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Y3 Reproduction > Pathology - Vulva, Cervix and Vagina > Flashcards

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
Q

where can cervical invasive squamous carcinoma spread to locally?

A 
uterine body
vagina
bladder
ureters 
rectum
26
Q

when does lymphatic spread occur in cervical invasive squamous carcinoma?

A

early in disease

27
Q

where can cervical invasive squamous carcinoma spread via the lymphatic route?

A

pelvic and para-aortic nodes

28
Q

when does haematogenous spread occur in cervical invasive squamous carcinoma?

A

late in disease

29
Q

where can cervical invasive squamous carcinoma spread via the haematogenous route?

A

liver
lungs
bone

30
Q

what are the four grades of cervical invasive squamous carcinoma?

A

well differentiated
moderately differentiated
poorly differentiated
undifferentiated/anaplastic

31
Q

what does CGIN stand for?

A

cervical glandular intraepithelial neoplasia

32
Q

where does CGIN originate?

A

endocervical epithelium of the cervix

33
Q

what is the preinvasive phase of endocervical adenocarcinoma?

A

CGIN

34
Q

what are some risk factors for endocervical adenocarcinoma?

A

higher SE class
later onset of sexual activity
smoking
HPV

35
Q

what does VIN stand for?

A

vulval intraepithelial neo[lasia

36
Q

what is VIN a precursor for?

A

HPV driven SCC of the vulva

37
Q

who is most commonly affected by vulvar invasive squamous carcinoma?

A

elderly women

38
Q

how does vulvar invasive squamous carcinoma present?

A

ulcer or exophytic mass

39
Q

what is the most important prognostic factor for vulvar invasive squamous carcinoma?

A

spread to inguinal lymph nodes

40
Q

what is the surgical treatment for vulvar invasive squamous carcinoma?

A

radical vulvectomy and inguinal lymphadenectomy

41
Q

how does vulvar Paget’s disease present?

A

crusting rash
pruritis
pain

Y3 Reproduction (49 decks)

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