Reproduction L16_Cervical_Pathology

Front 1

Which of the following structures that are derived from the Müllerian ducts: lower 1/5 of the vagina, upper 4/5 of the vagina, cervix, endometrium, cul de sac, ovaries, fornix, peritoneum.

Back 1

Which of the following structures that are derived from the Müllerian ducts: upper 4/5 of the vagina, cervix, endometrium, ovaries, peritoneum.

Front 2

Name the 4 major types of neoplasms seen in müllerian derived structures (upper 4/5 of the vagina, cervix, endometrium, ovaries, peritoneum)

Back 2

Name the 4 major types of neoplasms seen in müllerian derived structures (upper 4/5 of the vagina, cervix, endometrium, ovaries, peritoneum) Serous papillary, endometroid (most are adenocarcinomas), mucinous, clear cell

Front 3

Where sqamous and mullerian columnar cells meet: is this the squamocolumnar junction, TZ or migration?

Back 3

Where sqamous and mullerian columnar cells meet: is this the squamocolumnar junction

Front 4

What is happening in the transformation zone?

Back 4

where columnar is being replaced by basal cells that are transforming into sqamous cells

Front 5

Which direction does migration of the TZ move?

Back 5

cephalic

Front 6

Where does squamous metaplasia occur?

Back 6

Where does squamous metaplasia occur? In the TZ

Front 7

Where do the majority of cervical carcinomas occur?

Back 7

Where do the majority of cervical carcinomas occur? The TZ

Front 8

name the following pathology: is it candida, trichomonas, Herpes simplex virus (decribe what you see)

Back 8

name the following pathology: trichomonas [INSERT PICTURE] green with eye balls

Front 9

Name the following pathology: is it candida, trichomonas, Herpes simplex virus (decribe what you see)

Back 9

Name the following pathology: is it candida, [INSERT PICTURE] - Hyphae (branches) with spores

Front 10

Name the following pathology: is it candida, trichomonas, Herpes simplex virus (decribe what you see)

Back 10

Name the following pathology: simplex virus [INSERT PICTURE] Pink and dense cells

Front 11

What is the definition of a malignancy (carcinoma/cancer)?

Back 11

What is the definition of a malignancy (carcinoma/cancer, carcinoma in situ)? Malignancy is capable of invasion and metastasis, thus can be lethal

Front 12

What is the definition of a premalignancy (carcinoma in situ, dysplasia)?

Back 12

What is the definition of a premalignancy (carcinoma in situ, dysplasia)? Not yet capable of invasion or metastasis, but has the risk of progression if untreated.

Front 13

What is the basis of screening?

Back 13

What is the basis of screening? Find lesions in the premalignant stage and avoid malignancy

Front 14

T/F all HPV infx lead to Ca.

Back 14

T/F all HPV infx lead to Ca…. FALSE (Due to immune system)

Front 15

Which CIN (cervical intraepithelial neoplasm) matches this description: moderate dysplasia, 2/3 undifferentiated, HGSIL (high grade squamous intraepithelial lesion)?

Back 15

Which CIN (cervical intraepithelial neoplasm) matches this description: moderate dysplasia, 2/3 (undifferentiated???) HGSIL (high grade squamous intraepithelial lesion)? CIN II

Front 16

Which CIN (cervical intraepithelial neoplasm) matches this description: mild dysplasia, 1/3 undifferentiated, LGSIL (L grade squamous intraepithelial lesion)?

Back 16

Which CIN (cervical intraepithelial neoplasm) matches this description: mild dysplasia, 1/3 (undifferentiated???) LGSIL (L grade squamous intraepithelial lesion)? CIN I

Front 17

Which CIN (cervical intraepithelial neoplasm) matches this description: severe dysplasia,3/3 undifferentiated, HGSIL (L grade squamous intraepithelial lesion)?

Back 17

Which CIN (cervical intraepithelial neoplasm) matches this description: severe dysplasia, 3/3 (undifferentiated???) HGSIL (L grade squamous intraepithelial lesion)? CIN III

Front 18

Are all CINs precancerous?

Back 18

Are all CINs precancerous? Yes

Front 19

Name the CIN grade for the image above and describe the features. Which HPV subtypes are seen with this CIN?

