{"id":2040,"date":"2021-11-17T17:21:00","date_gmt":"2021-11-17T17:21:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=2040"},"modified":"2025-10-01T11:40:32","modified_gmt":"2025-10-01T19:40:32","slug":"usmle-step-1-question-of-the-day-cervix","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-cervix","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day: Cervix"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-cervix\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-cervix\/#D_Transition_from_squamous_to_columnar_epithelial_cells\" >D. Transition from squamous to columnar epithelial cells<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-cervix\/#Incorrect_answer_explanations\" >Incorrect answer explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-cervix\/#A_Squamous_epithelial_cells\" >A. Squamous epithelial cells<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-cervix\/#B_Cuboidal_epithelial_cells\" >B. Cuboidal epithelial cells<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-cervix\/#C_Columnar_epithelial_cells\" >C. Columnar epithelial cells<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-cervix\/#E_Transition_from_squamous_to_cuboidal_epithelial_cells\" >E. Transition from squamous to cuboidal epithelial cells<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-cervix\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-cervix\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-cervix\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case focuses on a speculum exam and the area from where the sample is obtained.&nbsp;<\/em><\/strong><strong><em>Can you figure it out?<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 30-year-old woman comes to her primary care physician for an annual examination. The patient feels well and has no complaints. Over the past year, she has been sexually active with three male partners and does not use barrier contraception. A speculum exam is performed, and a specimen is collected using a cytobrush. Pap smear testing reveals cells with enlarged nuclei and perinuclear halos. Which of the following best describes the normal histology of the region of the cervix from where this sample was obtained?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Squamous epithelial cells<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Cuboidal epithelial cells<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Columnar epithelial cells<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Transition from squamous to columnar epithelial cells<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Transition from squamous to cuboidal epithelial cells<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Scroll down to find the answer!<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Everybody loves Osmosis.org\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/kizbJZ9cdLg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><u><em><strong>\u2192 Reinforce your understanding with more self-assessment items on Osmosis.<\/strong>\u00a0<\/em><\/u><\/a><\/em><\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_Transition_from_squamous_to_columnar_epithelial_cells\"><\/span>D. Transition from squamous to columnar epithelial cells<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the&nbsp;<strong>Main Explanation<\/strong>, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_answer_explanations\"><\/span>Incorrect answer explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The incorrect answers to today&#8217;s USMLE\u00ae Step 1 Question are&#8230;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Squamous_epithelial_cells\"><\/span>A. Squamous epithelial cells<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Squamous epithelial cells are found in the ectocervix, which is continuous with the vagina. A Pap smear is obtained at the transformation zone, where dysplasia most frequently happens.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_Cuboidal_epithelial_cells\"><\/span>B. Cuboidal epithelial cells<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Cuboidal epithelial cells are often found in organs with secretory, absorptive, or excretory functions. These include the pancreas, kidneys, and parotid glands. Simple cuboidal epithelium is also present on the outer surface of the ovaries. However, cuboidal epithelial cells are not present in the cervix.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_Columnar_epithelial_cells\"><\/span>C. Columnar epithelial cells<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Columnar epithelial cells are found in the endocervix, which is closer to the uterus. Koilocytes (epithelial cells with enlarged nuclei and perinuclear halos) and cervical dysplasia are more likely to be present at the transformation zone, rather than the endocervix.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"E_Transition_from_squamous_to_cuboidal_epithelial_cells\"><\/span>E. Transition from squamous to cuboidal epithelial cells<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Cuboidal epithelial cells are not present in the cervix. Therefore, there would be no region in the cervix wherein squamous epithelial cells are replaced by cuboidal epithelial cells.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/www.osmosis.org\/plans\/md\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_9c34cd.png\" alt=\"Osmosis ad to create an account\" class=\"wp-image-2042\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_9c34cd.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_9c34cd.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span><strong>Main Explanation<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The cervical canal can be divided into three regions. The&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Cervix_and_vagina_histology?from=\/md\/foundational-sciences\/histology\/organ-system-histology\/reproductive-system\/female-reproductive-system\" target=\"_blank\" rel=\"noreferrer noopener\">endocervix<\/a><\/strong>&nbsp;is closer to the uterus, and is lined by columnar epithelial cells. The&nbsp;<strong>ectocervix<\/strong>&nbsp;is continuous with the&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Cervix_and_vagina_histology\" target=\"_blank\" rel=\"noreferrer noopener\">vagina<\/a>, and it is lined by mature squamous epithelial cells. Where the squamous epithelium of the ectocervix and the columnar epithelium of the endocervix meet, there is a line called the&nbsp;<strong>squamocolumnar junction<\/strong>&nbsp;(also termed the&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Cervical_cancer:_Clinical_practice\" target=\"_blank\" rel=\"noreferrer noopener\">transformation zone<\/a><\/strong>).