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OB GYN > Test 3 Deck 2 > Flashcards

Test 3 Deck 2 Flashcards

1
Q

When to screen for HPV?

A

> = 30, triage or surveillance of certain cytology abnormalities, post treatment surveillance

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2
Q

What are the ages for HPV vaccination?

A

9-26, but you can still give it afterwords

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3
Q

Cervical dysplasia screening for 21-29__, 30-65___, >65___, post hysterectomy __

A

21-29: PAP test q3

30-65: PAP w/ HPV testing q5 years, PAP alone q3 years

> 65: no hx of abnormal PAP and

  1. 3 neg. paps or
  2. 2 neg. co-tests in past 10 years w/ most recent test in past 5 years

Post hysterectomy:

  1. Retained cervix-> continue w/ age screening
  2. Cervix removed-> stopped screening
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4
Q

What do you do if you get a patient report that says atypical squamous cell of undetermined significance (ASC-US)?

A

Test for HPV

HPV + then treat like low grade squamous intraepithelial lesion -> colposcopy

HPV - then repeat PAP in 1 year and if still abnormal colposcopy

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5
Q

What do you do if you get if you have Atypical squamous cells, but can’t exclude HSIL (ASC-H)

A

Colposcopy indicated

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6
Q

What do you do if you get a report of High-Grade squamous intrepithelial lesion (CIN2 and CIN3)?

A

Colposcopy regardless of HPV and considers immediate loop electro surgical excision procedure (LEEP)

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7
Q

What is the treatment for atypical glandular cells and wha are you concerned for?

A

Colposcopy and endocervical sampling, women 35+ get endometrial sampling

Concern for cancers at other sites. endometrial/endocervical/ breast/ colon cancer

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8
Q

What to do with a woman that’s 21-24 w/ ASC-H, HSIL?

A

Colposcopy

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9
Q

What is the MC gynecologic cancer in women worldwide?

A

Cervical cancer caused by HPV, usually are aymptomatic

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10
Q

Tumor spread that arises from ectocervix

A

Exophytic

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11
Q

Tumor that arises from the endocervix??

A

Endophytic

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12
Q

What are the two kinds of cervical cancer spreads and which one is a poor prognostic factor?

A

Lymph node spread and lymphovascular spread (poor prognostic indicator)

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13
Q

What are the two most common types of cervical cancer and which is MC?

A

Squamous cell and adenocarcinoma

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14
Q

What is the MC cervical cancer and what has a.worse prognosis?

A

Squamous cell MC

Adenocarcinomas worse prognosis

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15
Q

PT presents w/ watery, purulent, or bloody discharge, They have polyploid mass, papillary tissue, barrel shaped cervix, a cervical ulceration, or granular mass, or necrotic tissue. They have an enlarged uterus, lymphadenopathy, hydronephrosis (tumor compressing ureter), lower back pain (sciatic), constipation, invasion of local tissues?

A

Cervical cancer

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16
Q

What is the follow up for cervical cancer?

A

Q 3 months for 2 years, then q 6 months until 5 years post-treatment then annually

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17
Q

Can you give hormone therapy during cervical cancer?

A

Yes, because the cancer is caused by a virus!

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18
Q

what are high estrogen states that cause the uterus to evert?

A

adolescence, pregnancy and hormonal birth control

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19
Q

where does almost all cervical neoplasia develop?

A

transition zone

20
Q

what encourages increased metaplastic changes?

A

early age of 1st intercourse, and first pregnancy, vitamin deficiencies, COC

21
Q

abnormal cells are confined to lower 1/3 of squmous epithelium

A

cervical intraepthelial neoplasia 1 CIN1

22
Q

abnormal cells extending to the middle third, mixture of low and high grade

A

cervical intraepithelial neoplasia 2

23
Q

abnormal cells extend to upper 3rd

A

cervical intraepithelial neoplasia 3

24
Q

what is the mc sti in the US?

A

HPV

25
Q

hpv causes nearly all __ neoplasia and a significant portion of __, ___, anal neoplasia

A

cervical, vulvar, vagina

26
Q

what are the low risk HPV’s?

A

6, 11 associated w/ visible warts, laryngeal papillomas, subclinical HPV infections

27
Q

high risk HPV lesions?

A

16, 18, 31, 33, 35, 45, 58 cause cervical CA development

28
Q

what is the MC HR hpv?

A

16 followed by 18

29
Q

type 16 causes what types of cancers?

A

anogenital and oropharyngeal, CIN 13, cervical

30
Q

type 18 causes what kinds of cancers?

A

squamous cell, adenocarcinomas, adenosquamous carcinomas

31
Q

HPV 16/18 lasting >6 months will develop into what?

A

squamous intrepithelial lesion

32
Q

what is the MC abnormality for cervical dysplasia?

A

atypical squamous cells of undertermined significance (ASC-US)

33
Q

what is considered LGSIL?

A

CIN1 and HPV infection

34
Q

what do you do if you get a report that says LGSIL (low grade squamous intraepithleial lesion)?

A

no HPV or + HPV -> colposcopy

-HPV -> repeat cotest 1 year

35
Q

pregnant woman w/ ASC-U and LSIL?

A

consider postponing until 6 weeks post partum, if you do coloposcopy no endocervical curette or EMB

36
Q

pregnant woman w/ ASC-H?

A

don’t defer colposcopy

37
Q

what do you do if the colposcopy is unsatifactory?

A

Loop electorsurgical excision procedure (LEEP) cold knife cone (CKC)

38
Q

what will you see on coploscopy?

A

acetowhite (take biopsies) + endocervical curettage, green filter for abnormal vasculature

39
Q

what do you do if you get an unsatisfactory cytology (not good enough)?

A

any age, HPV negative/positive

repeat cytology in 2-4 months

40
Q

what is the MC gynecologic cancer in women worldwide?

A

cervical cancer

41
Q

how to control abnormal bleeding associated w/ cervical cancer?

A

monsel paste

42
Q

lymphadenopathy suggests?

A

spread

43
Q

hydronephrosis suggests?

A

tumor compressing ureter

44
Q

LBP suggests?

A

compression of sciatic nerve

45
Q

cervical cancer in pregnancy treatment?

A

postpone if its early, but have to do something if advanced consider. cisplatin w/ vincristine, paclitaxel

OB GYN (9 decks)

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