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Flashcards in cervical CA Deck (32)
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1

what HPV infx are linked to cervical neoplasia?

16, 18, 31, 33

* - 80% of cervical intraepithelial neoplasia (CIN) lesions and 90% of invasive cervical carcinomas show the presence of HPV

2

what are types 6 and 11 linked to?

condylomata acuminata

3

what are other RF that may cause the development of cervical intraepithemlia neoplasia lesions?

early age at first intercourse, early childbearing, mul sex partners, hx of STI, low socioeconomic status, AA, smoking

4

what part of the cervix may show/initiate cervical ca

transformation zone! involved in 95% of the cases

5

what is mild dysplasia?

CIN-1 and may progress to moderate (CIN2) severr (CIN3), and carinoma in situ; it can also stay the same or regress

6

how many pts w/ CIN 3 may develop microinvasive and invasive carcinoma?

1/3

7

what age group showl CIN

women in their 20s

8

what age group may solw CIS?

25-35 yo

9

cervical cancer age group?

> 40

10

Clinical Features of cervical dyplasia?

no sx, advanced or invasive may cause abnormal vag bleeding and vag discharge, tumor



11

what is the mean age of dx ?

47, but 39 in lower sE status groups

12

what other PE findings might you see?

enlargment of the cervix- endophytic spread: "barrel" shaped cervix

exophytic- friable, fungating lesion

-ulceration: starts superficial, becomes deeper and encrotic as dz progresses

-nodularity of uterosacral ligaments

13

types of cervical cancer

squamous cell carcinoma
adenocarcinoma, adenosquamous carcinoma

14

features of squamous cell?

HPV 16, most common

90% develop from intraepithelial layers

typically w/ in 1 cm of squamocolumnar junx

-large cell nonkeratinizeing

15

types of squmous cell

verrucous- HPV 6 (more slowley growing and locally invasive, looks like condyloma

-large cell keratinizing or small cell

16

ADenocarcinoma

HPV 18 most prevalent,

dervived from glandular elements

women under age 35

increased incidence over lasat several decades (screening and prevention of squmous lesions)

17

where types of adenocarcinomas are there?

-mucinous, edometrioid, clear cell, serous

18

what is clear cell related to?

utero DES (diethylstilbestrol) exposure- drug used to prevent miscarriage

19

what is the worst type of cervical cancer?

neuroendocrine carcinoma!

most aggressive, survival is < 50% even in early stage, widespread hematogenous metastases are frequent

20

dx of cervical cancer

, liquid-based specimen, and other cytologic screening techniques are highly effective and should begin within 3 years of becoming sexually active or reaching age 21 (whichever comes first). Annual pap smear reduces incidence of invasive cervical carcinoma by 95% (BUT – now new guidelines

21

can you stop screening for cervical cancer after a hysterectomy?

yes!

22

who must get an annual screening?

the immunocompromised!

23

what if the results are abnormal?

o Biopsy of suspicious lesions is mandatory
o Colposcopy with biopsies is the most appropriate technique for histologic evaluation
o Conization is used when the results of colposcopy are unsatisfactory or endocervical curettage scrapings indicate severe disease

24

BEthesda Criteria?

ASC-US, ASC-H, LSIL, HSIL

25

ASC-US

atypical squamous cell of undetermined significance

26

AS-H

atypical squamous cells, high grade lesion cannot be excluded

27

LSIL

low-grade squamous intraepithelial lesion

28

HSIL

 high-grade squamous intraepithelial lesion

29

treament of CCA

mild lesions- may resolve spontaneously

-

30

preinvasive neoplasia tx

electrocautery or cryocautery, laser therapy, conization, large-loop excision of transitional zone, or loop electrodiathermy excision procedure (LEEP