cervical cancer

Question 1

what is the cervix

Answer 1

cylindrical shaped neck of tissue
joins vagina to uterus
2-3cm long
facilitates entry of sperm into utey

Question 2

what are the endo and ectocervix

Answer 2

endocervix = proximal/inner region w/columnar epithelium 
ectocervix = projects into vagina w/stratified squamous epithelium

Question 3

what is the transformation zone

Answer 3

where columnar meets squamous eipthelium
site of squamocolumnar junction
most neoplastic changes arise from here

Question 4

describe the squamocolumnar junction

Answer 4

junction betwene squamous and columnar epithelium
location on cervix is variable
result of continuous remodeling from uterine growth, cervical enlargement and hormonal status

Question 5

risk factors for cervical cancer

Answer 5

low socioeconomics, smoking, oral contraceptives, high-risk sexual partner. genetics

Question 6

structure of HPV

Answer 6

small, non-enveloped doucle stranded DNA virus

Question 7

how are there different types of HPV

Answer 7

changes in proteins it produces changes the way it interacts with tumour suppressor genes

Question 8

how does HPV drive cervical cancer

Answer 8

utilised hosts cellular machinery
E6 inactivates p53 = loss o tumour suppression apoptosis
E7 binds to retinoblastoma = inactivates = inc transcription

Question 9

What is CIN

Answer 9

cervical intrapeithelial neoplasia = dysplasia within the cervical epithelium
caused by HPV
CIN 3 = carcinoma in situ

Question 10

how to determine grade of the lesion

Answer 10

low0grade squamous intrapethileal = CIN 1= more frequent pap smear
high-grade squamous intraeptihelial = CIN 2 + 3 = colonoscopy

Question 11

sequence of events leading to cervical cancer

Answer 11

HPV infection
viral persisitance
progression to dysplatic change
development of invasive cervical cancer

Question 12

describe the clinical manifestaions of early and late stage cervical cancer

Answer 12

early = no symptoms 
late = abnormal bleeding (eg after sex), dysuria, pelvic/lower back pain

Question 13

describe the gardasil vaccine

Answer 13

hpv vaccine

protects against 90% of cervical cancers

Question 14

describe cervical screening

Answer 14

replaced pap smart by idnetidying presence of HPV infection rather than just dysplastic change
only once every 5 years instead of 1-2
same collection method (speculum -> cervical swab -> lab)