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Oral board studying Prep book > Office-Cervical cancer > Flashcards

Office-Cervical cancer Flashcards

1
Q

What is the recommended screening for cervical cancer?

A

Age 21-30= every 3 years
Age 30-65= every 5 years with HPV co-testing or 3 years with pap alone

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2
Q

What is the recommendation for pap screening after a benign total hysterectomy?

A

Pap smears stop

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3
Q

What is the recommendation for pap screening after a total hysterectomy with history of CIN2/3

A

Pap smear q 3 years until 25 years after initial post treatment surveillance

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4
Q

What is the recommendation for ASCUS Pap smear?

A

Age 21-24= repeat cytology in 1 year
Age 25-65= HPV testing if positive colposcopy

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5
Q

What is the recommendation for ASC-H?

A

Colposcopy

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6
Q

What is the recommendation for LSIL?

A

Age 21-24= repeat cytology in 1 year
Age 25-65= colposcopy

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7
Q

What is the recommendation for HSIL?

A

Age 21-24= colposcopy
Age 25-65= LEEP or colposcopy

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8
Q

What does LSIL stand for?

A

CIN 1

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9
Q

Is LSIL a precursor to cervical cancer?

A

No unless left untreated over extended period of time

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10
Q

What is CIN2?

A

Precancerous lesion that can either regress to CIN1 or progress to CIN3

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11
Q

How do you manage CIN2?

A

Age 21-24= colposcopy and cytology at 6 & 12 months
25-65= LEEP

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12
Q

When is a ECC indicated for colposcopy?

A
  1. Colposcopy unsatisfactory
  2. Pap shows ASC-H, HSIL, AGC, AIS
  3. Contemplating ablative therapy
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13
Q

What is management of abnormal pap for women age 25 years or older based on?

A

Present risk of CIN3 or higher rather than on cytology or HPV results alone

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14
Q

What is management if the immediate CIN3+ risk is >/= 4%?

A

Colposcopy or treatment

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15
Q

What is the management if the immediate CIN3+ risk is <4%?

A

Consider the 5 year CIN3+ risk

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16
Q

What is the management if the immediate CIN3+ risk is 4-24%?

A

Colposcopy

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17
Q

What is the management if the immediate CIN3+ risk is 25-59%

A

Colposcopy or expedited treatment

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18
Q

What is the management if the immediate CIN3+ risk is 60-100%?

A

Expedited treatment

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19
Q

What is the management of the 5yr CIN3+ risk is >/=0.55%

A

Repeat testing in 1 year

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20
Q

What is the management if the 5yr CIN3+ risk is 0.15-0.54%?

A

Repeat testing in 3 years

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21
Q

What is the management of the 5yr CIN3+ risk is <0.15?

A

Repeat testing in 5 years

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22
Q

After treatment of HSIL, CIN2, CIN3 or AIS what is the recommended surveillance?

A

Surveillance at 3 year intervals for at least 25 years

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23
Q

Women 25 y/o or older
Prior pap: Unknown or NILM, HPV neg
Current pap: NILM, HPV negative
What is recommended management?

A

Repeat in 5 years

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24
Q

Women 25 y/o or older
Prior pap: Unknown or NILM, HPV neg
Current pap: NILM, HPV positive
What is recommended management?

A

Repeat in 1 year

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25
Q

Women 25 y/o or older
Prior pap: Unknown or NILM, HPV neg
Current pap: ASCUS, HPV negative
What is recommended management?

A

Repeat in 3 years

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26
Q

Women 25 y/o or older
Prior pap: Unknown or NILM, HPV neg
Current pap: ASCUS, HPV positive
What is recommended management?

A

Repeat in 1 year

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27
Q

Women 25 y/o or older
Prior pap: Unknown or NILM, HPV neg
Current pap: LSIL, HPV negative
What is recommended management?

A

Repeat in 1 year

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28
Q

Women 25 y/o or older
Prior pap: Unknown or NILM, HPV neg
Current pap: LSIL, HPV positive
What is recommended management?

A

Repeat in 1 year

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29
Q

Women 25 y/o or older
Prior pap: Unknown or NILM, HPV neg
Current pap: ASC-H/AGC
What is recommended management?

A

Colposcopy

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30
Q

Women 25 y/o or older
Prior pap: Unknown or NILM, HPV neg
Current pap: HSIL, HPV negative
What is recommended management?

