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13 Cards in this Set
- Front
- Back
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PAP smear screening can potentially reduce the risk of dying from cervical cancer by __%.
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90%
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What are the risk factors for cervical cancer?
What other cancers can HPV cause? |
- early age of 1st intercourse
- mult sex partners - smoking - immunosuppression - DES exposure Anus, vagina, penis, vulva, oropharynx, oral cavity. |
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What is believed to be the most common STD globally?
- most will clear an HPV infection w/i how long? - what causes cervical cancer, then? |
HPV
- 8-24m. - persistent HPV --> progression to precancerous lesions --> local invasion |
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What type of virus is HPV?
- what cells does it infect? - What are the low risk types, that may cause genital warts? - higher risk types? - how many types can infect the genital tract? - What two types of genes is the virus composed of? + which two effect p53 and Rb? - what happens to these genes that --> cancer? |
double-stranded DNA virus that infects epithelial cells.
- 6, 11 - 16,18, 31, 33, 39, 45, etc. - >40 - 7 early ones (E1-7), 2 late ones (L1-2) - E6 & 7 - the DNA is integrated into the human genome. |
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What are the current PAP smear recommendations?
- are young women more likely to clear HPV? |
begin @ age 21, women 21-29 should have one every 2 years.
- yes. |
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Which are the only pap smear results that don't warrant further testing?
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1) no dysplasia
2) ASC-US (atypical squamous cells of undetermined significance - note that we still might send this one on if they're infected with high risk HPV type (dx w/ serum) |
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What is a colposcopy?
- if you see something wack, what to do? - what is abnormal on acetic acid stain? - what is abnormal on Lugol stain? |
look @ the cervix under a microscope; applying acetic acid or lugol's solution to see dysplastic changes.
- take colposcopic directed biopsy. - abnormal = white because of decreased glycogen... the acetic acid is dehydrating cells - Iodine is taken up by normal cells w/ high glycogen content --> NON-staining is abnormal. |
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What is the Transformation zone?
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area initially covered by columnar epithelium, replace by squamous epithelium through metaplasia.
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What are the stages of CIN?
- options? |
CIN1, 2, and 3
- with 3 being >2/3 of abnormal cells constituting the thickness. - observation for low end; ablation w/ cryotx (up to 8mm); LEEP (loop electro-diathermy excisional); CKC |
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What are the advantages/disadvantages of the two dx excisional procedures used to tx CIN?
- which is always done for AIS (adenoma in situ)? - CIN2? - CIN3? |
LEEP: office procedure; margins are difficult to assess
CKC: OR procedure, large specimin possible, non-cauterized margins - CKC - depends on age - usually always tx, but can just observe in adolescents. |
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What % of women clear CIN1?
CIN3? CIN2? CIN2/3 takes ~__ y to advance to cancer? |
90%
10% 50%, 20%persist, 30% progress 10y |
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Prophylactic vaccines produce what sort of immunity? Target?
- therapeutic vaccines? Target? |
- humoral (CD4+/MHC II), target extracellular virus [albiet indirectly]
- cellular (CD8+/MHC I), target viral-infected cells |
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Do the HPV vaccines work prophylatically or therapeutically?
- how young can you vaccinate? - up to age what? - how many doses? - boys? - pregnant women? |
prophylatically
- 9 - 26 - 3 doses - FDA approved for boys - no |
