Cervical Cytology Flashcards
Usual treatment for HPV positive results? x3
- recheck in year
- DNA 16/18 + colposcopy
- DNA 16/18 - recheck in a year
What to do anytime there is CIN 2,3?
excision or ablation of T zone and recheck in 12 and 24 months
Anytime there is HSIL?
LEEP, or if 21-24, wait 2 years and then leep
What to do if you have HPV and CIN 1?
Be aggressive after waiting two years?
What to do for cytology unsatisfactory for:
- HPV - or unknown
- HPV + and >30 years old
- repeat in 1 year
2. Colposcopy
Three options for ASC of unknown significance
- repeat in one year
- HPV + do coposcopy
- ASC same or increased do colposcopy
ASC of Unknown Significance?
- test HPV
- positive does colposcopy
- Negative tests in 3 years
IN 21-24 year olds, just repeat cytology in 12 months
LSIL in women with 1. no HPV and 2. HPV?
- No HPV- cytology in 12 months
2. Yes HPV- colposcopy
Pregnant women with LSIL?
Go straight to colposcopy and only do intervention if CIN 2,3
Women with ASC- H? Atypical squamous cells, cannot exclude high grade SIL
All do colposcopy
21-24 get it every 6 months for 2 years
Women with HSIL? High grade squamous intraepithelial lesion
Immediate loop or colposcopy
What to do for women with atypical glandular cells?
Colposcopy and endometrial sampling
What to do for CIN 1 with minor preceded variants?
Recheck in 12 months
- Cytology neg and HPV neg, recheck 3 years
- Cytology or HPV positive, colposcopy
What to do with CIN 1 with HSIL preceding?
cytology 12 or 24 months
or LEEP
or if HPV +, do LEEP
Treatemnt CIN 2,3?
- diagnostic excisional procedure and then cytology 12 and 24 months
- If 21-24, recheck at 6 and 12 months and then do procedure if it doesn’t regress.
Women presents with unsatisfactory cytology. HPV is unknown. What do you do?
Repeat Cytology in 2-4 months
Women presents with unsatisfactory cytology. HPV is positive. What do you do?
Colposcopy
Woman is 21-29. Cytology is NILM. What do you do?
Routine screening
Woman is 30. Cytology is NILM. What do you do?
HPV test or cytology and HPV test in 1 year.
Woman is 30 and cytology is negative, but she is HPV positive. What do you do?
- repeat at one year
2. or DNA test HPV
Woman is 30. Cytology is negative, but HPV is 16 or 18 positive. What do you do?
Colposcopy.
Woman is 30. Cytology is negative, but HPV is 16 or 18 NEGATIVE. What do you do?
Costest in one year.
Woman is 30. Her repeat cytology shows HPV continues, and/or more ASC. What do you do?
Colposcopy
Woman is 30. Cytology comes back as ASC-US. What do you do?
Test for HPV. If negative, recheckk in 3 years. If positive, do colposcopy.
A 21-24 year old comes in with ASC-US. What do you do?
Repeat cytology in 12 months. Orit comes back with ASC-H, AGC, or HSIL, do colposcopy.
What to do with anyone who comes back with same or more ASC?
Colposcopy
Woman cytology has LSIL with negative HPV test. What do you do?
Repeat cotesting.
Woman presents with LSIL with no HPV or positive HPV test. What do you do?
Colposcopy.
What to do with pregnant female with LSIL?
Colposcopy.
When do you manage pregnant women with advance intervention? further than Colposcopy?
CIN 2, 3
What to do with 30 year old with ASC-H? Regardless of HPV?
Colposcopy
What to do with women who is 21-24 with ASC-H?
Colposcopy
What to do with woman who is 21-24 who comes back with HSIL?
Colposcopy.
Colposcopy comes back with no CIN2,3 for 21-24 year old. What do you do next?
Observe with colposcopy and cytology every 6 months for 2 years.
What to do with 30 year old woman who as HSIL?
Leep or Colposcpy wo measure CIN 2,3
What to do with all women who come back with positive AGC (atypical glandular cells) on cytology? x2
Colposcopy and endometrial sampling
What to do with women with atypical glandular cells that initial cytology showed has no CIN, AIS, or cancer?
Cotest at 12 and 24 months with cytology and do colposcopy with any abnormality
What to do with woman who’s cytology comes back at CIN 1 preceded by ‘lesser abnormalities’ (ASC-UC, LSIL, HPV)
Cotest in 12 months
After co-testing a woman with CIN1 a year later, her cytology comes backs NEGATIVE for cytology and HPV. What do you do?
Retest in 3 years
After co-testing a woman with CIN1 (With history of lesser abnormalities) a year later, her cytology comes backs POSITIVE for cytology or HPV. What do you do?
Colposcopy.
Women comes back with CIN 1 preceded by ASC-H or HSIL. What o you do? x2
LEEP or
Co-test in 12 months
Woman comes in with CIN 1 after ASC-US or LSIL. What do you do?
Repeat cytology in 12 months.
- If same or greater ASC-H or HSIL, do colposcopy.
- If negative, repeat in 12 months
What to do with woman 30 years old with CIN 2 or CIN 3?
Excisional procedure and contest in 12 and 24 months.
