Sketchy Path: Reproductive & GU - "Cervical Neoplasia"

Question 1

The endocervix is lined with _____________, while the ectocervix is lined with _____________.

Answer 1

columnar cells (like the columnar caterpillars); squamous cells (like the flat butterflies)

Question 2

____________ are common benign findings in middle-aged women, arising from the os.

Answer 2

Endocervical polyps (like the caterpillar arising form the apple at the os stairs)

Question 3

What bacteria are responsible for the pH of the vagina?

Answer 3

Lactobacillus, a Gram-positive rod (represented by the white flower with blue stamens)

The low pH is what stimulates metaplasia from columnar to squamous epithelium (like the “metamorphosis” transformation zone).

Question 4

The most prevalent strains of HPV that cause CIN are ___________.

Answer 4

16 and 18 (like the girl with the car keys –16 –and the “I voted” sticker –18)

Question 5

Which two proteins knock out tumor suppressors in HPV and CIN?

Answer 5

• E6: p53 (like the checkpoint 6 being broken by the 53rd runner)
• E7: RB (like the 7 in the Root Beer)

Question 6

Other than HPV, what things increase the risk of CIN?

Answer 6

• Immunosuppression (guy on crutches)
• Multiple sexual partners (couple kissing)
• Smoking (kid smoking)

Question 7

HPV has a special affinity for _____________.

Answer 7

the transformation zone where immature squamous cells develop (like the pill bugs on the transition zone)

Question 8

The characteristic cell of HPV infection is ______________.

Answer 8

koilocytes (like the koi pond)

Question 9

What do koilocytes look like?

Answer 9

Large vacuolated cytoplasms (like the eyes of the fish)

Question 10

The stages of CIN go from ______________.

Answer 10

1 to 3 based on the layer from superficial to deep (like the butterflies piling up from deep to superficial)

Question 11

Cervical cancer develops when what happens pathologically?

Answer 11

Dysplastic cells breaking through the basement membrane (like the cracks in the tank)

Question 12

CIN I is also called _____________.

Answer 12

LSIL (like the Low fILter over the CIN I area)

Question 13

CIN II and III are also called ________________.

Answer 13

HSIL (like the High fILter over the right areas)

Question 14

Colposcopy is recommended for which stages?

Answer 14

All CINs

Question 15

What percent of cervical cancer is SCC versus adenocarcinoma?

Answer 15

80:20 SCC:AC

Question 16

Cervical cancer presents with what two signs/symptoms?

Answer 16

• Post-renal obstruction (crab grabbing hose)

* Post-coital bleeding (flowers with post-pollination redness)