Screening Flashcards
explain early disease detection
discovering/treating conditions which have already produced pathological changes but haven’t reached a stage needing immediate medical aid
name 5 principles for early disease detection
condition should be important
disease should have accepted treatment
recognisable latent/early stage
suitable test/exam
complete disease history must be understood
what is a main underlying cause of cervical cancer?
a high risk subtype of HPV
where does HPV replicate and what does it produce?
replicates in maturing squamous cells
produces koilocytes
what is the DNA difference in high risk and low risk HPV?
low risk - free viral DNA within the cell
high risk - incorporates DNA into host cell genome
what do E6 and E7 proteins do?
reactivates cell cycle in non-proliferating cells
how are CIN and CGIN formed?
persistent infection or cell cycle disruption in epithelial cells without an external stimulus causes precursor lesions
what is the difference in severity in the 3 different types of precursor lesions?
CIN1 - not that serious
CIN2/3 - at risk for cervical cancer
what is tested for in cervical cancer screening?
tested for HPV
cytology (if HPV+)
what is the difference between normal and abnormal cells when testing for cytology?
abnormal cells have enlarged and misshaped nuclei, and not as much cytoplasm
what is the term for the presence of abnormal cells in cytology?
dyskaryosis
what is colposcopy?
examination of the cervix using a specialist microscope
acetic acid applied to highlight abnormalities
how often is bowel screening tests carried out?
every 2 years in people between 50-74
how often is breast screening carried out?
every 3 years in women aged between 50 and 70
what is the test for breast cancer?
x-rays to both breasts
what is the test for bowel screening?
fecal immunochemical test testing for haemoglobin
what is the midwife responsible for in pregnancies?
care for expecting mothers and baby during pregnancy
care for mother/baby during labour and birth
health visitor takes over after birth
when are pregnancy scans offered?
week 12 - dating scan
week 20 - anomaly scan
how many appointments are provided for pregnant woman with their midwife?
first pregnancy - 7
otherwise - 5
what risk factors in the pregnant woman are initially tested by the midwife?
BP, pre-eclampsic features, mental health, BMI, gestational diabetes
describe what is looked at in the dating and anomaly scans
dating - baby development stage
anomaly - bones, heart, spine, face, kidneys, abdomen (looking for abnormalities)
what is the difference between screening and diagnostic tests?
screening - shows high chance of abnormality
diagnostic - shows whether abnormality is present
name some possible screening tests a pregnant woman can recieve
blood tests
prenatal ultrasounds
combined tests for downs (T21), edwards (T18) and patau’s (T13) syndrome
explain chorionic villous sampling
sample from the placenta taken will contain the same chromosome complement as the fetus
carried out between 11-14 weeks gestation
1% miscarriage risk
explain amniocentesis
samples amniotic fluid which contains fetal cells
cells grown in culture and chromosomes analysed to look for downs syndrome or cyctic fibrosis
carried out 15 weeks gestation
1% miscarriage risk
explain non-invasive prenatal testing
cell-free DNA testing
cell free fetal DNA migrate into maternal bloodstream through the apoptotic trophoblast cells shedding from placental tissue
blood test taken after 10 weeks gestation
what are the components of first trimester combined screening?
maternal age
nuchal translucency
free beta HCG
pregnancy associated plasma protein A (PAPPA)
what is nuchal translucency?
a fluid filled fold at the back of the neck is enlarged in downs syndrome (3mm+)
is only present during first trimester pregnancy so must be assessed before 12 weeks
name alternate risk factors for abnormalities in pregnancy markers
gestation
maternal weight
multiple pregnancies
smoking
ethnicity
IVF
previous downs syndrome pregnancy
what are chromosomal anomalies?
any changes to a persons chromosome complement
what is trisomy?
3 copies of a particular chromosome instead of 2
what is the most common reason for trisomy to occur?
non-disjunction of gametes in meiosis
(both chromosomes end up in the same cell)
what are the general symptoms of downs syndrome?
learning difficulties, slanting eyelids, small nose, large tongue, low set ears, single palmar crease
what conditions are downs syndrome patients at a higher risk of?
heart conditions
infections
epilepsy
GI issues
hypothyroidism
eyesight/hearing
what are the main clinical features of edwards syndrome?
learning difficulties, low birth weight, decreased muscle tone, low set ears, club feet, overlapping fingers
what are the severe side effects of edwards syndrome?
congenital heart/kidney disease, breathing issues, GI defects, hernias
what are the clinical features of patau’s syndrome?
learning difficulties, microphthalamia, cleft lip/palate, extra digits, low muscle tone
what is the most common severe defect in patau’s syndrome?
severe heart difficulties
