Gynaecological pathology: cervical intraepithelial neoplasia: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Gynaecological pathology: cervical intraepithelial neoplasia

Sample item

A 32-year-old woman has a high-grade squamous intraepithelial lesion on cytology, and colposcopic biopsy shows CIN 3. At which site did the lesion most likely arise, and why is that site vulnerable?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. The transformation zone, where dividing immature metaplastic cells are susceptible to HPV

Most CIN and cervical cancers begin at the squamocolumnar junction within the transformation zone, where columnar epithelium is replaced by squamous metaplasia. Immature metaplastic basal cells are actively dividing and can be infected by high-risk HPV. E6 and E7 then degrade p53 and inactivate Rb.

Option by option

  • A. The transformation zone, where dividing immature metaplastic cells are susceptible to HPV (correct)

    Correct. Immature metaplastic cells of the transformation zone are susceptible to high-risk HPV.

  • B. The mature ectocervical squamous epithelium, which has the highest proliferation

    Mature ectocervical squamous epithelium has low proliferation and is rarely the origin.

  • C. The endocervical glands, which lack protective mucus

    Endocervical glandular epithelium is the origin of adenocarcinoma, which is much less common than squamous lesions.

  • D. The vaginal fornix, where HPV preferentially infects keratinised cells

    The vaginal fornix is not the usual origin of CIN.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, The transformation zone, where dividing immature metaplastic cells are susceptible to HPV. Most CIN and cervical cancers begin at the squamocolumnar junction within the transformation zone, where columnar epithelium is replaced by squamous metaplasia.

Why is "The mature ectocervical squamous epithelium, which has the highest pr…" not the answer?

Mature ectocervical squamous epithelium has low proliferation and is rarely the origin.

Why is "The endocervical glands, which lack protective mucus" not the answer?

Endocervical glandular epithelium is the origin of adenocarcinoma, which is much less common than squamous lesions.

Why is "The vaginal fornix, where HPV preferentially infects keratinised cells" not the answer?

The vaginal fornix is not the usual origin of CIN.

What concept does this question test?

It tests Gynaecological pathology: cervical intraepithelial neoplasia in Pathology. Immature metaplastic basal cells are actively dividing and can be infected by high-risk HPV. E6 and E7 then degrade p53 and inactivate Rb.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological pathology: cervical intraepithelial neoplasia?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.