Term
What is the 5 year survival rate of Cervical Cancer for:
In-situ
&
Microinvasion |
|
Definition
In-situ
&
Microinvasion
100% |
|
|
Term
5 year survival rate of cervical cancer for:
Stage I
Stage II
Stage III
Stage IVa
Stage IVb
?? |
|
Definition
Stage I: 85%
Stage II: 70%
Stage III: 50%
Stage IVa: 25%
Stage IVb: <10% |
|
|
Term
| What is the number 1 cause of female cancer death worldwide? |
|
Definition
|
|
Term
How many types of HPV are there?
Human Papilloma Virus |
|
Definition
100 types
50 variants in genital tract |
|
|
Term
| What HPV causes the wart? Answer are numbers. |
|
Definition
|
|
Term
| What number of HPV causes oncogenic variety? |
|
Definition
16 & 18 are oncogenic variety
Remember 16 is the most common
90% females |
|
|
Term
What is this?
HPV infection
Abnormal cervical cytology
Development of intraepithelial lesion
Progression to invasive cancer |
|
Definition
| Pathogenesis of Cervical Ca |
|
|
Term
| What does HPV produce that begins the oncogenesis of cervical cancer? |
|
Definition
|
|
Term
| Protein E6 & E7 of HPV bind & inactivate what? |
|
Definition
Tumor Suppressive Genes p53 & rb
part of oncogenesis of HPV |
|
|
Term
| The binding of HPV proteins E6 & E7 to tumor suppressive genes p53 & rb could lead to what??? |
|
Definition
|
|
Term
Does the HPV integration into chromosone result in:
many high grade 70%
&
invasive cancer 90% |
|
Definition
|
|
Term
| What are the non-modifiable risk factors for cervical cancer? |
|
Definition
|
|
Term
| What are the difficult to modify risk factors for cervical cancer/HPV? |
|
Definition
HIV
Transplants
Chemo tx
Steroid
(immunocompromised) |
|
|
Term
| What are the modifiable risk factors for cervical ca/HPV? |
|
Definition
Sexual Behaviors
# of partners
age of onset
intercourse
STD
HPV
Contraception
Choice of nutrition
Smoking
Frequency of pap smear
|
|
|
Term
| What type of HPV does Gardisil protect against? |
|
Definition
6 & 11 (wart)
16 & 18 (oncogenesis) |
|
|
Term
| How is the Gardisil vaccine given? |
|
Definition
|
|
Term
T/F
HPV testing is done prior to Gardisil vaccine? |
|
Definition
|
|
Term
T/F
Safe to give Gardisil vaccine in pregnant women? |
|
Definition
FALSE
Contraindicated in Pregnant women even though category B |
|
|
Term
| Can a women still breast feed if Gardisil vaccine given? |
|
Definition
| Yes it is not contraindicated |
|
|
Term
| Who & what age group should have the Gardisil vaccine? |
|
Definition
ALL females & males between ages of 9-26
remember: males prevent genital warts condyloaccumalata |
|
|
Term
| What is the accuracy of Pap Smear in regards to specificity & sensitivity? |
|
Definition
| Specificity & Sensitivity are both HIGH |
|
|
Term
| Why is the age 21 chosen for Pap Smear testing? |
|
Definition
High incidence of HPV
Low incidence of invasive cancer
High spontaneous regression rate
goes away by its own 90% in 3 yrs
Early intervention leads to:
undue anxiety, expense, preterm birth after excision |
|
|
Term
| When do you stop doing Pap smears? |
|
Definition
After age 70
If 3 or more recent pap smears ar normal
&
no abnormal results in the last 10 years |
|
|
Term
| How often are pap smears done? |
|
Definition
Every year till age 30
after age 30: if all prior tests nl every 2-3 yrs after evaluating risk factors
After age 30, if pap & HR HPV are negative, every 3 yrs. |
|
|
Term
Frequence of pap smear for:
Q2 years
Q3 years
After age 65 or 70 |
|
Definition
Q2 years: ages 21-29 with HIGH risk of HPV
Q3 years: age after 30, 3 consecutive negative HPV, no previous CIN 2/3
After age 65 or 70: If 3 or more negative in a row & no abn in last 10 years |
|
|
Term
What is this?
21 yrs of age with atypical squamous cell
adjunct screening women 30 yrs of age after 3 consecutive negative annual paps
women 70 LGIL b/c of low prevalence at this age
follow-up after tx when pap, colonscopy, & biopsy are negative |
|
Definition
| Indications for HPV testing |
|
|
Term
| What are the risk factors for Pap? |
|
Definition
HIV Q6 x 2 in 1st yr, annuanlly thereafter
Immunocompromised
women exposed to DES
Women with previous CIN 2/3 or cancer
need yearly x20 years
(CIN 2/3 = high grade lesion) |
|
|
Term
| What are the 3 steps in a pap smear? |
|
Definition
1. Visualize cervix completely
2. Is this a grossly cervix or is there a lesion
3. BIOPSY LESION |
|
|
Term
| What is the only lubricant that can be used to insert speculum? |
|
Definition
|
|
Term
| What order do you do a pap & culture? |
|
Definition
Pap 1st
Culture 2nd
Endocervix 1st
Ectocervix 2nd |
|
|
Term
| What is the Bethesda system? |
|
Definition
| system for reporting cervical or vaginal cytologic diagnoses, used for reporting Pap smear results |
|
|
Term
| What does acetic acid allow for during a colposcopy? |
|
Definition
Allows for the lesion to be seen.
It is hydrophyllic, so water departs cytoplasm & turns it white, this is where to biopsy |
|
|
Term
| What is the ASCUS-LGIL triage study (ALTS) provide? |
|
Definition
Clarify management of pts with low grad cytologic abnormalities
Randomization to:
Immediate colposcopy
Accelerate pap testing
HPV-DNA testing for high risk virus |
|
|
Term
|
Definition
| Cervical Intraepithelial Neoplasia |
|
|
Term
These are biopsy results, what do they mean?
CIN 1
CIN 2
CIN 3
CIS
|
|
Definition
CIN 1 low grade dysplasia
CIN 2 moderate dysplasia
CIN 3 high grade dysplasia
CIS carcinoma in situ |
|
|
Term
| What do biopsies provide? |
|
Definition
Treatment options
Conservative
Aggressive
Changes with age
Pt reliability |
|
|
Term
| A large area of tissue from the cervix is excised for examination |
|
Definition
LEEP or Cold Cone Biopsy
provides a confirmation of dx
&
therapeutic |
|
|
Term
| What are the complications assoc. with Cold Cone or LEEP biopsy? |
|
Definition
Infertility
Incompetent cervix
Bleeding
Cervical stenosis |
|
|
Term
T/F
Follow up is not important after treatment. |
|
Definition
| Follow is the most important. |
|
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