Premalignant Management of CeCa

Question 1

Ectocervix epithelium

Answer 1

Stratified squamous

Question 2

Endocervix epithelium

Answer 2

Columnar

Question 3

Describe how transition zone is formed x3

Answer 3

Edema caused by estrogen> endocervix moving out and being exposed to harsh environment> squamous metaplasia > formation of new SCJ
Transition zone is Between new and old SCJ

Question 4

Target groups for CeCa screening X4

Answer 4

Non pregnant women
Age>25yrs
STI clients with AVD
Women attending STI/FP clinics who request it

Question 5

CECA screening techniques x4

Answer 5

VIA
VILI/ Schillers test
Pap smear
HPV DNA testing

Question 6

VIA findings of CECA suspicion

Answer 6

Ulcerative cauliflower like growth, oozing or bleeding with contact

Question 7

Bethesda grading of results x4

Answer 7

1. Atypical squamous cells of undetermined significance
2. Low grade Sq intraepithelial lesion - CIN1
3. High grade Sq intraepithelial lesion- CIN2+
4. Sq CC

Question 8

4 CECA ablation methods

Answer 8

Cryotherapy
Laser ablation
Electro diathermy
Thermal/cold coagulation

Question 9

5 types of excision procedures

Answer 9

Laser excision
Hysterectomy
Cold knife conization
Loop electrosurgical excision procedure (LEEP)
Large loop excision of TZ (LLETZ)

Question 10

3 types of refrigerants in cryotherapy

Answer 10

NO
CO2
Liquid nitrogen

Question 11

Management of HSIL x2

Answer 11

LEEP
Hysterectomy

Question 12

Factors affecting hysterectomy x5

Answer 12

Old parous women
HIV positive with high grade CIN
Failure to follow up
In situ adenocarcinoma of cervix
Persistent HSIL regardless of other treatments

Question 13

Patients eligible for cryotherapy if x3

Answer 13

Entire lesion visible
Entire SCJ visible
Lesion <75% of ectocervix

Question 14

When to rescreen according to CIN stages x2

Answer 14

i- 3 years
ii, iii- 1 year