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YEAR 5: Histopathology > Histo: Gynaecological pathology Pt.1 > Flashcards

Histo: Gynaecological pathology Pt.1 Flashcards

1
Q

List some gynaecological infections that cause discomfort but no serious complications.

A
  • Candida
  • Trichomonas vaginalis
  • Gardnerella
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2
Q

List some gynaecological infections that cause serious complications.

A
  • Chlamydia (infertility)
  • Gonorrhoea (infertility)
  • Mycoplasma (spontaneous abortion and chorioamnionitis)
  • HPV (cancer)
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3
Q

What is pelvic inflammatory disease?

A

Ascending infection of the female genital tract that can affect the uterus, fallopian tubes and ovaries

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4
Q

What are the usual causes of pelvic inflammatory disease?

A
  • Gonococci
  • Chlamydia
  • Enteric bacteria
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5
Q

List some complications of pelvic inflammatory disease.

A
  • Peritonitis
  • Intestinal obstruction due to adhesions
  • Bacteraemia (sepsis)
  • Infertility
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6
Q

What is salpingitis?

A

Infection of the fallopian tubes

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7
Q

List some complications of salpingitis.

A
  • Infertility
  • Ectopic pregnancy
  • Plical fusion
  • Adhesions to the ovary
  • Tubo-ovarian abscess
  • Peritonitis
  • Hydrosalpinx
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8
Q

What is an ectopic pregnancy?

A

When the fertilised ovum implants outside the uterus (e.g. in the Fallopian tube)

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9
Q

What is the mean age of onset of cervical cancer?

A

45-50 years

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10
Q

List some risk factors for cervical cancer.

A
  • Human papilloma virus (present in 95%)
  • Many sexual partners
  • Sexually active early
  • Smoking
  • Immunosuppression
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11
Q

Which HPV strains are considered low risk and what is infection associated with?

A

Types 6, 11
Associated with warts and low grade cervical dysplasia

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12
Q

Which HPV strains are considered high risk and what is infection associated with?

A

Types 16, 18, 31, 33
Associated with:

  • Low and high grade cervical dysplasia
  • Cervical cancer
  • Vulval, vaginal, penile, and anal cancer
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13
Q

What epithelium type is the found in the cervix?

A

Endocervix - columnar epithelium
Ectocervix - stratified squamous epithelium

Sepearted by the transformation zone

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14
Q

What is the outcome of HPV infection in most people?

A
  • Nothing - virus is eliminated by immune system and becomes undetectable within 2 years in 90% of people
  • Persistent infection with high-risk HPV types is associated with dysplasia and cancerous changes
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15
Q

What are the two types of HPV infection? Describe them.

A
  • Latent (non-productive)
    • HPV DNA continues to reside within basal cells
    • Infectious virions are not produced
    • Replication of viral DNA is coupled to replication of epithelial cells
    • This means that complete viral particles are not produced
    • Cellular effects of HPV are not seen
  • Productive
    • Viral DNA replication occur independently of host chromosomal DNA synthesis
    • Large amount of viral DNA and infectious virions are produced
    • Characteristic cytological and histological featuers are seen (halo around the nucleus - koilocyte)
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16
Q

What components of high-risk HPV viruses are responsible for the carcinogenic effects of HPV?

A

Viral proteins can inactivate tumour suppressor genes

  • E6 protein - inactivates p53 gene
  • E7 protein - inactivates retinoblastoma (Rb) gene
17
Q

What is cervical intraepithelial neoplasia?

A

Epithelial cells have undergone malignant changes but basement membrane is intact (no invasion)

18
Q

Describe the classification of cervical intraepithelial neoplasia.

A
  • CIN1 = lower 1/3 of the epithelium
  • CIN2 = lower 2/3 of the epithelium
  • CIN3 = entire epithelium
19
Q

In which type of cervical epithelium does CIN occur?

A

Squamous epithelium is involved more often (CIN) than glandular epithelium (CGIN)

20
Q

What is the term used to describe CIN occurring in columnar epithelium?

A

Cervical glandular intraepithelial neoplasia (CGIN)

21
Q

What differentiates CIN from cervical cancer?

A

Invasion through the basement membrane defines change from CIN to invasive carcinoma

22
Q

What are the two types of cervical cancer?

A
  • Squamous cell carcinoma (most common)
  • Adenocarcinoma (20%)
23
Q

Which staging system is used for cervical cancer?

A

FIGO staging

24
Q

Outline the screening intervals for cervical cancer screening.

A
  • 25-49 = every 3 years
  • 50-64 = every 5 years
  • 65+ = if no screening since 50 or if abnormal test results
25
Q

Describe the process of the cervical cancer screening

A

Women are first screened for high-risk HPV. If positive, sample then undergoes cytological analysis

YEAR 5: Histopathology (33 decks)

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