Cervical cancer

Question 1

what part refers to the cervix

1. upper part of the uterus
2. middle part of the uterus
3. lower part of the uterus

Answer 1

3. lower part of the uterus

Question 2

what does cervical cancer refer too

1. neoplasm arising from the fundus of the uterus
2. neoplasm arising from the cervix
3. neoplasm arising from the body of the cervix

Answer 2

2. neoplasm arising from the cervix

Question 3

what is the majority type of cervical cancer

1. squamous cell carcinoma
2. adenocarcinoma

Answer 3

1. squamous cell carcinoma

Question 4

what are the most common sites for cervical cancer mets

Answer 4

lung
bone
liver
bowel

Question 5

what does usually cervical cancer usually develop from

Answer 5

cervical intraepithelial neoplasia (CIN)

Question 6

when is cervical cancers considered invasive

1. breach of the fibrous membrane
2. breach of basement membrane
3. breach of the epithelial membrane

Answer 6

2. breach of basement membrane

Question 7

what infection is the major cause of cervical cancer

Answer 7

HPV

Question 8

which HPV have the highest risk

1. 6
2. 16
3. 16 and 18
4. 6 and 11

Answer 8

3. 16 and 18

Question 9

how does HPV 16 and 18 cause cancer

Answer 9

inhibit tumour suppressor protein p53 = uncontrolled cell division

Question 10

what prophylaxis measure can be offered to prevent/reduce incidence of cervical cancer

Answer 10

HPV vaccine

Question 11

what strains of HPV does the vaccine prevent against

Answer 11

6, 11, 18, 16

Question 12

give 4 examples of RFx for developing cervical cancer

Answer 12

smoking

sexually transmitted infections

long term COCP use (>8 yrs)

immunodeficiency

Question 13

what is the most common presenting symptom of cervical cancer

Answer 13

abnormal vaginal bleeding

Question 14

give 2 examples of abnormal vaginal bleeding

Answer 14

post ictal bleeding

post menopausal bleeding

Question 15

give 4 symptoms of cervical cancer

Answer 15

vaginal bleeding

abnormal vaginal bleeding

dyspareunia

pelvic pain

weight loss

Question 16

why might a patient with cervical cancer experience loin pain and haematuria

Answer 16

cancer has invaded local structures e.g. kidneys

Question 17

what 3 clinical examination can be used to investigate cervical cancer

Answer 17

speculum exam

bimanual exam

gi examination

Question 18

what does the speculum examination look for when investigating cervical cancer

Answer 18

evidence of bleeding, discharge or ulceration

Question 19

what does the bimanual examination look for in cervical cancer

Answer 19

assessing for pelvic masses

Question 20

give 3 differentials for cervical cancer

Answer 20

STI
cervical ectropion 
polyps 
fibroids 
pregnancy related bleeding

Question 21

what is always important to rule out with post menopausal women

Answer 21

endometrial cancer

Question 22

what investigations should be carried out ina pre menopausal women

Answer 22

test chlamydia infec

colposcopy + biopsy

Question 23

what might you carry out imaging in cervical cancer patients

Answer 23

look for mets

Question 24

what does a radical trachelectomy involve

1. removal of the uterus, vagina and parametrial tissues
2. removal of the cervix and upper vagina
3. removal of all pelvic structures e.g. bladder and rectum

Answer 24

2. removal of the cervix and upper vagina

Question 25

what does a radical hysterectomy involve 1. removal of the uterus, vagina and parametrial tissues 2. removal of the cervix and upper vagina 3. removal of all pelvic structures e.g. bladder and rectum

Answer 25

1. removal of the uterus, vagina and parametrial tissues

Question 26

what does total pelvic extenteration involve

Answer 26

3. removal of all pelvic structures e.g. bladder and rectum

Question 27

how often should a patient with a PMHx if cervical cancer be followed up/reviewed

Answer 27

every 4 months

Question 28

who is the national NHS cervical screening programme offered too

Answer 28

all women aged between 25-64 yrs + free opt out

Question 29

what does theNHS cervical screening programme involve

Answer 29

taking mid cycle samples of the cells from the transformation zone of the cervix