PCB Flashcards
What is PCB ?
A PCB is any Bleeding that occurs immediately after sex, unless if it’s your first time which is normal
All PCBs are what ?
All PCBs are cervical carcinomas until proven otherwise
When a women presents with a PCB, what 2 things should do ?
Perform an examination of cervix and cervical smear
After performing the relevant investigations for a PCB, you get an abnormal result; what do you do then ?
Refer for Colposcopy
For a PCB, you must do a screen to rule out a sexual infection, what is it ?
Screen for chlamydia and treat if positive
What are the 3 common differentials for PCB ?
Cervical carcinoma, cervical polyps and cervical ectropion
cervical carcinomas are 90% what and are a few of what are Cervical carcinomas ?
Cervical cancers are 90% SCC and a few are adenocarcinomas
Why is the incidence of cervical cancer decreasing ?
Due to cervical cancer screen
What is the mnemonic for the risk factor for cervical cancer ?
What are the risk factors for cervical cancer ?
HIPS C
HPV types 16, 18, and 31; 13 high risk exposure; High parity
Immunocompromised individuals: long term steroids, HIV, transplant patients
Promiscuity: multiple partners
Smoking
COCP
What is the mnemonic for the spread of cervical cancer ?
Where can cervical cancer spread to ?
BRUV; Bladder, rectum, uterus and vagina
What is the incidence for cervical cancer ?
Bimodal (30s,80s)
What is the peak age incidence for cervical cancer ?
25-49
How does cervical cancer present (2) ?
PCB or IMB/HMB or rarely PMB
Offensive vaginal discharge
What are the late signs of cervical cancer ? (2)
Haematuria or rectal pain and bleeding
What will you find on examination of a patient with cervical cancer ?
Initially, cervix appears normal then becomes ulcerated and is replaced by an irregular mass
If abnormal cervix examination and smear, what’s the next step ?
Refer for colposcopy
What are the 3 investigations done for cervical cancer including staging ?
Bloods: FBC, U and Es
Imaging: Punch biopsy and CXR
Staging: EUA, colposcopy and MRI Pelvis
Why is EUA (examination under anaesthetic) less often used ?
EUA is less often used as MRI is more accurate
Treatment of cervical cancer depends on the stage, what are the different stages ?
Stage 1: lesions confined to the cervix; Stage 2: invasion of Vagina but not pelvic side wall; Stage 3: invasion of lower vagina or pelvic wall or causing uteric obstruction; Stage 4: invasion of bladder or rectal mucosa or beyond the true pelvis
What is the treatment for cervical cancer stage 1ai ?
Cone biopsy or simple hysterectomy
What is the treatment for cervical cancer stage 1aii-1bi ?
Laparoscopic Lymphadectomy (confirm LNs -ve) and radical tracheloctomy (to preserve fertility)
What is the treatment for cervical cancer stage 1bii-2a ?
Radical hysterectomy (if LNs -ve) or chemoradiothwrapy (if LNs +ve)
What is another name for radical hysterectomy ?
Wertheim hysterectomy
What is the treatment for cervical cancer stage, 2b-4?
Chemo-radiotherapy alone
What is the prognosis of cervical cancer and what does this depend on (3) ?
Lymph node involvement clinical staging and histological grading
What is cervical ectropion?
Red area of columnar epithelium around the os
Cervical ectropion is common in those that what ? (2)
Young and on the COCP
How would a cervical ectropion present ?
Usually asymptomatic; PCB with/without vaginal discharge
What is the treatment for cervical ectropion? (2)
Cryotherapy or diathermy
What is a cervical polyp ?
Benign tumour
Cervical polyps are common in what age group ?
In those over 40
How does a cervical polyp present ? (1)
PCB (usually on contact) or IMB/PMB
How does the PCB usually occur in a cervical polyp ?
On contact; so during sex
How would you treat a cervical polyp ? (1)
Avulse and sent for histology
What are the groups of other causes ?
Cervicitis (chronic or acute) and infection (PID)
Why does acute cervicitis usually occur and what is the treatment ?
Rare and occurs due infection and RX: Abx
Why does chronic cervicitis usually occur ? (2)
Due infectionand inflammation of ectropion
chronic cervicitis is a common cause of ?
Increased vaginal discharge
What is the treatment for chronic cervicitis?
Abx with/without cryotherapy/ diathermy
What 3 infections can cause PCB ?
Chlamydia, gonorrhoea, trichomoniasis
Which is more common during pregnancy: cervical polo or ectropion
Ectropion
