Gynae Path

Question 1

Epitheliium of ectocervix

Answer 1

Squamous epithelium

Question 2

Epithelium of endocervix

Answer 2

Glandular columnar epithelial

Question 3

What is the area called where the ecto and endocervix join?

Answer 3

Transformational zone

Question 4

How regular does routine smear testing occur?

Answer 4

Every 3-5 years for >25y/o

Question 5

What is the Follow up if a smear test is graded unsuitable?

Answer 5

Repeat in 3months

Question 6

Why would a smear test be unsuitable?

Answer 6

not enough cells

Blood

lots of Inflammatory cells

Question 7

What is the Follow up if a smear test is graded Borderline?

Answer 7

Repeat in 6 months

Question 8

What is the Follow up if a smear test is graded Mild Dyskaryosis (CIN1)?

Answer 8

Repeat in 6months

Question 9

What is the Follow up if a smear test is graded CIN2 Moderate dyskaryosis?

Answer 9

Colposcopy

Question 10

What is the Follow up if a smear test is graded CIN 3 Severe dyskaryosis?

Answer 10

Colposcopy

Question 11

What is the hallmark sign of HPV infection in the cervix?

Answer 11

Koliocytes

Question 12

What do CIN 1-3 cells look like?

Answer 12

Enlarged nuclei

Specaled chromatin

Getting progressively darker and larger
Never breach the basement membrane

Question 13

What type of epithelium is affected in CIN?

Answer 13

Squamous

Cervical intraepithelial Neoplasia

Question 14

What type of epithelium is affected in CGIN

Answer 14

Glandular —> Columnar

Cervical Glandular Intraepithelial Neoplasia

Question 15

Are CIN lesions invasive or non-invasive?

Answer 15

NON- invasive

Question 16

What does the USA mean by:

Low Grade Squamous Intraepithelial Lesion (LSIL)

Answer 16

Koliocytosis + CIN1

Question 17

What does the USA mean by:

High Grade Squamous Intraepithelial Lesion (HSIL)

Answer 17

CIN2 and CIN 3

Question 18

Describe the Epithelial layer in Koliocytosis

Answer 18

Koliocytes near surface

Enlarged nuclei along basement membrane

Question 19

Describe the Epithelial layer in CIN1

Answer 19

Koliocytes at surface

Enlarged and abnormal cell in lower 1/3 of epithelium

Question 20

Describe the Epithelial layer in CIN2

Answer 20

Enlarged and abnormal cell in lower 2/3 of epithelium

Question 21

Describe the Epithelial layer in CIN3

Answer 21

Enlarged and abnormal cell in full thickness of the epithelium

Question 22

How are Glandular cervical lesions graded in UK?

Answer 22

Low grade CGIN

High grade CGIN

Question 23

How are Glandular cervical lesions graded in USA?

Answer 23

Glandular Dysplasia (=low grade)

Adenocarcinoma in situ (=high grade)

Question 24

What does the epithelium look like in HCGIN?

Answer 24

Pale muccint in cells

Dark nuclei

Lots of apoptotic bodies

Question 25

What does CIN progress to?

Answer 25

Squamous Ca

Question 26

What does CGIN progress to?

Answer 26

Adenocarcinoma

Question 27

Rx CIN/CGIN lesions?

Answer 27

Ablate Excise Colposcopy follow up

Question 28

RF for HPV infection?

Answer 28

Early age at first intercourse Multiple sexual partners Smoking OCP

Question 29

Which strains of HPV are low risk?

Answer 29

HPV 6 & 11

Question 30

What strains of HPV are high risk?

Answer 30

16 and 18

Question 31

In order, list the most common cervical cancers

Answer 31

Squamous ca —> 84% Adencocarcinoma —> 14% Small cell ca Adenosquamous ca

Question 32

Describe stage 1a cervical ca

Answer 32

Cancer confined to cervix < 5x7mm

Question 33

Describe stage 1b cervical ca

Answer 33

Cancer confined to cervix and <4cm

Question 34

Describe stage 2 cervical ca

Answer 34

Extended beyond cervix Not near pelvic wall may involve upper 2/3 of vagina

Question 35

Describe stage 3 cervical ca

Answer 35

Extended to pelvic wall or lower 1/3 of vagina

Question 36

Describe stage 4 cervical ca

Answer 36

cancer spread beyond the pelvis

Question 37

Shape of cervical tumour

Answer 37

Barrel shaped

Question 38

What is the most aggressive cervical ca?

Answer 38

Small cell

Question 39

Rx Stage 1a cervical ca

Answer 39

Cone biopsy OR Simple hysterectomy

Question 40

Rx stage 1b cervical ca

Answer 40

Radical hysterectomy AND Pelvic lymphadenectomy MAYBE Chemoradiation

Question 41

Rx stage 2+ cervical ca

Answer 41

Chemoradio

Question 42

Prognosis stage 1 cervical ca

Answer 42

90-95%

Question 43

Prognosis stage 2 cervical ca

Answer 43

50-70%

Question 44

Prognosis stage 3 cervical ca

Answer 44

30%

Question 45

Prognosis stage 4 cervical ca

Answer 45

<20%