Cervical Abnormalities, Fibroids, Ovarian Cysts/Cancer – Flashcards
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Dysplasia
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disordered growth, pre-cancerous changes
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3 classification of dysplasia
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-severe dysplasia: most likely to become cancerous -moderate dysplasia: may become cancerous -mild dysplasia: may go away on its own
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All degrees of dysplasia fit under one of three categories:
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-Atypical squamous cells of undetermined significance (ASCUS): borderline, some abnormal cells -Low grade squamous intraepithelial lesions (LGSIL): includes mild dysplasia, cellular changes associated with HPV -High grade squamous intraepithelial lesions (HGSIL): includes moderate dysplasia, severe dysplasia
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Evaluation of Abnormal Pap Smears
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-Repeat Pap -Biopsy: biopsy preceded by Colposcopy; painless procedure using a colposcope to examine cervix more closely (microscope) -Reasons for biopsy: more aggressive approach to abnormal Pap smears; increased STD's (especially HPV) linked to pre-cancerous and cancerous changes in cervix
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Evaluation of the Cervical Biopsy
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-Treatment depends on what biopsy reveals -Inflammation of cervix (cervicitis) may be an infection and treated locally (creams/suppositories)
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Treatments for more severe dysplasia
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-Cone biopsy: removes deeper section of tissue (called cold knife surgery); provides tissue for diagnosis and removes abnormal tissue -"LEEP" procedure (Loop Excision Electrosurgical): technique using a special form of high frequency current to cut across cervix -Cryosurgery -Radiation -Chemotherapy -Hysterectomy
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Risks factors for Cervical Cancer
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-Sexual intercourse -Early sexual intercourse, pregnancy in teen years (cells of cervix are more vulnerable) -Multiple partners -STD's (HPV) -Possible long term use of synthetic hormones -Large family size
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4 steps of pelvic exam
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-External genitalia is inspected -Speculum exam: Pap test -Bimanual exam: evaluates uterus, fallopian tubes, and ovaries -Rectovaginal exam: inspects for hemorrhoids, polyps
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Fibroids
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-A cause of abnormally enlarged uterus -Found in 20-25% of women of reproductive age -Most common reason for hysterectomy -Muscular, fibrous tissue forming tumors originating in the wall of the uterus -Grow slowly -Nearly always benign -Diagnosed during routine pelvic exam
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Treatment of Fibroids
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-Medication: non-steroidal anti-inflammatory drugs; low-dose birth control pills -Myomectomy: surgical removal and repair -Hysterectomy: most radical and most effective approach
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Ovarian Cysts and Tumors
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-Usually benign tumors or cysts -May produce pelvic pain -Evaluation depends on age, symptoms and characteristics of tumor/cyst -Treatment varies: smaller (less than 2" diameter, synthetic hormones to suppress growth); larger (more than 3" diameter, exploratory surgery, biopsy (remove and sent to lab))
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Ovarian Cancer
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-5th most common cause of cancer in women -Cause unknown -Symptoms: bloating, pelvic pain , abnormal menstrual cycles -Occurs more in women over 55
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Carcinoma-in-situ
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When severe dysplasia progresses to a surface cancer involving the outer layer of the cervix
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Invasive cancer
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Cells disordered throughout entire tissue and invades deeper layers of cervix (treated differently)
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CIN (cervical intraepithelia neoplasia)
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Collective term that refers to both dysplasia and carcinoma-in-situ
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CIN classification or grades of dysplasia
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-CIN (1) mild dysplasia -CIN (2) moderate dysplasia -CIN (3) severe dysplasia or carcinoma-in-situ
