Cervical Dysplasia

Question 1

What starts in puberty because of hormonal influence and changes in the vaginal pH, the tissue of the cervix can undergo cellular changes?

Answer 1

Cervical dysplasia

Question 2

Infection with ___ may lead to cellular abnormalities and over a period of time, this can develop into cervical dysplasia or cancer

Answer 2

HPV

Question 3

There are varying degrees of dysplasia also known as what?

Answer 3

Neoplasia

Question 4

True or False

All atypia (presence of abnormal cells) must be observed and treated if persistent or worsening

Answer 4

True

Question 5

Cervical dysplasia is defined by the degree of what?

Answer 5

Cellular atypia

Question 6

Cervical dysplasia is also called what?

Answer 6

Cervical Intraepithelial Neoplasia (CIN)

Question 7

Are there specific symptoms or signs of cervical dysplasia?

Answer 7

No, patients are often asymptomatic

Question 8

A presumptive diagnosis of cervical dysplasia is made by what abnormal test of an asymptomatic woman with no grossly visible cervical changes?

Answer 8

PAP smear

Question 9

True or False

All visible abnormal cervical lesions should be referred to OB/GYN for biopsy and possible therapy

Answer 9

True

Question 10

In immunocompetent women, cervical cancer screening should begin at what age, regardless of the age of onset of sexual intercourse?

Answer 10

21 y/o

Question 11

The US Preventive Services Task Force (USPSTF) recommends screening for cervical cancer in women aged 21 to 65 years with cytology (PAP smear) every ____ years or for women aged 30 to 65 years, screening with a combination of cytology and HPV testing every__ years. Assuming negative HPV risk factors.

Answer 11

1. 3 years

2. 5 years

Question 12

The USPSTF recommends against screening for cervical cancer with HPV testing, alone or in combination with cytology, in women younger than age ____. HPV can “go away’ in younger women.

Answer 12

30 years old

Question 13

The USPSTF also recommends against cervical cancer screening for women older than age ____ who have had adequate prior screening and are not otherwise at high risk or cervical cancer.

Answer 13

65 years old

Question 14

In cervical dysplasia, pap smear findings can be described in one of several ways using the Bethesda system, such as what?

Answer 14

1. Atypical squamous cells of unknown significance (ASC-US)
2. Squamous intraepithelial lesions (SIL)
   a. Low-grade (LSIL)
   b. High-grade (HSIL

Question 15

What is a diagnostic procedure in which a colposcope (a dissecting microscope with various magnification lenses) is used to provide an illuminated, magnified view of the cervix, vagina, vulva, or anus?

Answer 15

Colposcopy

Question 16

Women with ASC-US and a negative HPV infection screening may be followed up in ___ year for a repeat Pap smear and HPV co-testing?

Answer 16

1 year

Question 17

Is a colposcopy indicated if the HPV screen is positive?

Answer 17

Yes

Question 18

True or False

All patients with SIL or atypical glandular cells should undergo colposcopy

Answer 18

True

Question 19

True or False

Cervical dysplasia

Colposcopically directed punch biopsy and endocervical curettage is necessary for diagnosis and planning of treatment

Answer 19

True

Question 20

Cervical infection with what is associated with a high percentage of all cervical dysplasia and cancers?

Answer 20

HPV

Question 21

What vaccination can prevent cervical, vaginal, and vulvar cancers and low grade and precancerous lesions caused by HPV, and is recommended for females and males aged 9 and older?

Answer 21

Gardasil

Question 22

All treatments for cervical dysplasia are performed by OB/GYN but varies on the degree and extent of CIN, but what should precede the treatment?

Answer 22

Biopsies (except in cases of HSIL)

Question 23

What treatment for cervical dysplasia is effective for noninvasive small lesions visible on the cervix?

Answer 23

Cryosurgery

Question 24

In cases of HSIL it may be appropriate to proceed directly to what?

Answer 24

Loop electrosurgical excision procedure (LEEP) (wire loop is used for excision)

Question 25

What treatment is reserved for cases of severe dysplasia or cancer?

Answer 25

Conization of the cervix

Question 26

True or False

ALL patients with an abnormal PAP smear findings should be referred to physician supervisor or OB/GYN for further evaluation

Answer 26

True