PAP Flashcards
where do we sample with PAP?
ectocervix & endocervix
transformation zone
screening for 21-29 yo
pap only q 3 yrs
screening for 30-65 yo
pap only q 3 yrs OR cotesting q 5 yrs OR HPV only q 5yrs
normal PAP result
normal cytologic appearance + satisfactory pap
what is a satisfactory pap
includes squamous and endocervical cells
what is cytology?
2D sample of cells
name the two abnormal cytology results that are NOT high grade?
ASC-US– undeterminant
LSIL– low grade squamous
what are the 4 high risk cytology results
ASC-H
HSIL
AGC
AIS
what to do if 21-24 w/ ASCUS or LSIL
repeat pap in 1 yr
what to do if 25+ w/ ASCUS or LSIL
check HPV
if HPV(-) then repeat pap in a yr
if HPV + get colpo & Bx
how do we check for HPV in 30+ yo with abnormal cytology
cotesting for HPV
what is reflex testing
when we check for HPV after abnormal cytology in <30 yo
what do we do for all ages w/ HSIL, AGC, AIS
colpo & Bx
what is histology?
a Bx– 3D sample of tissue
results of histology
CIN-1
CIN-2
CIN-3– high risk
what are the high grade lesions on bx?
dysplasia
CIN-3
what do you do if bx shows high grade lesions?
excision or ablation
hysterectomy, radiation, chemo
where does spatula & cytobrush go?
spatula– ectocervix
cytobrush– endocervix
sx of cervical cancer
irregular vaginal bleeding (usually after sex)
watery discharge
pelvic pain
dyspareunia
bladder changes
kidney failute
tx for early stage cervical CA (IA1,IA2)
microinvasive
simple hysterectomy, cold knife cone
tx for mid-size lesions (IB1,IIA)
radical hysterectomy
radical trachelectomy
tx for large lesions (IB2, IIB, IIIB)
chemotherapy
radiation
