Question

Which STDs lead to Pelvic Inflammatory Disease (PID) and what are the consequences of PID?

What is the relationship between HPV and Carcinoma of the Cervix?

What is cervical dysplasia and how is it diagnosed?

Why is knowing the status of the lymph nodes in breast cancer so important? How are lymph nodes examined?

Answer 1

pelvic inflammatory disease(PID)

Pelvic inflammatory disease is an infection of a woman's reproductive organs. PID can lead to infertility and permanent damage to woman's reproductive system.there are other causes which are not because of sexually transmitted diseases.

causes

• untreated sexually transmitted diseases
• multiple sex partners
• previous history of pelvic inflammatory disease
• sexually active and are age of 25 or younger
• douche
• use of intra-uterine device

A number of pathogens are responsible for the disease like gram positive and gram negative anaerobic bacteria,gram-negative rods and cocci are also responsible.especially, sexually transmitted pathogens chlamydia trachomitis and neisseria gonnorrhoeae( chlamydia and gonnorhea)

complications of pelvic inflammatory disease

• tubo-ovarian abscess(TOA)-inflammatory mass involving the fallopian tube, ovary and other adjacent pelvic organs.
• tubal factor infertility
• ectopic pregnancy
• chronic pelvic pain

RELATION BETWEEN HPV AND CERVICAL CANCER

human papillomavirus infection (HPV)is the most common viral infection of the reproductive tract.sexually active men and women are likely to be infected.skin-to skin genital contact is the mode of transmission.

carcinoma of cervix is the most common HPV related disease in long run.most cases of cervical cancer can be attributable to HPV infection.

signs and symptoms

majority of HPV infections do not cause symptoms or disease and resolve spontaneously. however, persistent infection with specific types of HPV may lead to percutaneous lesions.if untreated, these lesions may progress to cervical cancer, but this progression takes many years.

symptoms of cervical cancer appear only after it becomes advanced and may include:

• irregular inter-menstruation bleeding or bleeding after sexual intercourse
• back, leg or pelvic pain
• fatigue, weight loss, loss of appetite;
• odorous discharge; and
• a single swollen leg.

Although most HPV infections resolve by their own and most pre-cancerous lesions resolve spontaneously, there is a risk for all women that HPV infection may become chronic and pre-cancerous lesions progress to invasive cervical cancer.

It takes 15 to 20 years for cervical cancer to develop in women with normal immune systems. It can take only 5 to 10 years in women with weakened immune systems, such as those with untreated HIV infection.

Risk factors

• Early first sexual intercourse
• Multiple sexual partners
• Tobacco use
• Immune suppression

CERVICAL DISPLASIA

Cervical dysplasia is a pre-cancerous condition in which abnormal cell growth occurs on the surface lining of the cervix or endocervical canal. It is also called cervical intraepithelial neoplasia (CIN).

it is caused by human papillomavirus(HPV), but there are other factors too.

diagnosis

• Traditionally, the Papanicolaou test (Pap test or Pap smear) has been the screening method of choice. To perform the Pap smear healthcare practitioner removes a swab or brush sample of cells from the outside of the cervix during a pelvic examination using a speculum for visualization. The cells are smeared onto a glass slide, stained, and observed under the microscope for any evidence of abnormal cells.
• Newer, liquid-based systems to screen samples of cervical cells are now much more common and are effective screening tools for detection of abnormal cells. The samples for this test are obtained the same way as for the conventional Pap smear, but the sample is placed in a vial of liquid that is later used to prepare a microscope slide for examination as with the Pap smear.

For women whose initial screening result is unclear or abnormal, other diagnostic tests are used:

. Colposcopy is a gynecological procedure that illuminates and magnifies the vulva, vaginal walls, and uterine cervix in order to detect and examine abnormalities of these structures. A colposcope is a microscope that resembles a pair of binoculars. The instrument has a range of magnification lenses. It also has color filters that allow the physician to detect surface abnormalities of the pelvic organs.
. A Biopsy is a tissue sample obtained for examination under the microscope. A biopsy is taken from suspicious surface areas seen during colposcopy. A diagnosis can only be made from a tissue biopsy.
. HPV testing to detect a "high-risk" type is done if a Pap smear is abnormal or may be recommended for some women. Use of HPV testing alone is being suggested as a replacement for pap smear.