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REPRO II Exam 1 > Cervical Pathology I > Flashcards

Cervical Pathology I Flashcards

(65 cards)

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1
Q

transformation zone

A

of cervix - susceptible to HPV infection, dysplasias, cancer

puberty and pregnancy - eversion** - exposure of endocervical canal

adult - squamous metaplasia** of exposed endocervical canal - creates the transformation zone

post-menopause - inversion** - transformation zone into the endocervical canal again

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2
Q

eversion

A

puberty and pregnancy

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3
Q

squamous metaplasia

A

adult - forms transformation zone

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4
Q

inversion

A

post-menopause

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5
Q

lugals

A

iodine
-turns healthy tissue brown

cervix exam

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6
Q

colored lights

A

to examine cervix

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7
Q

acetic acid

A

to examine cervix

white HPV infection

acetyl white lesion

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8
Q

transition zone

A

cervix-endocervix

SCJ - squamocolumnar junction

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9
Q

chronic cervicitis

A

changing microbiome

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10
Q

at puberty with flora

A

estrogen > formation of glycogen > lactobacilli > lactic acid and peroxide

loss of acidosis - loss of flora and overgrowth of bacteria - cervicitis

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11
Q

all infections

A

may cause changes in squamous mucosa of cervix which may result in atypia on pap smear

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12
Q

ASCUS

A

atypical squamous cells of uncertain significance

problem for path and clinician

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13
Q

asymptomatic women, PID, ectopic

A

chlamydia

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14
Q

newborn chlamydia

A

conjunctivitis
pneumonia
blindness

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15
Q

NAAT

A

nucleic acid amplification test

dx of chlamydia

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16
Q

chlamydia over time

A

more chronic
-may scar fallopian tube

site of ectopic pregnancy**

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17
Q

chronic follicular cervicitis

A

chlamydia trachomatis infection

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18
Q

herpes on cervix

A

blisters/ulcers

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19
Q

multinucleated cells with intranuclear ground glass viral inclusions

A

herpes

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20
Q

gonococcus

A

neisseria gonorrhoeae

gram negative diplococci

thayer martin

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21
Q

lesion

A

any abnormal finding

shorthand - something of interest

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22
Q

polyp

A

any mass causing elevation on epithelial surface

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23
Q

sessile

A

broad based polyp

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24
Q

pednuculated

A

polyp with stalk

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25
polyp >5cm
may be called tumor
26
thayer martin
chocolate agar with antibiotics grows neisseria gonorrhoeae
27
tx of endocervical polyp
polypectomy can extrude from endocervical canal
28
endocervical gland full of mucus
nabothian cyst very common - often cause no problems
29
leading cause of cancer death in third world
cervical neoplasms
30
high risk HPV
16 - 60% of cervical cancers | 18 - 10%
31
risk for HPV
``` young first intercourse multiple partners immunosuppression BCPs smoking ```
32
HBV
causes hepatocellular carcinoma by inserting into hepatic DNA
33
HPV life cycle
can only infect immature squamous cells | can only replicate in maturing squamous cells
34
proteins of HPV
E6 | E7
35
E6
HPV product binds to p53 and inactivates it
36
E7
HPV product binds to Rb protein - prevents binding to E2F - free E2F binds promoter genes - like c-myc
37
episome
cytoplasmic form of HPV
38
high grade HPV and cancer
inserts into DNA - leading to presence of E6 and E7
39
other locations of HPV squamous cancer
oropharynx, anus, penis, vulva, vagina
40
p53
involved in causing G1 arrest for DNA repair -G1 to S transition guardian of genome LOF p53 - DNA unrepaired
41
hyperP Rb
no inhibition of E2F - cancer
42
hypoP Rb
inhibition of E2F - no transcription
43
CIN
cervical intraepithelial neoplasm
44
CIN I
mild dysplasia low grade squamous intraepithelial lesion (LSIL) 95% go away minimal nuclear enlargement above lower third
45
CIN II
moderate dysplasia high grade SIL half way nuclear enlargement
46
CIN III
severe dysplasia high grade SIL full thickness nuclear enlargement
47
HSIL
need excised for CIN II and CIN III
48
koilocytic atypia
hallmark of HPV low grade and high grade but if this only - low grade
49
Ki 67
marker of cell proliferation should only be on basal layer of cell if extends higher - expansion of proliferation zone
50
p16
cell cycle regulator -cyclin kinase inhibitor high levels - but cell still proliferates - bc p16 target (Rb) is inactivated by E7
51
HSIL to cancer
10 years - so takes a long time
52
Tx of cervical dysplasia
abnormal pap - follow up coloscopy and cervical biopsy also removal of dysplastic tissue
53
cervical cancer screening recommendations
age 21 to 65
54
cone bx
area of tissue around cervix is removed and examined
55
majority of cervical cancers
SCC - 80% 15% - adenocarcinoma 5% - adenosquamous carcinoma and small cell
56
peak age of invasive cervical cancer
age 45
57
bleeding after sex
with cervical cancer
58
T2
extends beyond cervix
59
death in cervical cancer
invasion of local structures | -obstruction of ureters - renal failure**
60
tx of cervical cancer
radical hysterectomy
61
keratin pearl
SCC of cervix
62
stage 1
confined to cervix
63
pap smear
10% false negative rate average lab - misses one every 2 years combined with HPV DNA test - 99.5% sensitive no HPV DNA testing in women <30 - high rate of infection
64
tx with abnormal pap
follow up colposcopic exam - removal of tissue if high grade - watchful expectantly low grade
65
HPV vaccine
new vaccine covers 6, 11, 16, 18, 31, 33, 45, 52, 58 -called 9v now vaccinating males

REPRO II Exam 1 (14 decks)

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