The cervix and its disorders Flashcards

1
Q

What is cervical ectopy?

A

Columnar epithelium of the endocervix protrudes out through the external os due to eversion and undergoes squamous metaplasia, transforming into stratified squamous epithelium. It appears as a red area around the os on the surface of the cervix.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When is cervical ectopy, due to eversion commonly seen?

A

In younger women and those taking the COCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why does the cervical ectropion appear red?

A

Glandular cells are red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What symptoms do a cervical ectropion usually cause?

A

Vaginal discharge or post-coital bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How can cervical ectropion be treated?

A

Freezing (cryotherapy) without anaesthetic but only after a smear and ideally colposcopy has excluded carcinoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are cervical polyps?

A

They are benign tumours of the endocervical epithelium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Who are cervical polyps most common in?

A

Women of 40 years of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are nabothian follicles?

A

They are squamous epithelium formed by metaplasia over endocervical cells and the columnar cell secretions are trapped forming retention cysts. NO SYMPTOMS normally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is CIN 1 histologically described?

A

Mild dysplasia- with atypical cells found in the lower third of the epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is CIN 2 histologically described?

A

Moderate dysplasia- with atypical cells found in the lower two-thirds of the epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is CIN 3 histologically described?

A

Atypical cells which occupy the full thickness of the epithelium. They are similar in appearance to malignant lesions but there is no invasion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How are malignant cells described?

A

Atypical cells which occupy full thickness of the epithelium and invade the basement membrane.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What percentage of women with CIN II/III will go on to develop cervical cancer?

A

About a third of women will develop cancer over the next 10 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which age group and class is cervical cancer most prevanent in?

A

35-45 and in the lower socio-economic class

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When does the peak incidence of cervical cancer occur?

A

25-29

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the main aetiology associated with cervical cancer?

A

Number of sexual partners, especially at an early age.

17
Q

Which factors increase the risk of cervical cancer slightly?

A

Smoking and OCP. Immunocompromised patients are obviously more at risk too

18
Q

How often are women screened for cervical cancer?

A

Every 3 years from 25-49 and then every 5 years from 50-64

19
Q

What is a pap smear?

A

This is usually carried out by a GP or nurse in primary care or can be in GUM clinic. The cervical cells are collected using a disposable spatula device.

20
Q

What are the disadvantages of a pap smear?

A

Approx 8% are inadequate meaning women must re-attend causing anxiety and inconvenience. The presence of inflammatory cells, blood or mucous also obscure the sample.

21
Q

How does liquid based cytology work (LBC)?

A

Samples are collected using a brush like device rather than a spatula and the head is broken off into a vial or preservative fluid.

22
Q

What are the advantages of LBC?

A

Improved means of slide preparation, producing more homogenous samples than a pap. There is also increased sensitivity and specificity and there is improved efficiency of handling lab samples.

23
Q

What are the current methods of LBC?

A

Sure path and Cytoscreen (manual method of sample prep)

24
Q

How are the smear results evaluated, (according to what guidelines)?

A

Categorised using the british society for clinical cytologists (BSCC).

25
Q

What are the categories of smear test results?

A

Negativem borderline, mild, moderate, severe, glandular neoplasia or adenocarcinoma in situ-15% cervical cancers

26
Q

If results are borderline or mildly dyskaryotic, what happens?

A

Invited back to screen at 6 months and if still present then, colposcopy.

27
Q

How many smears are required if the result is mildly dyskaryotic?

A

Maximum 2 smears

28
Q

What happens if the results show moderate dyskaryosis?

A

Colposcopy

29
Q

What happens if the results show severe dyskaryosis?

A

Urgent colposcopy

30
Q

What is the results show CGIN (any grade)?

A

Colposcopy, hysteroscopy

31
Q

What does colposcopy show?

A

The presence and grade of CIN