Pap smears Flashcards
physiologic leukorrhea
elevated estrogen levels and can see episodic thin vaginal discharge. Women with OCP’s can have this resolve on week of placebo pills. Seen during ovulation and pregnancy
what does physiologic leukorrhea?
thin vaginal discharge and minimal vulvular irritation and odor. resolves during week of placebo pills and low estrogen.
What is cervicitis?
presents with mucopurulent discharge, cervical friability (cervix bleeds on contact and an abundance of polymorphonuclear leukocytes on microscopy.
Name the condition. this is a pap smear
bacterial vaginosis. Clue cells -epithelial cells with coccobacilli. See thin gray malodorous vaginal discharge.
pH >4.5 and amine odor (fishy smell with whiff test)
strawberry cervix and green frothy vaginal discharge
Trichomoniasis
vulvar pruritis, vulvovaginal erythema and thick white discharge
candial vulvovaginitis
Treatment of candidal vulvovaginitis
fluconazole x 1
Treatment of trichomoniasis
treat partner and pt with metronidazole x 1 better to do oral that vaginal.
What do you do if your pap smear shows ASCUS or atypical squamous cells of undetermined significance?
ASCUS is the most common abnormal pap smear result. SHows atypical cervical cells that have reactive changes but do not meet cytologiccriteria for premalignant dx.
In order to dermine if there’s increased risk for CIN (cervical intraepithelial neoplasia) need HPV testing.
What is colposcopy
Colposcopy will look at the cervix and can do a endoservical currettage during colposcopy to look for any changes of cervical transformation zone to see if there’s signs of CIN.
what are the diagnostic excisional procedure indicated for a high grade squamous intraepithelial lesions on pap smear or a grade 2/3 CIN on cervical biopsy
LEEP or cold knife conization