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It is at the transformation zone where cellular&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Metaplasia_and_dysplasia\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>metaplasia<\/strong>&nbsp;and&nbsp;<strong>dysplasia<\/strong><\/a>&nbsp;most often take place, and therefore a Pap smear specifically samples tissue from the squamocolumnar junction. Metaplasia occurs when a stressor, such as acidity of the vaginal canal during reproductive years, causes replacement of one cell type by another. In the cervix, columnar epithelium is replaced by squamous epithelium. Metaplasia is&nbsp;<strong>reversible<\/strong>&nbsp;once the stressor is removed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In contrast, dysplasia occurs when fully differentiated cells are replaced by immature cells with varying shape and nuclear morphology, as demonstrated by the&nbsp;<strong>koilocytes<\/strong>&nbsp;in this question stem, with their enlarged nuclei and perinuclear halos. Mild dysplasia is reversible. However moderate or severe dysplasia is&nbsp;<strong>irreversible,<\/strong>&nbsp;and if not monitored, it can progress to&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Cervical_cancer\" target=\"_blank\" rel=\"noreferrer noopener\">cervical cancer<\/a>.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"511\" height=\"259\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T112339.718.png\" alt=\"Cervical pathologies: physiology.\" class=\"wp-image-2043\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T112339.718.png 511w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T112339.718.png?resize=300,152 300w\" sizes=\"auto, (max-width: 511px) 100vw, 511px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span><strong>Major Takeaway<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The cervical canal can be divided into three regions: the<strong>&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Cervix_and_vagina_histology?from=\/md\/foundational-sciences\/histology\/organ-system-histology\/reproductive-system\/female-reproductive-system\" target=\"_blank\" rel=\"noreferrer noopener\">ectocervix<\/a>,&nbsp;<\/strong>the<strong>&nbsp;squamocolumnar junction<\/strong>, and the&nbsp;<strong>endocervix<\/strong>. The ectocervix contains&nbsp;<strong>squamous epithelial cells<\/strong>&nbsp;whereas the endocervix contains&nbsp;<strong>columnar epithelial cells<\/strong>. Cellular&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Metaplasia_and_dysplasia\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>metaplasia<\/strong>&nbsp;and&nbsp;<strong>dysplasia<\/strong><\/a>&nbsp;most often occurs at the squamocolumnar junction (i.e. transformation zone).<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Cervix and vagina: Histology\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/H2frmAhXLgk?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span><strong>References<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Callahan, T.L., Caughey, A.B. (2018)&nbsp;<em>Blueprints Obstetrics &amp; Gynecology<\/em>. Wolters Kluwer. ISBN: 978-1975134877.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Sellors, J.W., Sankaranarayanan, R. (2020)&nbsp;<a href=\"https:\/\/screening.iarc.fr\/colpochap.php?lang=1\" target=\"_blank\" rel=\"noreferrer noopener\">Colposcopy and treatment of cervical intraepithelial neoplasia: A beginners\u2019 manual<\/a>.<em>&nbsp;International Agency for Research on Cancer<\/em>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em><strong>_________________________<\/strong><br><br><strong>Want more USMLE\u00ae Step 1 practice questions? Try Osmosis today! Access your&nbsp;<em><strong><a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a><\/strong><\/em>&nbsp;and find out why millions of current and future clinicians and caregivers love learning with us.<\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/www.osmosis.org\/ultimate-guide\/usmle-step-1\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T112410.374.png\" alt=\"Osmosis display ad.\" class=\"wp-image-2044\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T112410.374.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T112410.374.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.osmosis.org\/ultimate-guide\/usmle-step-1\" target=\"_blank\" rel=\"noreferrer noopener\"><\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em><sub>The United States Medical Licensing Examination (USMLE\u00ae) is a joint program of the Federation of State Medical Boards (FSMB\u00ae) and National Board of Medical Examiners (NBME\u00ae). Osmosis is not affiliated with NBME nor FSMB.&nbsp;<\/sub><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case focuses on a speculum exam and the area from where the sample is obtained.&nbsp;Can you figure it out? A 30-year-old woman comes to her primary care physician for an annual examination. The patient feels well and [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":2041,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[27,20,1369,44],"tags":[],"class_list":["post-2040","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-step-1-questions","category-step-1"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 1 Question of the Day: Cervix - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-cervix\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 1 Question of the Day: Cervix - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Each week, Osmosis shares a USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics. Today&#8217;s case focuses on a speculum exam and the area from where the sample is obtained.&nbsp;Can you figure it out? A 30-year-old woman comes to her primary care physician for an annual examination. 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