Back 19

Name the CIN grade for the image above and describe the features. CIN II: 2/3 undifferentiated with miosis up till the middle cells… Which HPV subtypes are seen with this CIN? 16, 18, 31, 33 (same as type CIN III)

Front 20

Name the CIN grade for the image above and describe the features. Which HPV subtypes are seen with this CIN?

Back 20

Name the CIN grade for the image above and describe the features. CIN I/ LGSIL: little if any undifferentiated cells, Koilocyte (large ballooning cells, with enlarged dark irregular nucleus, with a halo)… Which HPV subtypes are seen with this CIN? HPV subtypes: 6, 11, 42, 44

Front 21

Name the CIN grade for the image above and describe the features. Which HPV subtypes are seen with this CIN?

Back 21

Name the CIN grade for the image above and describe the features: CIN III/HGSIL: full 3/3 thickness of undifferentiated cells, smaller cells w/ larger nucleus, Which HPV subtypes are seen with this CIN? 16, 18, 31, 33 (same as type CIN II)

Front 22

T/F: low grade cervical lesion can have high risk subtypes, while high grade lesions will always have high risk lesions.

Back 22

T/F: low grade cervical lesion can have high risk subtypes, while high grade lesions will always have high risk lesions. TRUE

Front 23

Which CIN types (I, II, or III) has a higher risk of persistance and progression?

Back 23

Which CIN types (I, II, or III) has a higher risk of persistance and progression? CIN III

Front 24

If there is no HPV do cell CINs regress or progress (to invasion)?

Back 24

If there is no HPV do cell CINs regress or progress? Regress yes, progress no.

Front 25

How often to CIN I and CIN II regress or progress (to invasive)?

Back 25

How often to CIN I and CIN II regress or progress? Regress most of the time (57% and 43% respectively), almost never progress (1% and 5% respectively)

Front 26

If CIN III only progresses to invasive neoplasms 12% of the time, why do we treat all people with CIN III ?

Back 26

If CIN III only progresses 12% of the time, why do we treat all people with CIN III? We don't know which patient will progress

Front 27

Where do carcinomas of the cervic present? (hint: where on the cervix)

Back 27

Where do carcinomas of the cervic present? In the TZ

Front 28

What does staging in cancer represent?

Back 28

What does staging in cancer represent? Metastasis

Front 29

For cervical cancer, which staging has the worst prognosis?

Back 29

For cervical cancer, which staging has the worst prognosis? When it reaches the cervical wall

Front 30

What is the survival rate after 5 years for stage III cervical cancer versus stage II?

Back 30

What is the survival rate after 5 years for stage III cervical cancer versus stage II? Stage II: 70%… Stage III: 35%

Front 31

For which is morbidity from cervical cancer worst, direct extension or metastasis?

Back 31

For which is morbidity from cervical cancer worst, direct extension or metastasis? Direct extension

Front 32

Identify the image and describe the finding.

Back 32

Identify the image and describe the finding. Squamous carcinoma No longer organized

Front 33

T/F cervical lesions progress quickly

Back 33

T/F cervical lesions progress quickly… FALSE they progress slowly

Front 34

Match the proceedure tool (cryo, laser, LEEP, conization) with the decriptions: burn, wire-scoops out lesion, freeze, excise area with LEEP or knife

Back 34

Match the proceedure tool (cryo, laser, LEEP, conization) with the decriptions: Laser=burn, LEEP=wire-scoops out lesion, freeze=cryo, excise area with LEEP or knife=conization

Front 35

Describe the picture above and which HPV is it most associated with?

Back 35

Endometrial adenocarcinoma… HPV 18 (maybe 16)

Front 36

Describe the gross finding in a cervical polyp.

Back 36

fibromuscular stroma lined by benign epithelium

Front 37

Polyps can bleed, what is the significance of this?

Back 37

Polyps can bleed, what is the significance of this? Clincally insignificant, but you should know this since bleeding is a sign of cancer

Front 38

Which HPV subtypes account for 70% of all cervical cancers? What is the name of the vaccine that includes these subtypes? Which other subtypes are included in this vaccine?

Back 38

Which HPV subtypes account for 70% of all cervical cancers? 16 and 18… What is the name of the vaccine that includes these subtypes? Gardisil… Which other subtypes are included in this vaccine? 6, 11, 16, 18