Cervical Dysplasia

Question 1

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

Answer 1

HPV

Question 2

S/S of what issue?
There are no specific symptoms or signs of this. Often asymptomatic
(a) Presumptive diagnosis is made by an abnormal Papanicolaou (PAP) smear of an asymptomatic woman with no grossly visible cervical changes.
(b) All visible abnormal cervical lesions should be referred to OB/GYN for biopsy and possible therapy

Answer 2

Cervical Dysplasia

Question 3

General considerations Cervical dysplasia
(1) Starting in _____ because of hormonal influence and changes in the vaginal pH the tissue of the cervix can undergo cellular changes.
(2) Infection with ___ may lead to cellular abnormalities
—-(a) Over a period of time, this can develop into cervical dysplasia or cancer
(3) There are varying degrees of dysplasia AKA _____
(4) All atypia (presence of abnormal cells) must be observed and treated if persistent or worsening
(5) Defined by degree of ______
(6) Also called ___________; A grading system applies.

Answer 3

1) puberty
2) HPV
3) Neoplasia
5) Cellular atypia
6) Cervical Intraepithelial Neoplasia (CIN)

Question 4

Screening
In immunocompetent women, cervical cancer screening should begin at age ____ regardless of the age of onset of sexual intercourse.
(a) Cervical cancer is very ____ in women younger than age 21 years

Answer 4

21
a) rare

Question 5

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 5

21-65 = Q 3 Y
30-65 = Q 5 Y

Question 6

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

Answer 6

30

Question 7

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

Answer 7

65

Question 8

Women with risk factors that place them at higher risk for CIN may require more frequent screening. What are the risk factors?

Answer 8

1) HIV infection
2) Immunosuppression
3) Exposure to diethylstilbesterol (DES) in utero,
4) Previous treatment for CIN 2, CIN 3, or cervical cancer.

Question 9

Papanicolaou Smear
Findings can be described in one of several ways.
What is the system?

Answer 9

Bethesda System
1) Atypical squamous cells of unknown significance (ASC-US)
2) Squamous intraepithelial lesions (SIL)
—a) Either low-grade (LSIL)
—b) High-grade (HSIL)

Question 10

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

Answer 10

colposcope

Question 11

Women with ASC-US and a negative HPV screening may be followed up in ___ year(s) for a repeat Pap smear and HPV co-testing.

Answer 11

1

Question 12

When is colposcopy is indicated.

Answer 12

If the HPV screen is positive,

Question 13

If HPV screening is unavailable, repeat cytology may be done when?

Answer 13

at 12 months

Question 14

All patients with ________ or ______ cells should undergo colposcopy.

Answer 14

SIL or atypical glandular

Question 15

Cervical infection with the HPV is associated with a high percentage of what?

Answer 15

cervical dysplasias and cancers.