Week 4: Cervix Flashcards
Cervical pathology basics
90% of cervical pathology falls into three categories
- Acute and chronic cervicitis
- endocervical polyps
- cervical epithelial abnormalities
- squamous atypia
- squamous dysplasia
- carcinoma: Squamous cell and adenocarcinoma
Uterine anatomy
Cervix anatomy
Cervix anatomy
Cervical squamous epithelia
Cervical histology
Endocervical polyps
Endocervical polyps histology
Soft poft polyps with dilated glands and active stroma
Endocervical polyps epidemiology
benign inflammatory hyperplasia seen in 2-5% of women
Endocervical polyps gross histological features
- Small to large (5cm) masses arising in the endocervix and protruding through os
- Soft polyps with dilated glands and active stroma
What is Acute and chronic cervicitis
- Cervical transformation zone undergoes changes at menarche with estrogen increase and exposure to acidic vaginal fluid
- Endocervical glandular epithelium transformed to squamous epithelium: Squamous metaplasia
- epithelium glycogenated; substrate for organisms
- Acute and chronic inflammation increase
- Cervix colonized by nonpathogenic bacteria
- endogenous aerobes and anaerobes, lactobacilli, streptococci, staphylococci, enterococci, E. coli
Acute and chronic cervicitis uncommonly present pathogenic microorganisms
- Chlamydia trachomatis
- Neisseria gonorrhoeae
- Mycoplasmas
- HSV type 2
Acute and chronic cervicitis transmission
role in sexual transmission
Acute and chronic cervicitis complications
may ascend into uterus and beyond to cause PID
Complications of PID
Fertility problems and pregnancy complications such as ectopic pregnancy
Histology of Cervical transformation zone w/ squamous metaplasia
Histological features of chronic cervicitis
History of cervical cancer
The pap test as a screening test for cervical cancer
How good is the pap test for screening for cervical cancer?
Length of dysplasia to cervical cancer
long progression ~ 10 years
Ancillary tests to improve pap test effectiveness in screening for cervical cancer
eg HPV test
Performance of the Pap test
What type of cells should the vagina be?
what type of cells should be in the endocervical canal?
Pap test slide prep w/ normal pap test
Question 1
what is cervical dysplasia?
Histology of cervical dysplasia
What is cervical cancer?
Risk factors for cervical dysplasia and cervical cancer
8 listed
Cervical dysplasia and HPV
Who’s affected by HPV and cervical dysplasia
Epidemiology of HPV and cervical cancer
The male component of HPV infection
Male HPV warts
Male HPV warts
What is the role of HPV in cervical dysplasias?
Low risk HPV types
HPV types 6 and 11
High risk HPV types
*HPV 16, 18, 31 and 45*
HPV viral oncogenesis
Features of cervical dysplasia
4 listed
What is the viral cytopathic effect of HPV
alteration in cell architecture, shape and size due to HPV
Normal pap test
Abnormal pap tests
Normal vs abnormal pap tests
What is the Bethesda system?
Paptest terminology
Normal Pap vs LSIL
LSIL pap test
LSIL pap test
HSIL pap test
HSIL pap test
HSIL pap test
What is the follow-up of cervical dysplasias?
HPV test
Cervical opening anatomy
Cervical opening and cervical biopsies
LAST terminology for HPV-associated lesions: Tissue samples
LAST terminology for HPV-associated lesions: Tissue samples
LSIL gross histology
HSIL gross histology
LSIL histological features
HSIL histological features
Cervical cancer
Cervical cancer gross histology
Cervical cancer gross histology
Cervical cancer histological features
Cervical cancer histological features
Endocervical adenocarcinoma
Endocervical adenocarcinoma histology
Endocervical adenocarcinoma histology
HPV vaccine advances
HPV vaccine
HPV vaccine update
HPV vaccine is recommended for?
Primary HPV screening
Treatment of Endocervical polyps
simple excision or curettage
Most common form of cervical cancer?
Squamous cell carcinoma
Which types of HPV most likely progress to cancer
70% of cervical cancers are HPV 16 & 18
HPV treatment
The HPV vaccine is 92% effective against getting the virus and 100% effective against persistent infection
