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Year2 Repro exam II > Pap smear > Flashcards

Pap smear Flashcards

1
Q 
42 y.o G2P2 with LMP one week ago. tubal ligation as birth control. annual exam
hypothyroid, 22pack year, +FMH breast CA
no mammogram, last PAP 5 yrs prior
2 c sections for LGA babies
\+gestational DM
\+vaginal discharge on exam
next step?
A

wet prep
KOH
pap

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2
Q

if pap shows atypical squamous cells high grade

next step?

A

colposcopy and Bx

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3
Q

Sx bacterial vaginosis

A

odor

no inflammation or itching

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4
Q

risk factors bacterial vaginosis

A

sexual activity, douching

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5
Q

what causes bacterial vaginosis

A

overgrowth of anaerobic bacteria- gardnerella

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6
Q

What is Amsel criteria

A

3 of following:

  • homogenous white to gray discharge
  • pH >4.5
    • whiff test with KOH
  • clue cells on wet mount
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7
Q

pregnancy risks of bacterial vaginosis

A 
preterm
PROM
amniotic fluid infection
chorioamnionitis
post partum endometritis
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8
Q

bacterial vaginosis Tx

A

metronidazole
clindamycin
tindazole

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9
Q

Tx asymptomatic patient with bacterial vaginosis

A

not recommended but most people Tx

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10
Q

yeast on wet mount

A

pseudohyphae

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11
Q

Sx yeast

A

itching, red cervix

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12
Q

bubbly discharge of vaginal fluid

A

trichomonas

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13
Q

koilocyte

A

HPV

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14
Q

what do you look for in cells on pap smear

A

increased nuclear to cytoplasmic ratio
abnormal cell structure
koilocyte indication

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15
Q

cervical cancer associated with

A

sex

precursors: HPV etc

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16
Q

most common sexually transmitted infection

A

HPV

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17
Q

how many types HPV sexually transmitted

A

40 types

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18
Q

how is HPV Dx

A

DNA hybrid testing

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19
Q

clinical infection of HPV

A

warty growths- condylomata accuminata (6 and 11)

on vulva, vagina, cervix, urethra, perianal

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20
Q

HPV asociated with what genital neoplasias

A

cervical, vaginal, vulvar CA

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21
Q

HPV infection normal course

A

spontaneously clears within 2 years

22
Q

high risk HPV

23
Q

what is ASCUS

A

atypical squamous cells of udetermined significance

24
Q

What is ASC-H

A

atypical squamous cells, high grade

25
what is AGUS
atypical glandular cells of undetermined significance (endocervical cells)
26
what is LSIL
low grade squamous intraepithelial lesion
27
HSIL
high grade squamous intraepithelial lesion
28
work up of abnormal pap
age dependent degree abnormality
29
risk factors for abnormal pap
``` no recent pap smoking age of 1st intercourse number of patients HIV or any other reason to be immunocompromised ```
30
how does smoking increase risk cervical cancer
destroys epithelial cells
31
what is colposcopy
looking at cervix with microscope and usually take biopsy
32
biopsy can tell you what about cervix pathology
CIN I II III and invasive
33
what is CIN I
mild dysplasia
34
what is CIN II
moderate dysplasia
35
what is CIN III
severe dysplasia, carcinoma in situ
36
what occurs in CIN I prognosis
70% regress
37
what occurs in CIN II prognosis
30% regress, 30% stay same, 30-40% progress
38
Tx CIN II
excise usually
39
how does cervical cancer spread
lymph nodes
40
radical hysterecotmy includes what part of vagina
top third
41
what are indications for conization
CIN II III endocervical disease on colposcopy inadequate colposcopy depth on invasion
42
contributing factor to cervical cancer death
lack of screening
43
highgest incidence cervical CA
30-50
44
screening for ages 21-29
cytology every 3 years | HPV testing not used as screen
45
screening for ages 30-64
cytology and HPV testing (co testing) every 5 years
46
reason for cotesting
increased detection CIN3 | enhances detection adenocarcinoma
47
normal pap with HPV high risk positive what is next step
colposcopy
48
when to stop screening in women
age 65 with negative screening before | 3 consecutive neg paps or 2 consecutive neg HPV tests
49
When not to stop screening at age 65
history CIN 2 or 3 | change of partners
50
vaccine against HPV 16 18 reduces risk of what
CIN3

Year2 Repro exam II (19 decks)

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