Cervical Dysplasia

Question 1

what is dysplasia also known as?

Answer 1

neoplasia
also called Cervical Intraepithelial Neoplasia (CIN): a grading system applies.

defined by degree of cellular atypia

Question 2

Signs and SX of cervical dysplasia:

Answer 2

no specific sx; often asymptomatic

diagnosis made by abnormal PAP

visible abnormal lesions are referred to OBGYN

Question 3

at what age should cervical cancer screening be begun regardless of onset of sexual intercourse?

Answer 3

21 years old

Question 4

Who sets the recommended screening standards for cervical cancer?

Answer 4

USPSTF (US preventive Services Task Force

Question 5

what is the frequency of testing for women 21 to 65 with PAP for cervical cancer?

Answer 5

every 3 years

Question 6

what is the recommended testing for cervical caner with combo of cytology and HPV testing for women 30-65, assuming negative HPV risk factors?

Answer 6

5 years

Question 7

who does the USPSTF recommend against cervical cancer screening for?

Answer 7

HPV testing, alone or in combo with cytology, in women younger than age 30. HPV can “go away” in younger women.

women older than 65 w adequate prior screening and not at otherwise high risk

Question 8

what are some risk factors for cervical cancer that may require more frequent testing?

Answer 8

HIV infection
Immunosuppression
exposure to DES
previous treatment for CIN 2 or CIN 3 or cervical cancer

Question 9

How would you diagnose Cervical Cancer?

Answer 9

PAP smear
Colposcopy
Biopsy

Question 10

What is the Bethesda System used for? and what are the categories?

Answer 10

describing the findings of a PAP smear for diagnosis cervical cancer.

ASC- US- unknown significance

SIL either lowgrade of high grade (LSIL, HSIL)

Question 11

women with ASC US and a negative HPV screening may be followed for how long for a repeat PAP and HPV testing?

Answer 11

1 year

Question 12

If after one year, a patient with ASC US has a positive HPV what test would be indicated?

Answer 12

colposcopy

Question 13

what patients are always indicated for colposcopy?

Answer 13

patients with SIL or atypical GRANDULAR cells… (not to be confused with atypical Squamous cells)

Question 14

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

Answer 14

Cervical infection with the HPV

Question 15

at what age is HPV vaccination recommended? (gardasil)

Answer 15

ages 9 and older

Question 16

biopsies should precede all treatment of cervical dysplasia with the exception of what types of identified cells?

Answer 16

HSIL (high grade squamous intraepithelial lesions)

Question 17

what type of treatment is effective for noninvasive small lesions visible on the cervix?

Answer 17

cryosurgery

Question 18

what type of cervical dysplasia treatment minimizes tissue destruction and is colposcopically directed?

Answer 18

CO2 Laser

Question 19

what type of cervical dysplasia is reserved for severe dysplasia or cancer in situ?

Answer 19

conization of the cervix