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ENRP > PAP Smear, Cervical Dysplasia/Cancer > Flashcards

PAP Smear, Cervical Dysplasia/Cancer Flashcards

1
Q

What type of epithelium lines the Endocervix?

A

Columnar

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2
Q

What type of epithelium lines the Ectocervix?

A

Stratified Nonkeratinizing Squamous

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3
Q

Where do most of the Cervical Neoplasias arise?

A

Squamocolumnar Junction = Transformation Zone

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4
Q

The cervical Transformation zone location depends on age, when is it most easily accessible?

A

Reproductive years

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5
Q

What causes Cervical Cancer?

A

HPV

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6
Q

What are the High Risk strains of HPV that commonly cause cervical cancer?

A

16
18
31
45

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7
Q

What are some risks for developing Cervical Cancer?

A
  • Smoking
  • Multiple sexual partners, STI, HIV
  • Infrequent PAP screens
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8
Q

What are some risks for developing Cervical Cancer?

A
  • Smoking
  • Multiple sexual partners, STI, HIV
  • Infrequent PAP screens
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9
Q

What is the guidelines for screening for 21-29 years old?

A

Cytology every 3 years if normal

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10
Q

What is the guidelines for screening for 30-65 years old?

A

Cotesting

= HPV + Cytology every 5 years if normal

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11
Q

What is the guidelines for screening if above 65 years old and if a patient has had a hysterectomy?

A

No screening if normal

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12
Q

At what age are PAP smears recommended?

A

21

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13
Q

If the PAP comes back negative for lesions/malignancy, what else can it report on?

A

Organisms

Reactive cellular changes - inflammation, etc.

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14
Q

What are the 2 types of Epithelial Cell Abnormalities identified on PAP?

A
  • Squamous cell

- Glandular cell

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15
Q

ASC-US

A

Atypical Squamous Cells of Undetermined Significance

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16
Q

ASC-H

A

Atypical Squamous Cells that cannot exclude High grade

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17
Q

LSIL and what it encompasses?

A

Low grade Squamous Intraepithelial Lesion

= encompasses mild dysplasia and CIN1

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18
Q

HSIL and what it encompasses?

A

High grade Squamous Intraepithelial Lesion

= Encompasses moderate-to-severe dysplasia, CIS, CIN2 and CIN3

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19
Q

Atypical Glandular cells may give rise to?

A

Adenocarcinoma

20
Q

If you are under 25 and ASC-US or LSIL comes back, what is the next step?

A

Repeat Cytology at 1 year

21
Q

If you are under 25, had ASC-US or LSIL, repeated cytology at 1 year and it came back ASC-US or LSIL again, what is the next step?

A

Repeat Cytology at 1 year

22
Q

If you are under 25, had ASC-US or LSIL, did cytology, had it again, did cytology and ASC-US came back for a 3rd time, what is next?

A

Colposcopy

23
Q

If you are under 25 and ASC-US or LSIL is present, you repeated your cytology 1 year later and ASC-H or HSIL came back, what is the next step?

A

Colposcopy

24
Q

What should be done with ASC-US?

A
  • Repeat cytology at 1 year

- HPV testing

25
Q

If ASC-US was present and you repeated cytology at 1 year and got ASC or if HPV was (+), what is the next step?

A

Colposcopy

26
Q

What is the next step for LSIL with a (-) HPV?

A

Cotesting at 1 year

27
Q

What is the next step for LSIL with no HPV test?

A

Colposcopy

28
Q

What is the next step for LSIL with a (+) HPV?

A

Colposcopy

29
Q

What are the 2 options with HSIL?

A

Excision

Colposcopy

30
Q

What is the gold standard for Cervical Cancer diagnosis?

A

Colposcopy with biopsy

31
Q

With a Colposcopy, what do you apply to the cervix and then look for?

A

3% Acetic Acid applied

–> Large abnormal nuclei turn WHITE

32
Q

In the order of better to worse prognosis, what can be seen on Colposcopy?

A 
Acetowhite changes
Punctuations
Mosaicism
Abnormal vessels
Mass
33
Q

What are 2 Ablative treatments?

A

Cryotherapy

Laser Ablation

34
Q

What are 2 Excisional Treatments?

A

Cold Knife Cone

LEEP

35
Q

Cold Knife Cone is an excisional procedure. When is it done?

A

(+) endocervical curettage

36
Q

LEEP is an excisional procedure. What does it stand for?

A

Loop Electrode Excisional Procedure

37
Q

If an Unsatisfactory Colposcopy or there is a discrepancy between the PAP and Biopsy is present, what should you do?

A

Excisional procedure

    • Cold Knife Cone
    • LEEP
38
Q

What are some risks of Excisional procedures?

A

Bleeding, infection

Cervical stenosis or incompetence –> pregnancy issues

39
Q

What are the symptoms of Cervical Cancer?

A

Postcoital bleeding (after sex)
Watery vaginal bleeding
Spotting

40
Q

What are the symptoms of Cervical Cancer?

A

Postcoital bleeding
Watery bleeding
Spotting

41
Q

How can you prevent Cervical Cancer?

A
  • Use protection, decrease sexual partners
  • Regular exams and PAPs
  • VACCINE
42
Q

Vaccination with the HPV Vaccine can prevent Cervical Cancer. What is 1 called?

A

Gardasil

43
Q

Gardasil protects against high risk HPV strains to prevent cervical cancer. When and who is it recommended for?

A

9-26 = GIRLS AND BOYS

– can still give up to 45

44
Q

Can you still receive the Gardasil vaccination after you have had an abnormal PAP?

A

Yes

45
Q

Is Gardasil safe in pregnancy?

A

No

– safe in breast feeding though

ENRP (45 decks)

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