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Gyn Procedures


Women <21 yo w/ASCUS or LSIL repeat pap in 12 mos
Women <21 yo w/ HSIL colposcopy +/- cytology
Adult women w/ASCUS repeat cyto (6 & 12 mos), HPV DNA, and colposcopy
Adult women w/ASCUS-H colposcopy; if neg: cyto (6 & 12 mos), HPV DNA q 12 mos
Adult women w/ LSIL Colpo, then endomet bx; if no CIN: cyto (6&12) & HPV DNA (12 mos)
Adult women w/ HSIL immediate excision OR colpo, then observe or dx excision
Adult women w/ AGC endomet/endocerv bx, then colpo
Tx of cervical abnormalities Cyrotherapy of Cervix; LEEP; Laser; Cervical Conization
Risks of tx of cervical abnormalities Antibodies to sperm; Cervical Stenosis; Incompetent Cervix; Missing a significant lesion
most common symptom of endometrial neoplasia: AUB
indications for endometrial ca testing AUB >35-40 yo; AGC on Pap (also needs Colposcopy); Benign Endometrial Cells on pap if woman post menopausal
endometrial ca RF Postmenopausal; FH/PMH ca (ov, BrCa, colon, endomet); Tamoxifen; PCOS; Obesity; Estrogen Tx w/o progestin; Prior Endometrial Hyperplasia; DM
endomet bx advantages in office; minimal dilation; anesthesia not req; prophylactic Abx not req; low cost
endomet bx CI PG; infxn; diathesis, cerv stenosis or ca (refer)
endomet bx: most common AE: Cramping
average uterine length = 6-8 cm
Simple/Complex Endometl Hyperplasia: causes unopposed estrogen: Premenopause Obesity; PCOS; eating disorders; Thyroid; Herbals; other anovulation
Simple/Complex Endometl Hyperplasia: causes unopposed estrogen: Postmenopause Obesity; HRT; herbals w/estrogen (soy); Ovar/ adrenal estrogen producing tumor
Endometrial hyperplasia w/o atypia: tx Provera; Micronized Progesterone; if HRT is resumed, resume at higher dose progestin for longer time, repeat bx 3-6 mos
Created by: Adam Barnard Adam Barnard