lecture 1: papsmear, wooton Flashcards
risk factors for cervical neoplasia
more than one sexual partner or a male sex partner who has had sex with more than one person
smoking
organ transplant
DES expsoure
High Parity
young age first intercourse or preg
HIV
STI
infreq or absent pap screening tests
lower socioeconomic status
screening for someone under 21
none
screening for comseone 21-29
cytology alone every 3 yrs
screening for someone from age 30-65
HPV and cytology cotesting every 5 yrs
screening for someone over 65
no screening following adequate negative prior screening
SCREENING after hysterectomy
none
what is the gold standard for diagnosis and treatment for hpv and lsil and stuff
colposcopy with directed biopsy
what are you looking for on a colposcopy
acetowhite changes, punctuations, mosaicism, abnormal vessels, masses
all pretty concerning except for acetowhite changes
if have ASC-US (atypical squamous cell of undetermined significane on cytology) then whats next step
repeat cytology at 1 year (acceptable)
or
HPV testing (preferred)
if HPV positive for ASC-US then what next
-what if hpv negative
colposcopy and manage per guidelines
negative = repeat cotesting at 3 years
if repeat cytology for ASC-US is negative then what
-if same or worse ASC then what
routine screen
colposcopy and manage per guidelines
for LSIL with negative HPV test what do you do
repeat cotesting in 1 year (preferred)
- if negaitve then repeat in 3 years
- if hpv positive or > or same ASC then colposcopy
colposcopy is acceptable
LSIL with no HPV test what is next
colposcopy then manage per guidelines
LSIL with positive HPV test what is next
colposcopy then manage per guidelines
managment with HSIL
immediate loop electrosurgical excision or colposcopy and manage per guidelines
