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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

A

16 18 30

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
Q

what is AGUS

A

atypical glandular cells of undetermined significance (endocervical cells)

26
Q

what is LSIL

A

low grade squamous intraepithelial lesion

27
Q

HSIL

A

high grade squamous intraepithelial lesion

28
Q

work up of abnormal pap

A

age dependent degree abnormality

29
Q

risk factors for abnormal pap

A 
no recent pap
smoking
age of 1st intercourse
number of patients
HIV or any other reason to be immunocompromised
30
Q

how does smoking increase risk cervical cancer

A

destroys epithelial cells

31
Q

what is colposcopy

A

looking at cervix with microscope and usually take biopsy

32
Q

biopsy can tell you what about cervix pathology

A

CIN I II III and invasive

33
Q

what is CIN I

A

mild dysplasia

34
Q

what is CIN II

A

moderate dysplasia

35
Q

what is CIN III

A

severe dysplasia, carcinoma in situ

36
Q

what occurs in CIN I prognosis

A

70% regress

37
Q

what occurs in CIN II prognosis

A

30% regress, 30% stay same, 30-40% progress

38
Q

Tx CIN II

A

excise usually

39
Q

how does cervical cancer spread

A

lymph nodes

40
Q

radical hysterecotmy includes what part of vagina

A

top third

41
Q

what are indications for conization

A

CIN II III
endocervical disease on colposcopy
inadequate colposcopy
depth on invasion

42
Q

contributing factor to cervical cancer death

A

lack of screening

43
Q

highgest incidence cervical CA

A

30-50

44
Q

screening for ages 21-29

A

cytology every 3 years

HPV testing not used as screen

45
Q

screening for ages 30-64

A

cytology and HPV testing (co testing) every 5 years

46
Q

reason for cotesting

A

increased detection CIN3

enhances detection adenocarcinoma

47
Q

normal pap with HPV high risk positive what is next step

A

colposcopy

48
Q

when to stop screening in women

A

age 65 with negative screening before

3 consecutive neg paps or 2 consecutive neg HPV tests

49
Q

When not to stop screening at age 65

A

history CIN 2 or 3

change of partners

50
Q

vaccine against HPV 16 18 reduces risk of what

A

CIN3

Year2 Repro exam II (19 decks)

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