14
Q

what is seen on histology of CIN?

A

immature basal cells occupying more of the epithelium than normal

nuclear abnormalities

excess mitotic activity

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15
Q

what nuclear abnormalities can be seen in CIN?

A

hyperchromasia
increased nuclear:cytoplasmic ratio
pleomorphism

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16
Q

what are the grades for CIN?

A

I
II
III

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17
Q

define CIN I

A

abnormal cells in the basal third of the epithelium

18
Q

define CIN II

A

abnormal cells extend into the middle third of the epithelium

19
Q

define CIN III

A

abnormal cells occupying the full thickness of the epithelium

20
Q

what are some risk factors for cervical cancer?

A

high risk HPV infection
smoking
immunosuppression

21
Q

what is the most common malignant cervical tumour?

A

cervical invasive squamous carcinoma

22
Q

what does cervical invasive squamous carcinoma develop from?

A

pre-existing CIN

23
Q

how can cases of cervical invasive squamous carcinoma be prevented?

A

detection of CIN on screening

24
Q

what are the possible symptoms of cervical invasive squamous carcinoma?

A
abnormal bleeding 
pelvic pain 
Haematuria 
UTIs
ureteric obstruction 
renal failure
25
where can cervical invasive squamous carcinoma spread to locally?
``` uterine body vagina bladder ureters rectum ```
26
when does lymphatic spread occur in cervical invasive squamous carcinoma?
early in disease
27
where can cervical invasive squamous carcinoma spread via the lymphatic route?
pelvic and para-aortic nodes
28
when does haematogenous spread occur in cervical invasive squamous carcinoma?
late in disease
29
where can cervical invasive squamous carcinoma spread via the haematogenous route?
liver lungs bone
30
what are the four grades of cervical invasive squamous carcinoma?
well differentiated moderately differentiated poorly differentiated undifferentiated/anaplastic
31
what does CGIN stand for?
cervical glandular intraepithelial neoplasia
32
where does CGIN originate?
endocervical epithelium of the cervix
33
what is the preinvasive phase of endocervical adenocarcinoma?
CGIN
34
what are some risk factors for endocervical adenocarcinoma?
higher SE class later onset of sexual activity smoking HPV
35
what does VIN stand for?
vulval intraepithelial neo[lasia
36
what is VIN a precursor for?
HPV driven SCC of the vulva
37
who is most commonly affected by vulvar invasive squamous carcinoma?
elderly women
38
how does vulvar invasive squamous carcinoma present?
ulcer or exophytic mass
39
what is the most important prognostic factor for vulvar invasive squamous carcinoma?
spread to inguinal lymph nodes
40
what is the surgical treatment for vulvar invasive squamous carcinoma?
radical vulvectomy and inguinal lymphadenectomy
41
how does vulvar Paget's disease present?
crusting rash pruritis pain