Cervical Cancer Flashcards
HPV infx causes metaplastic changes to the cells in the ________
cervical transformation zone (junction b/w squamous epithelium of ectocervix and glandular epithelium of endocervix)
order a ___ for cervical CA
Colposcopy + Bx
PAP screening guidelines
< 21 yo
do NOT screen
PAP screening guidelines
21-29 yo
PAP alone q 3yrs
dont do HPV screen bc its very common in this age grp and will likely clear on its own
PAP screening guidelines
30-65
3 options
1. PAP alone q 3 yrs
2. HPV test alone q 5yrs
3. CO-Test (PAP + HPV) q 5yrs
PAP screening guidelines
> 65yo
None if average risk pt and norm screens for past 10yrs and no risk factors
PAP screening guidelines
Post-hysterectomy
Hysterctomy d/t CIN or CA -> vaginal cuff PAP
No CIN/CA + TOTAL hysterectomy -> NONE
No CIN/CA + subtotal hysterectomy (cervix intact) -> norm screen based on age
You can stop PAP screens if youve had healthy screens your entire life and are now ___yo
65
List the PAP terminology reports from least to most severe
- Negative for intraepithelial lesion or malig
- ASC-US
- LSIL
- ASC-H
- HSIL
- SCC
- AGC
- Adenocarcinoma in Situ or Adenocarcinoma
PAP reports
LSIL is associated with CIN _____
HSIL is associated with CIN ___
LSIL -> CIN I
HSIL -> CIN II/III
is LSIL and HSIL squamous or glandular?
squamous
ASC-US Trmnt
21-24yo -> repeat PAP in 1yr
25+ -> HPV (+) -> Colposcopy + Bx. HPV (-) -> CO-TEST q 3yrs
Only do a colposcopy + Bx on a pregnant pt if their PAP report shows ____
HIGH GRADE LESIONS
HSIL, AGC, OR HIGHER
Pregnant pt had a PAP and report says CNII/III. Trmnt?
defer trmnt until postpartum
Preferred trmnt of cervical cancer if pt was to become pregnant in the future
Ablation > excision