A

Colposcopy

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31
Q

Women 25 y/o or older
Prior pap: Unknown or NILM, HPV neg
Current pap: HSIL, HPV positive
What is recommended management?

A

Colposcopy/treatment

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32
Q

Women 25 y/o or older
Prior pap: ASCUS, HPV neg
Current pap: NILM, HPV negative
What is recommended management?

A

Repeat in 5 year

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33
Q

Women 25 y/o or older
Prior pap: ASCUS, HPV neg
Current pap: NILM, HPV positive
What is recommended management?

A

Repeat in 1 year

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34
Q

Women 25 y/o or older
Prior pap: ASCUS, HPV neg
Current pap: ASCUS, HPV negative
What is recommended management?

A

Repeat in 1 year

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35
Q

Women 25 y/o or older
Prior pap: ASCUS, HPV neg
Current pap: ASCUS, HPV positive
What is recommended management?

A

Repeat in 1 year

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36
Q

Women 25 y/o or older
Prior pap: ASCUS, HPV neg
Current pap: LSIL, HPV negative
What is recommended management?

A

Repeat in 1year

37
Q

Women 25 y/o or older
Prior pap: ASCUS, HPV neg
Current pap: LSIL HPV positive
What is recommended management?

A

Repeat in 1 year

38
Q

Women 25 y/o or older
Prior pap: ASCUS, HPV neg
Current pap: ASC-H/AGC
What is recommended management?

A

Colposcopy

39
Q

Women 25 y/o or older
Prior pap: ASCUS, HPV neg
Current pap: HSIL, HPV negative
What is recommended management?

A

Colposcopy

40
Q

Women 25 y/o or older
Prior pap: ASCUS, HPV neg
Current pap: HSIL, HPV positive
What is recommended management?

A

colposcopy/treatment

41
Q

Women 25 y/o or older
Prior pap: LSIL, HPV neg
Current pap: NILM, HPV negative
What is recommended management?

A

Repeat in 1 year

42
Q

Women 25 y/o or older
Prior pap: LSIL, HPV neg
Current pap: NILM, HPV positive
What is recommended management?

A

colposcopy

43
Q

Women 25 y/o or older
Prior pap: LSIL, HPV neg
Current pap: ASCUS, HPV negative
What is recommended management?

A

Repeat in 1 year

44
Q

Women 25 y/o or older
Prior pap: LSIL, HPV neg
Current pap:ASCUS, HPV positive
What is recommended management?

A

colposcopy

45
Q

Women 25 y/o or older
Prior pap: LSIL, HPV neg
Current pap: LSIL, HPV negative
What is recommended management?

A

Repeat in 1 year

46
Q

Women 25 y/o or older
Prior pap: LSIL, HPV neg
Current pap: LSIL, HPV positive
What is recommended management?

A

colposcopy

47
Q

Women 25 y/o or older
Prior pap: LSIL, HPV neg
Current pap: ASC-H/AGC
What is recommended management?

A

Colposcopy

48
Q

Women 25 y/o or older
Prior pap: LSIL, HPV neg
Current pap: HSIL, HPV negative
What is recommended management?

A

Colposcopy

49
Q

Women 25 y/o or older
Prior pap: LSIL, HPV neg
Current pap: HSIL, HPV positive What is recommended management?

A

Colposcopy/treatment

50
Q

Women 25 y/o or older
Prior pap: NILM, HPV positive
Current pap: NILM, HPV negative
What is recommended management?

A

Repeat in 1year

51
Q

Women 25 y/o or older
Prior pap: NILM, HPV positive
Current pap: NILM, HPV positive
What is recommended management?

A

Colposcopy

52
Q

Women 25 y/o or older
Prior pap: NILM, HPV positive
Current pap: ASCUS, HPV negative
What is recommended management?

A

Repeat in 1 year

53
Q

Women 25 y/o or older
Prior pap: NILM, HPV positive
Current pap: ASCUS, HPV positive
What is recommended management?

A

Colposcopy

54
Q

Women 25 y/o or older
Prior pap: NILM, HPV positive
Current pap: LSIL, HPV negative
What is recommended management?

A

Repeat in 1 year

55
Q

Women 25 y/o or older
Prior pap: NILM, HPV positive
Current pap: LSIL, HPV positive
What is recommended management?

A

Colposcopy

56
Q

Women 25 y/o or older
Prior pap: NILM, HPV positive
Current pap: ASC-H/AGC
What is recommended management?

