Cervical HPV, dysplasia and carcinoma Flashcards Preview

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Flashcards in Cervical HPV, dysplasia and carcinoma Deck (22):
1

Describe the different histological grading of precancerous cervical squamous lesions?

HPV

CIN1
CIN2
CIN3

2

Describe the different cytological grading of precancerous cervical squamous lesions?

Low grade squamous intraepithelial lesion

High grade squamous intraepithelial lesion 

3

Where does HPV complete its infectious cycle?

In differentiated squamous epithelium

4

Describe the human papillomavirus?

Capsid encompassing DNA

Early and late genes

 

5

What do the early and late genes encode for in HPV?

Early genes code for replication, proliferation and viral release

Late genes code for capsid

6

Describe how HPV gains access to human cells?

Pre-exisiting damage to epithelium > HPV enters > gains access to basement membrane > capsid contact > enters cells > differentiation > release for re-infection

7

Describe the importance of HPV episomal DNA?

HPV DNA can be episomal or integrate into host DNA

Episomal DNA associated with latent disease

HPV genetic material replicated in nucleus of infected cell in form of episome, then amplified to high copy numbers

8

Describe how episomal HPV DNA can become integrated into host DNA?

At some point, break in E2 > integration 

9

Describe the function of E2, E6 and E7 in HPV?

E2: encodes for transcription function that suppresses E6 and E7

E6 binds p53 > TSG deactivated

E7 binds Rb gene > TSG deactivated

10

Describe how HPV causes cell proliferation?

Break in E2 > loss of regulation of E6 and E7

E6 binds p53 > TSG deactivated
E7 binds Rb gene > TSG deactivated

Uncontrolled proliferation

11

Which cells are most susceptible to HPV infection?

Cells at transformation zone (ectocervical-endocervical junction)

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12

What is a cervical condyloma?

Large exophytic lesion 

Thickened squamous epithelium

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13

Describe a flat condyloma?

Flat lesion 

Koilocytes present

Haphazard arrangement

Enlarged nuclei

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14

Describe a CIN1 lesion?

Atypical chnages to lower 1/3 of epithelium 

 

15

Describe a CIN2 lesion?

Atypical changes to lower 2/3 of epithelium

High grade lesion

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16

Describe a CIN3 lesion?

Changes to greater than 2/3 of the epithelium/full thickness change

High grade lesion

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17

Describe the risks associated with CIN2 and CIN3 lesions?

High chance of progressing to squamous cell carcinoma or adenocarcinoma

18

Describe a low grade squamous intraepithelial lesion?

Encompasses both HPV and CIN1 or both

Koliocytes
 

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19

Describe koilocytes?

Binucleated
Cytoplasmic clearing
Hyperchromatic nuclei
Irregular

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20

Describe a high grade squamous intraepithelial lesion?

Encompasses CIN2 and CIN3

More significant atypia

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21

What is adenocarcinoma in situ?

Precursor to adenocarcinoma

Forms glandular structures on pap smear, nuclear atypia more significant

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22

Describe the cytological appearrance of carcinoma?

Necrotic debris in background

High degree of cytological atypia