The cervix and it's disorders Flashcards

(32 cards)

1
Q

What is cervical ectropion?

A

When the columnar epithelium of the endocervix is visible as a red area around the os on the surface of the cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What causes a cervical ectropion?

A

It is due to eversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Are cervical ectropions normal?

A

Elevated oestrogen levels

They are normal in pregnant women, particularly those who are pregnant or taking the ‘pill’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the symptoms of cervical ectropion?

A

Normally asymptomatic, ectropians occasionally cause vaginal discharge or postcoital bleeding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you treat cervical ectropions?

A

It can be treated by freezing (cryotherapy) without anaesthetic, but only after a smear, and ideally colposcopy to exclude carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is chronic cervicitis?

A

Chronic inflammation or infection, often of an ectropion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What symptoms does chronic cervicitis cause?

A

It is a common cause of vaginal discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you treat chronic cervicitis?

A

Cryotherapy is used, with or without antibiotics, depending upon bacterial culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are cervical polyps?

A

Benign tumours of the endocervical epithelium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What age are cervical polyps most common?

A

Most common in women above the age of 40 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the symptoms of cervical polyps?

A

They may be asymptomatic or cause intermenstrual bleeding or postcoital bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is cervical intraepithelial neoplasia (CIN)?

A

CIN, or cervical dysplasia, is the presence of atypical cells within the squamous epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the cells that are atypical in CIN?

A

The atypical cells are dyskaryotic, exhibiting larger nuclei with frequent mitoses.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is CIN graded?

A

Depending on the extent to which these cells are found in the epithelium (histologically)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is CIN 1?

A

Mild dysplasia - atypical cells are found only in the lower third of the epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is CIN 2?

A

Moderate dysplasia - atypical cells are found in the lower 2/3of the epithelium

17
Q

What is CIN 3?

A

Severe dysplasia - atypical cells occupy the full thickness of the epithelium - carcinoma in situ - malignant lesion but no invasion

18
Q

How many women will get cervical cancer if CIN 2/3 is untreated?

A

About 1/3 women within 10 years

19
Q

Can CIN 1 regress?

A

Yes, it can regress spontaneously

20
Q

What age is CIN most common?

A

90% of CIN 3 cases are in women under 45, with peak incidence in this 25-29 years of age

21
Q

What is the histological change that occurs during CIN?

A

Columnar epithelium to squamous epithelium

22
Q

What is the treatment for CIN 2 or 3?

A

Cutting diathermy under local anaesthetic - ‘LLETZ- Large Loop Excision of the Transformation Zone’

23
Q

What age in cervical cancer most common?

A

The disease can occur at any age after first intercourse but has two peaks of incidence, in her 30s and 80s. The majority of cases occur in women aged 25-49 years.

24
Q

What is the pathology of cervical cancer?

A

90% are squamous cell carcinoma, 10% are adenocarcinoma

25
What type of cervical cancer has the worst prognosis?
Adenocarcinomas have a worse prognosis and are increasing in proportion as smear programme prevents proportionally more squamous cell carcinoma
26
What can accelerate CIN to cervical cancer?
Immunosuppression
27
What are the symptoms of cervical cancer?
Postcoital bleeding, offensive vaginal bleeding, intermenstrual bleeding or postmenopausal bleeding are common. Pain is a late feature.
28
Is nodal spread common in cervical cancer?
Lymphatic spread to the pelvic nodes is an early feature but blood borne spread occurs late
29
How is cervical cancer staged?
FIGO - clinical from examination
30
List 2 causes of inadquate smears.
1. masking of epithelial cell detail by pus | 2. insufficient epithelial cells being present for accurate assessment
31
What are the risk factors for cervical cancer?
Human papillomavirus (HPV), particularly serotypes 16,18 and 33 is by far the most important factor in the development of cervical cancer. Other risk factors include: smoking human immunodeficiency virus early first intercourse, many sexual partners high parity lower socioeconomic status combined oral contraceptive pill*
32
Mechanism of HPV causing cervical cancer
HPV 16 and 18 produces the oncogenes E6 and E7 genes respectively E6 inhibits the p53 tumour suppressor gene E7 inhibits RB suppressor gene