CERVIX Flashcards Preview

Repodction > CERVIX > Flashcards

Flashcards in CERVIX Deck (54):
1

This inflammatory condition is characterised by loads of lymphocytes in the sub-epithelial tissue (sub-epithelial reactive lymphoid follicles)

Follicular cervicitis

2

When might a cervical polyp cause bleeding?

If it becomes ulcerated

3

The squamo-columnar junction is very vulnerable in early life, what could influence this

-age at first intercourse
-long term use of OCP
-non-use of barrier contraception

4

Effect of smoking on cervical cancer risk

Increases risk times THREE

5

Cervical intraepithelial neoplasia is caused by which types of HPV?

HPV 16 and 18

6

How long does it take for HPV infection to transform to high grade CIN?

6 months - 3 years

7

How long does it take for high grade CIN to transform into invasive cancer?

5-20 years

8

What is the pre-invasive stage of cervical cancer?

Cervical intraepithelial neoplasia

9

Where does cervical intraepithelial neoplasia occur? What type of cells?

-Occurs in the transformation zone
-dysplasia of squamous cells
-detectable by cervical screening

10

Percentage of CIN1 that progress to invasion?

1%

11

Percentage of CIN2 that progress to invasion

5%

12

Percentage of CIN3 that progress to

>12%

13

Stage 1 cervical cancer

Confined to cervix

14

Stage 2 cervical cancer

Spread to adjacent organs (vagina, uterus etc)

15

Stage 3 cervical cancer

Involvement of pelvic wall

16

Stage 4 cervical cancer

Distant metastases or involvement of rectum or bladder

17

Symptoms of invasive cervical carcinoma

Abnormal bleeding:
-post coital
-post menopause
-brownish or blood stained vaginal discharge
-contact bleeding - friable epithelium

Pelvic pain
Haematuria/urinary infections
Ureteric obstruction / renal failure

18

Spread of squamous carcinoma

Local - uterine body, vagina, bladder, ureters, rectum

Lymphatic - EARLY, pelvic, para-aortic nodes

Haematogenous - LATE, liver, lungs, bone

19

Lymphatic spread of cervical carcinoma

This spread is EARLY
-pelivc, para-aortic nodes

20

Haematogenous spread of cervical carcinoma

This spread is LATE
-liver, lungs, bone

21

What is CGIN?

Cervical glandular intraepithelial neoplasia (CGIN)

22

CGIN is the preinvasive phase of which type of cancer

Endocervical adenocarcinoma

23

What is the preinvasive phase of ednocervical adenocarcinoma?

CGIN

24

Which HPV is associated with cervical adenocarcinoma

HPV 18

25

Which age groups get vulval intraepithelial neoplasia?

Bimodal incidence:
Young women and older women

Can present as an ulcer of an exophytic mass

Often but not always HPV related

26

Crusting rash

Vulvar pagets disease

27

Where does vulvar pagets disease arise from?

Tumour cells in epidermis (CONTAIN MUCIN !!) - cancer arises from the sweat glands in the skin

28

What do the tumour cells contain in vulvar paget's disease?

Tumour cells contain mucin !!

29

How does vulvar invasive squamous carcinoma present?

In elderly women, as an ulcer or as an exophytic mass

30

Melanoma of the vagina?

This is vary rare, but may present as a polyp

31

What type of cells will you see in cervicitis?

Subeptihelial reactive lymphoid follicles

32

How might vulval carcinoma present?

Very itchy
May present as a nodule (this could then ulcerate) or may present as a cauliflower growth
-burning, tingling
-sex may be sore

33

Smoking effect on cervical cancer

3x risk

34

Condyloma Acuminatum: thickened "papillomatous" squamous epithelium with cytoplasmic vacuolation (“koilocytosis”)

HPV

35

Which cells are affected in CIN?

Dysplasia of squamous cells

36

Stage 1A1

Depth up to 3mm
Width up to 7mm

37

Stage 1A2

Depth up to 5mm
Width up to 7mm

38

Stage 1B

Confined to cervix

39

Stage 2A

Spread to adjacent organs (vagina, uterus etc)

40

Stage 3

Involvement of pelvic wall

41

Stage 4

Distant metastases or involvement of rectum or bladder

42

Lymphatic spread of squamous carcinoma?

Lymphatic spread it early to pelvic and para-aortic nodes
Haematogenous spread is late to liver, lungs and bone

43

Which nodes does vulvar invasive squamous carcinoma spread to and why is this important?

Spreads to inguinal nodes
-important prognostic factor

44

Crusting rash.
Tumour cells in epidermis, contain mucin

Pagets disease
Arises from sweat glands

45

What is it about HPV that increases risk of cervical cancer?

PERSISTENCE increases risk of disease

46

Mild karyotosis management

Check HPV status
if negative, patient goes back to routine recall

If HPV positive --> patient is referred for colposcopy

47

Moderate karyotosis management

This is consistent with CIN II - refer for coloposcopy

48

Severe dyskaryosis management

This is consistent with CIN III - refer for colposcopy

49

Suspected invasive cancer management

Refer for urgent colposcopy (within 2 weeks)

50

Results from smear are inadequate, what should you do?

Repeat smear - if persistent (3 inadequate samples - assess by colposcopy)

51

Histology findings of CIN

-the cells take longer to mature (so you'll see lots more immature cells, like me lol)
-Nuclear abnormalities (hyperchromasia, increased nucleocytoplasmic ratio, pleomorphism)
-Excess mitotic activity

52

What does koilocytosis indicate?

Indicates HPV infection

53

This cancer is associated with a higher SE class

Adenocarcinoma

54

This cancer is associated with a later onset of sexual activity

Adenocarcinoma