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13 Cards in this Set
- Front
- Back
what is on the cervix? what is it caused by? |
nabothian cysts (a mucus retention cyst) It is a condition that arise from squamous metaplasia. A layer of superficial squamous epithelium entraps an invagination of columnar cells beneath it, and the cells continues to secrete mucus, thus forming a cyst. |
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Assuming this is a benign condition, what is this? what will the patient present with? describe the mechanism. |
Cervical ectropion the patient will present with increased vaginal secretions, post-coital bleed/spotting mechanism: - during birth, there is a endocervix (columnar epithelial cell) and ectocervix (squamous epithelial cell), well demarcated - during puberty, eversion occurs and more endocervix is exposed to the vaginal acidic pH - there is a squamous metaplasia of the everted endocervix - however, some of the everted endocervix has not undergone squamous metaplasia, thus appearing red |
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what is this? |
ectocervix (notice the broad base, and the pale color) |
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what is this? |
endocervix (notice that it is beefy red, and arises from the endocervical canal, and it's stalk-like) |
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what are the causes and complications of cervical stenosis? |
causes: trauma (post-op, D&C, LLETZ, cone biopsy) /hypoestrogenism complications: Hematometra/ subfertility/ cervical dystocia |
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what are the causes and complications of cervical incompetence? |
causes: intrinsic/cervical trauma(post-op, D&C, LLETZ, cone biopsy) complications: increased risks of early pregnancy loss and premature labor |
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What is the most common cause of cervical CA? |
persistent HPV 16 and 18 infection of the transformational zone on the cervix, leading to malignant transformation |
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What are the risk factors for cervical CA? |
basically increased exposure to coitus risk factors: - high parity - young onset of sexual activity - multiple sexual partners - smoking - sexual partner has multiple other sexual partners |
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what are the vaccines available for cervical CA? what is the vaccine schedule? |
Gardasil (HPV 6,11,16,18) and Cervarix (HPV 16,18) 3 doses, given at 0,1,6 months |
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what is the recommendation for cervical screening by cervical screen singapore? |
1st pap smear done at 25 y/o or within 1 year of sexual life, if it commences after 25 y/o 2nd pap smear done 1 year after the 1st pap smear then repeat pap smear every 3 years till 65y/o |
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define CIN 1,2,3 |
CIN = cervical intraepithelial neoplasia CIN 1 = dyskaryosis in <33% of epithelium CIN 2 = dyskaryosis in 33-66% of epithelium CIN 3 = dyskaryosis in >66% of epithelium |
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when is colposcopy indicted? |
1) when there is abnormal result on pap smear (ie. CIN/malignancy) 2) 3 continuous inflammatory smears 3) 3 continuous unsatisfactory smears |
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when is punch biopsy indicated? |
1) when on gross examination, cervix is abnormal 2) when during colposcopy, the acetowhite areas are sampled via directed punch biopsies |
