Pap Smear, Colposcopy/endometrial biopsy
Help!
|
|
||||
|---|---|---|---|---|---|
| 2nd most common cancer worldwide | cervical cancer
🗑
|
||||
| Highest incidence of cervical cancer in women ages | 20-50
🗑
|
||||
| Prevalence of HPV infection in ages 14-59 | 26%
🗑
|
||||
| ____% of women get HPV 2 years after first sex | 50%. Usually transient, rarely lifelong
🗑
|
||||
| How to prevent HPV infection | avoid smoking, use condoms, limit partners, vaccine
🗑
|
||||
| How often is a pap smear reocommended according to USPSTF? | at least every 3 years. Start at age 21 or within 3 years of sexual debut
🗑
|
||||
| Where should you sample a cervix? | At the white border where squamous and columnar cells meet = squamocolumnar junction. This is where cancer most often occurs
🗑
|
||||
| Organisms on a pap | yeast, bacterial vaginosis, Trichomonas
🗑
|
||||
| ASCUS | Atypical Squamous Cells of Undetermined Significance (something is wrong but we don't know what it is)
🗑
|
||||
| LSIL | Low grade squamous intraepithelial lesion
🗑
|
||||
| HSIL | high grade squamous intraepithelial lesion
🗑
|
||||
| AGC | Atypical Glandular Cells (this is the most worrisome pap; can't see this with the naked eye, need to ask about hx of bleeding)
🗑
|
||||
| Interpretation of Pap results depends on | the age of the woman
🗑
|
||||
| In an adolescent woman with ASC-US or LSIL the next step is | to repeat cytology in 12 months. If then the woman has > or equal to HSIL, get a colposcopy. If less than HSIL, repeat cytology in 12 months
🗑
|
||||
| In an adolescent woman with HSIL who is - for CIN 2,3 the next step is | Observation with Colposcopy and Cytology every 6 months for up to 2 years. A high grade Colpscopy lesion or HSIL that persists for 1 year should then be biopsied
🗑
|
||||
| Management of women with ASCUS | Repeat cytology at 6months, Colposcopy, HPV DNA Testing
🗑
|
||||
| ASC-H | Atypical Squamous Cells cannot rule out High Grade dysplasia. (note: pap smears are not diagnostic, they are screening tests and 80% of the time are appropriate)
🗑
|
||||
| Pregnant women with low-grade Squamous Intraepithelial Lesion (LSIL) | Colposcopy or Defer Colposcopy. Don't brush or currettage the endocervix in pregnancy
🗑
|
||||
| Management of women with High-grade Squamous Intraepithelial Lesion (HSIL) | Immediate Loop Electrosurgical Excision or Colposcopic Examination
🗑
|
||||
| 3 parts of Atypical Glandular Cell (AGC) work up | Colposcopy, endocervical brushing, endometrial biopsy
🗑
|
||||
| Preparing your patient for Colposcopy | refer to colposcopist, make sure she is not in her menses, premedicate with motrin 400-800mg to reduce cramps. Colposcopist will use vinegar and possibly Iodine (iodine stains only normal tissue): Lugols or Schiller test. Do a pregnancy test before.
🗑
|
||||
| Preparing your patient for what they can expect post-Colposcopy | expect mild cramping, discharge will be a mixture of blood and monsels (used to stop bleeding), will occasionally get an odor several days later due to a mild vaginal infection (10%)
🗑
|
||||
| CIN | Cervical Intraepithelial Neoplasia - used to describe abnormal tissue findings. Diagnostic term used from biopsy/colposcopy
🗑
|
||||
| Dysplasia | is a cytology dx, screening, from Pap smear
🗑
|
||||
| If you need to bx the anterior and posterior portion of the cervix, first bx | the posterior so that bleeding will not contaminate the anterior bx
🗑
|
||||
| Tx of cervical abnormalities | Cryotherapy of Cervix, LEEP (loop electrosurgical excision procedure), Laser, Cervical Conization
🗑
|
||||
| Risks of cervical tx | antibodies to sperm, cervical stenosis, incompetent cervix, missing a significant lesion
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
ltm12