Disorders of the Cervix

Question 1

What is the most likely diagnosis for a women who comes in complaining of purulent discharge from her vagina, dysuria, and postcoital bleeding?

Answer 1

cervicitis

Question 2

What type of findings on cervix suggest HSV?

Answer 2

diffuse vesicular lesions

Question 3

What type of findings on cervix suggest trichomonas infection?

Answer 3

punctate hemorrhages (“strawberry spots”)

Question 4

What is a sign of coexisting PID?

Answer 4

cervical motion tenderness

Question 5

What antibiotic treatment should be used for gonorrhead and chlamydia?

Answer 5

ceftriaxone 250mg IM and zithromax 1g immediately

Question 6

What is the antibiotic treatment for a patient who cannot tolerate zithromax for chlamydial infection?

Answer 6

doxy 100mg BID x 7 days

Question 7

What is the antibiotic treatment for trichimonas?

Answer 7

metronidazole 500mg BID x 7 days

Question 8

Benign, pedunculated growths of varying size that extend from the ectocervix or endocervical canal

Answer 8

cervical polyps

Question 9

What is often found concurrently with cervical polyps?

Answer 9

endometrial hyperplasia

Question 10

What should you do with all polyps once they’ve been removed?

Answer 10

send to pathology

Question 11

Most common symptom for cervical polyps

Answer 11

postcoital bleeding

Question 12

What do cervical polyps look like on physical exam?

Answer 12

pear-shaped growths protruding from cervix. usually smooth, soft, reddish purple to cherry red

Question 13

What is the treatment for cervical polyps?

Answer 13

tie off and twist off at base with forceps

Question 14

Mucous filled cyst on the surface of the cervix. caused when stratified squamous epithelium of the ectocervix grows over the simple columnar epithelium of the endocervix

Answer 14

Nabothian cysts

Question 15

Treatment for symptomatic Nabothian cysts

Answer 15

removed by electrocautery or cryotherapy

Question 16

central to the development of cervical neoplasia and can be detected in 99.7% of cervical cancer

Answer 16

HPV

Question 17

Most common cell type of cervical cancer

Answer 17

squamous cell (69%)

Question 18

Percentage of sexually active women who will have aqcuired a genital HPV infection by age 50

Answer 18

80%

Question 19

How long does it usually take from time of HPV infection to presentation of cervical cancer?

Answer 19

15 years

Question 20

What HPV subtypes are involved in the majority of cervical cancers?

Answer 20

18 and 16

Question 21

Between what ages is invasive carcinoma encountered most frequently?

Answer 21

40-50 years

Question 22

What subtypes of HPV does Gardasil cover?

Answer 22

6, 11, 16, and 18

Question 23

What is the dosing schedule for Gardasil?

Answer 23

Administered over 6 month period. Second dose 2 months after 1st dose and third dose 6 months after the first dose