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OB/GYN > Cervical Intraepithelial neoplasia > Flashcards

Cervical Intraepithelial neoplasia Flashcards

1
Q

Where does cervical cancer fall in terms of the incidence of gyn malignancies?

A

3rd

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2
Q

In whom is incidence and mortality of cervical cancer the highest?

A

Incidence highest in hispanic women, but mortality highest in blacks

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3
Q

When was it discovered that HPV causes cervical cancer?

A

2008

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4
Q

Is HPV screening by itself recommended?

A

Not currently–combined with Pap

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5
Q

What is an ectropion? Is this normal?

A

Cervix is inverted– this is normal

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6
Q

What is the role of acetic acid in determining cervical abnormalities?

A

visualize abnormal areas by dehydrating so that squamous cells with dense nuclei will appear white

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7
Q

What are nabothian cysts? Treatment?

A

Cervical mucus gland that is plugged

Self limiting and asymptomatic

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8
Q

What is the recommendation for pap smears? (when start, how often, what is done)

A
  • Begin at age 21 (regardless of age at first intercourse)
  • Tested with cervical cytology alone (not HPV)
  • q 3 years
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9
Q

Why is co testing for HPV not recommended for pap smears for 21-29 years?

A

high prevalence in 21-29 years and low incidence of cervical CA

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10
Q

When does HPV co-testing begin? How often? At what age does it stop?

A
  • Co-test at 30-65 q 5 years

- Screen cytology alone 1 3 years

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11
Q

Who should be screened for cervical cancer more often?

A

-immunocompromised
-h/o cervical CA
-

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12
Q

When do Pap smears stop? Who is the exception to this?

A

65, unless immunocompromised or has a h/o cervical CA

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13
Q

Do women with a total hysterectomy need a pap smear?

A

Nah

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14
Q

Are pap smears and HPV testing recommended for below 21 years?

A

No

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15
Q

True or false: most epithelial abnormalities require further assessment

A

True

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16
Q

What is a colposcopy?

A

Microscope on wheels for cervical screens

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17
Q

What are the treatment modalities for cervical cancer?

A

Cryotherapy

-Excisional (LEEP)

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18
Q

What is the LEEP procedure?

A

Loop electrocautery excision

19
Q

When is a cone excision indicated?

A

Concern for deeper carcinoma

20
Q

What percent of cervical cancer is SCC?

A

90%

21
Q

Adenocarcinomas of the cervix are most commonly (endophytic or exophytic)? What are the characteristics of this in terms of malignancy?

A

Endophytic

Aggressive

22
Q

What are the lesions that are commonly found with adenocarcinoma of the cervix?

A

Skip lesions–start from multiple areas

23
Q

Does microinvasion apply to adenoCA?

A

No

24
Q

What are the s/sx of cervical CA? (if any)

A
  • Vaginal d/c
  • Odor
  • Abnormal bleeding
  • Postcoital bleeding
25
Q

What are the structures that are affected with direct extension of cervical CA?

A
  • Involvement of the pelvic side wall
  • venous compression
  • Hydroureter
26
Q

What is the only gyn CA that is staged clinically?

A

Cervical

27
Q

What are IVPs? What are they used for?

A

Intravenous pyelogram– an x-ray examination of the kidneys, ureters and urinary bladder that uses iodinated contrast material injected into veins

28
Q

What is stage 0 cervical CA?

A

CIS

29
Q

What is stage 1 cervical CA?

A

carcinoma confined to the cervix

30
Q

What is stage 2 cervical CA?

A

Carcinoma extends beyond the cervix either to the vagina or parametrium

31
Q

What is stage 3 cervical CA?

A

Lower 1/3 of the vagina or the pelvic side wall

32
Q

What is stage 4 cervical CA?

A

CA extends beyond the true pelvis or involves the mucosa of the bladder

33
Q

Treatment for cervical CA depends largely on what?

A

Staging

34
Q

What is the treatment for IA, IA2, IIB and above?

A
  • IA1 = Excise
  • IA2 = Radial hysterectomy
  • II and above = XRT and chemo
35
Q

What is excised with a radical hysterectomy? (4)

A
  • uterus + ovaries
  • pelvic side wall
  • upper 2/3 of vagina
  • pelvic nodes
36
Q

What are the risks of radical hysterectomy? (3)

A
  • Ureteral occlusions
  • Ureteral fistula
  • Bladder atony
37
Q

Why bladder atony with radical hysterectomy?

A

Damage to the nerves

38
Q

What are the two different XRTs for cervical CA?

A

EBRT

Brachytherapy

39
Q

What is brachytherapy?

A

Intracavitary radiation –Place radioactive things in cervix to crush CA

40
Q

What are the complications of XRT to the cervix?

A
  • Ileus
  • Urinary frequency
  • dyspareunia
41
Q

What is pelvic exenteration?

A

Radical procedure for recurrent cervical CA

–Radial hysterectomy + cystectomy, and rectum removal

42
Q

True or false: HPV vaccines must be given before or at the onset of sexual activity to be effective

A

True

43
Q

What is the difference between partial, total, and radical hysterectomy?

A 
Partial = just the uterus
Total = uterus + cervix
Radical = above + vagina
44
Q

What is the concern with performing the LEEP procedure?

A

If take too much tissue, may cause cervical issues

OB/GYN (33 decks)

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