Disorders of Cervix Flashcards
What are some disorders of the Uterine Cervix?
Acutre and Chronic Cervicits
Endocervical Polyps
Premalignant and Malignant Neoplasms (Cervical Intraepithelial Neoplasias, Cervical Cancer)
Is cervicitis extremely common?
Yes
Sources of Infection in Cervicitis?
C. Trachomatis
U. Urealyticum
T. Vaginalis
Candida spp
N. Gonorrheae
HSV-2 and HPV
Types of Cervicitis?
Non Specific
Chronic
Acute
Chronic Cervicitis
Epithelial Regeneration
Hyperplasia
Squamous Metaplasia
Acute Cervicitis
Postpartum (rare)
Staphylococcus or Streptococcus
Endocervical Polyps
Benign Lesion
Adult Women
Clinical Sign: VAGINAL BLEEDING OR SPOTTING
Mostly in the endocervical canal
What is the link between HPV and Cervical Cancer?
HPV has a HIGH association with Cervical Cancer
Increases risk by 50-100x
Factors that increase risk of HPV
Multiple sexual partners
Male partner with multiple previous/present sexual partner
Young age at first intercourse
High parity
Oncogenic Risk of certain HPV infections?
Type 16 and 18– HIGH ONCOGENIC RISK
Types 6, 11, 42-44– LOW ONCOGENIC RISK
Where does HPV infect?
the immature cells at the metaplastic squamo-columnar junction
LOOK AT SLIDES FOR HPX INFECTION AND PREMALIGNANT LESION
LOOK AT SLIDES FOR HPX INFECTION AND PREMALIGNANT LESION
Natural History of infection?
Normal–> Low grade SIL–> High grade SIL–> Invasive Cancer–> Local–> Regional–> Distant
Consequences of HPV infection
Immune status is compromised and increased genetic vulnerability to development of cancer
Factor that may promote progression to CaCx?
Immunosupression
Persistent Infection with viral integration into genome
Co-infection with other STDs
Hormanal Status (use of contraceptive pills)
Use of Nicotene
Certain HLA types
Mutation of tumor suppressor gene LKB I (recent)
Low risk infections that only cause episomal infection?
HPV 6 and 11
Management of persistem CIN1
Ablation
Management of CIN 2 and CIN 3
Excision
(Loops electrosurgical excision procedure (LEEP), Colonization, Cryosurgery)
Management of Invasive CA, depending on stage?
Hysterectomy
Radio and chemotherapy
What are the types of CaCx
Grossly: Exophytic and Infiltrative
Microscopically: Keratinizing, non-keratinizing, microinvasion
First sign of CaCx
Spotting after intercourse or douching
Prevention of HPV?
VACCINES
Vaccines used in HPV
GARDASIL
CERVARIX
Age for vaccination?
ideally, before the age of sexual activity.
11 or 12 year old girls
Quadrivalent HPV vaccine: 11 or 12 year old boys, but may be given to 22-26 year old males.
