The Pap Smear (1) Flashcards
Where does cervical CA ultimately arise from?
Squamo-columnar junction (SCJ)
What does HPV cause?
Cervical CA, genital warts (condyloma accuminatum), cervical intra-epi neoplasia (CIN)
Which HPVs are responsible for cervical CA? Genital warts?
16 and 18 for CA
6 and 11 for warts
What are risk factors for cervical neoplasia?
Multiple sexual partners Young age at first intercourse or preg Smoking HIV Organ transplants STIs DES exposure Infrequent/absent pap screenings High parity (many births) Low socioeconomic status
What are the screening guidelines for a Pap?
Under 21 = no screening
21-29 = every 3 years
30-65 = every 5
65+ = no screening following adequate neg prior screenings
Pts w/ hysterectomy: no screening afterwards
What the common Pap test done today?
Liquid-based
Does a mild Candida infection req tx?
No, if it’s normal flora can often let it go (unless it’s serious)
What are some non-neoplastic findings on a Pap?
Reactive cellular changes d/t (inlammation, radiation)
Atrophy (in elderly when E levels drop)
What does ASC-US and ASC-H stand for?
Atypical squamous cells
US = undetermined sig H = high-grade
When diagnosed w/ ASC-US, what are the next few steps of the treatment plan?
HPV testing
If positive > colposcopy
If neg, repeat testing in 3-5 years
Repeat cytology in 1 year to begin with is also acceptable, but not preferred
A pt is diagnosed w/ LSIL, what are the next steps in the tx plan?
Colposcopy if HPV presence is undetermined or positive
If HPV is neg, repeat testing in 1 year, then if ASC or HPV is found > colposcopy
What is the gold standard for diagnosis and treatment planning for cervical CA? What are you looking for?
Colposcopy
Large nuclei of abnormal cells w/ white “acetowhite” changes
Severity of abnormal colposcopy findings is:
Acetowhite changes < punctuations, mosaicism, abnormal vessels, masses
What biopsy technique is not used in pregnant women?
Endocervical curettage
Are Nabothian cysts benign or of concern?
Benign
