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ObGyn Lecture > Lecture 8- PapSmear/ Vulvovaginitis > Flashcards

Lecture 8- PapSmear/ Vulvovaginitis Flashcards

1
Q

What is when cells are scraped from the cervix and examined under a microscope to check for cancer or other problems ?

A

Pap smear

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2
Q

What age should women get a pap smear?

A

21 and older

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3
Q

Do women with a total hysterectomy need a pap smear?

A

No as long as it wasn’t done as treatment for cervical pre-CA or CA

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4
Q

Is a Pap Smear a diagnostic test?

A

No- it is only screening

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5
Q

What is a diagnostic test to get a tissue biopsy to confirm the findings of the pap smear?

A

Colposcopy

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6
Q

Testing for what other conditions can also be obtained if the Pap is liquid based?

A

Gonorrhea and chlamydia

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7
Q

When can paps normally be stopped?

A

After age 65 with a normal history

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8
Q

Most HPV infections clear the immune system within how many months?

A

24-36 months

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9
Q

how many subtype of HPV are there?

A

More than 100

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10
Q

What are the 2 most high risk strains of HPV?

A

16 and 18 cause 2/3 of cervical cancer

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11
Q

how long does it take for invasive cervical CA to develop after detection of a precancerous state (CIN2/3)?

A

average of 10 years

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12
Q

What can increase the risk of getting HPV?

A 
Multiple sexual partners
Engaging in intercourse at a young age
Multiparity
Immunodeficiency 
Smoking
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13
Q

What does ASC-US stand for?

A

Atypical squamous cells of undetermined significance

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14
Q

what is the advantage of testing for HPV over 30?

A

Immune system isn’t as robust, most susceptible to infection

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15
Q

What does the HPV vaccine have?

A

viral like particles which lack viral genetic

material and are non-infectious.

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16
Q

What does CIN stand for?

A

Cervical intraepithelial neoplasia

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17
Q

What 2 strains are most commonly associated with genital warts?

A

Types 6 and 11

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18
Q

What are encapsulated HPV virons expressed as morphologically?

A

koilocytes

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19
Q

What are the two types of cervical epithelium?

A

Columnar (glandular)

Stratified non-keratinizing squamous epithelium

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20
Q

Where do most neoplasms arise?

A

Squamocolumnar Junction (SCJ)

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21
Q

What is the are b/w the original SCJ and teh active SCJ (area of squamous metaplasia)

A

Transformation Zone (TZ), area most vulnerable to oncogenic changes

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22
Q

What is a cyst that happens when glands within the columnar epithelium becomes trapped causing these cysts.

A

Nabothian Cysts

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23
Q

What does LGSIL stand for?

A

Low grade squamous interepithelial lesions

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24
Q

what determines the grade and extent of the lesion

A

colpo (coloposcopy)

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25
Q

What are options for abnormal pap results?

A

Repeat Pap in 6 months (for low grade)
HPV testing (already done with reflexive testing)
Colposcopy (most common(
Endocervical curretage (ECC)

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26
Q

If there is a ASCUSC with negative HPV what should you do?

A

Repeat Pap in 1 year

27
Q

Where are glandular cells located?

A

Endocervical canal

28
Q

What do AGC stand for?

A

Atypical glandular cells

29
Q

What could AGC indicate?

A

Uterine, fallopian tube, glandular cancers

or could be CIN (mis-identified)

30
Q

What should be done after an AGC comes back?

A

Colpo

Endocervical sampling

31
Q

What are excisional treatments for CIN? (most common)

A

Cold-knife cone
LEEP
LLETZ (laser conization and electrosurgical needle conization)

32
Q

WHat are some ablation techniques for CIN? (not as common)

A

cryotherphy
Laser ablation
Electrofulguration and cold coagulation

33
Q

After treatment for noninvasive abnormalities how often should a Pap be done?

A

Every 6 months for 2 years

34
Q

What are the two major types of cervical cancer?

A

Squamous cell and adenocarcinoma

35
Q

What is the most common form of cervical cancer?

A

Squamous cell

36
Q

What is the good bacteria in the vagina? Formed after puberty.

A

Lactobacilli

37
Q

What do lactobaccili break down glycogen to to keep the vagina acidic?

A

lactic acid

38
Q

What give vaginal secretions a white to off-white color?

A

Exfoliated squamous cells

39
Q

What is a polymicrobial infection characterized by a lack of H2O2 producing lactobacilli and an overgrowth of facultative anaerobic organisms.

A

Bacterial vaginosis (BV)

40
Q

What are common symptoms of bacterial vaginosis (BV)?

A

discharge, odor that gets worse after intercourse

41
Q

What will the discharge smell like with bacterial vaginosis (BV)?

A

musty of fishy odor because of bacteria producing amines

42
Q

What is a way to test for BV?

A

Drop KOH on swab with vaginal discharge and will have fishy smell.

43
Q

what does the discharge look like with BV?

A

thin, homogenous, white adherent discharge

44
Q

What type cells are present on microscopic appearance with BV?

A

Clue cells

45
Q

How do you treat BV?

A

Oral or topical metronidazole (flagil) or oral or topical clindamycin

46
Q

What form of metronidazole should you give if the person is going to drink?

A

Topical form

47
Q

What is an infection caused by ubiquitous airborne fungi, approximately 90% of these infections

A

Yeast infection (candidiasis)

48
Q

What will the pH be like with a yeast infection?

A

Normal (lactobacilli aren’t disrupted)

49
Q

What are common symptoms of a yeast infection?

A

Itching, burning, irritation, thick, white discharge

50
Q

What does the discharge look like with yeast infection?

A

Thick, white cottage cheese like

51
Q

What will the vulva and vaginal tissues look like with a yeast infection?

A

Bright red in color

52
Q

What is the microscopic appearance of a yeast infection?

A

Hyphae and buds (apply KOH and look at under 10x power)

53
Q

How do you treat a yeast infection?

A 
Topical antifungals (micronazole, clotrimazole, terconazole, etc.)
Oral fluconazole (only one pill, one dose) 
-STD lecture: butocanzole or fluconazole
54
Q

What is flagellate protozoan that lives only in the vagina, Skene ducts, and male or female urethra?

A

Trichomonas Vulvovaginitis (trich)

55
Q

What is the pH with trich?

A

Greater than 4.5

56
Q

What is the most common symptom with trich?

A

Frothy discharge (gray-green)

57
Q

What will the cervix look like with trich?

A

Strawberry cervix

58
Q

What is the microscopic appearance with trich?

A

Flagellated organisms present (look at 40x)

move independently

59
Q

What is the treatment for trich?

A

Metronidazole or Tinidazole

60
Q

What is Atrophy of the vaginal epithelium due to diminished estrogen levels?

A

Atrophic vaginitis

61
Q

What is a vaginitis that occurs with a dry vagina?

A

Atrophic vaginitis.

62
Q

How do you treat atrophic vaginitis?

A

Topical estrogen therapy

63
Q

What is a vaginitis that is characterized by purulent discharge, exfoliation of epithelial cells and vulvovaginal burning and erythema?Generally seen in peri and postmenopausal women

A

Desquamative inflammatory vaginitis

64
Q

How do you treat desquamative inflammatory vaginitis?

A

Clindamycin cream 2% applied for 14 days

ObGyn Lecture (21 decks)

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