A

Colposcopy

57
Q

Women 25 y/o or older
Prior pap: NILM, HPV positive
Current pap: HSIL, HPV negative
What is recommended management?

A

Colposcopy/treatment

58
Q

Women 25 y/o or older
Prior pap: NILM, HPV positive
Current pap: HSIL, HPV positive
What is recommended management?

A

Colposcopy/treatment

59
Q

What is the management for a colposcopy result with <CIN1?

A

Repeat in 1 year

60
Q

What is the management of colposcopy result of CIN 1?

A

Repeat in 1 year

61
Q

What is the management of colposcopy result of CIN2?

A

Treatment

62
Q

What is the management of colposcopy result of CIN3?

A

Treatment

63
Q

How do you manage current pap post colposcopy with CIN 1 or lesser?

A

Look at the prior cytology whether it was low grade or high grade

64
Q

How do you manage current pap post colposcopy with prior cervical treatment due to CIN2/3?

A

Look at prior HPV results

65
Q

Prior colposcopy CIN 1 or less
Prior pap Low grade
Current pap low grade
What is management?

A

Repeat pap in 1 year

66
Q

Prior colposcopy CIN 1 or less
Prior pap Low grade
Current pap high grade
What is management?

A

Colposcopy

67
Q

Prior colposcopy CIN 1 or less
Prior pap high grade
Current pap low grade
What is management?

A

Colposcopy

68
Q

Prior colposcopy CIN 1 or less
Prior pap high grade
Current pap high grade
What is management?

A

Colposcopy or treatment

69
Q

Prior colposcopy CIN 2 or greater
Prior HPV negative
Current pap low grade
What is management?

A

Repeat in 1 year

70
Q

Prior colposcopy CIN 2 or greater
Prior HPV negative
Current pap high grade
What is management?

A

Colposcopy

71
Q

Prior colposcopy CIN 2 or greater
Prior HPV positive
Current pap low grade
What is management?

A

Colposcopy

72
Q

Prior colposcopy CIN 2 or greater
Prior HPV positive
Current pap high grade
What is management?

A

Colposcopy or treatment

73
Q

What is the management after treatment of HSIL?

A

Follow up in 6 months with HPV testing or colposcopy/ECC

74
Q

What is the longterm followup after treatment of HSIL?

A

Annual HPV or contesting until 3 consecutive negative results

Then every 3 years for 25 years

75
Q

What is the management for AGC or AIS on cytology?

A

Colposcopy and ECC
Endometrial sampling if >35 y/o or older

76
Q

What is the management of benign endometrial cells on cytology in premenopausal woman?

A

No evaluation

77
Q

What is the management of benign endometrial cells on cytology in postmenopausal woman?

A

EMB

78
Q

What is the management for women under 25 with a pap result of ASCUS HPV negative?

A

Repeat in 3 years

79
Q

What is the management for women under 25 with a pap result of ASCUS HPV positive?

A

Repeat in 1 and 2 years

80
Q

What is the management for women under 25 with a pap result of ASCUS HPV unknown?

A

Repeat in 1 and 2 years

81
Q

What is the management for women under 25 with a pap result of LSIL?

A

Repeat in 1 and 2 years

82
Q

What is the recommendation for CIN2/CIN3 histology in pregnant patient?

A

Colposcopy , testing every 12-24 weeks
Postpartum follow per guidelines

83
Q

When is treatment for high risk cytology warranted in pregnant patient?

A

Suspected or biopsy proven invasive disease

84
Q

What is the recommendation for AIS result in pregnant patient?

A

Refer to gyn onc

85
Q

What is the recommended screening for Pap smears in HIV positive patient?

A

Start screening within 1 year of sexual activity

Screen annually for life

Colposcopy for ASCUS HPV positive or higher results

86
Q

What is the recommended screening for patient who received hysterectomy for high grade cervical disease?

A

Annual for 3 years
After 3 negative annual screens
Screen every 3 years for 25 years

87
Q

What is the advantage of a cone vs a LEEP?

A

Less likely to have positive margins

88
Q

What is a disadvantage of cone v LEEP?

A

High incidence of bleeding, infertility, cervical incompetence, spontaneous abortion, preterm labor

89
Q

What factors should make you opt for cone biopsy over LEEP?

A
  1. Completed family
  2. Inadequate colposcopy
  3. Discrepancy between pap and colposcopy results
  4. CIS
  5. Positive ECC
  6. Positive margins on LEEP specimens
  7. AIS

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