Flashcards in Pathoma Cervix Deck (14):
Where does cervical cancer usually happen?
transformation zone between the squamous epithelium of exocervix and single layer columnar on endocervix
HPV. cancer and stuff from it, if you have questions about HPV, see the vuvla cards
What are the two cancer proteins in HPV?
E6 knocks out p53, so no checking DNA before S phase and BAX isn't activated.
E7 destroys Rb, which holds E2F until. If Rb is destroyed, E2F goes buckwild
Briefly, how do you grade cervical intraepithelial neoplasm?
CIN I is 1/3 of thickness of epithelium (reversible 66% of time)
CIN II is 2/3 of thickness (33% reversible)
CIN IIIis almost the entire epithelium (unlikely to reverse)
Carcinoma is insitu is entire thickness and not reversible
What are risk factors for cervical carcinoma?
HPV, immunodeficiency. SMOKING. Smoking is bad, it causes it, no way to really understand why, just don't forget it (similar to how smoking causes pancreatic cancer for unknown mechanism)
What is most common cause of death from cervical cancer?
Blocks ureter and hydronephrosis causing renal failure
What do you look for in a pap smear?
Dysplasia. A high nucleus:cytoplasm ratio with dark nucleus
What type of cancer does a pap smear find?
Squamous cell carcinoma, not good for adenocarinoma (which HPV can also cause)
What is ASCUS, ASC-H, LSIL, HSIL?
Atypical squamous cells of undetermined significance
Atypical squamous cells can't exclude high grade dysplasia
Low grade squamous intraepithelial lesions consistent with HPV. CIN2 or worse in 12%
HSIL is high grade squamous intraepithelial lesions. Often CIN2 or CIN3. Sometimes carcinoma
When do you need to do ECC with coop?
ASC-H or worse
What do you do with ASCUS?
HPV test, if positive do colposcopay, if negative, it is normal epithelial change and no worries.
More than 90% of invasive squamous cervix are people who don't do screening
oh thats sad
What is vaccination good for?
5 years on 6, 11, 16, 18