Gynecology
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| Women <21 yo w/ASCUS or LSIL | repeat pap in 12 mos
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| Women <21 yo w/ HSIL | colposcopy +/- cytology
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| Adult women w/ASCUS | repeat cyto (6 & 12 mos), HPV DNA, and colposcopy
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| Adult women w/ASCUS-H | colposcopy; if neg: cyto (6 & 12 mos), HPV DNA q 12 mos
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| Adult women w/ LSIL | Colposcopy, then endometrial bx. If no CIN: repeat Pap in 6 & 12 months and HPV DNA in 12 months
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| Adult women w/ HSIL, CIN-2, CIN-3, or CIS on Pap: | Colposcopy & bx. Outside cervix: LEEp or cryotherapy. Inside cervix: cone bx.
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| Adult women w/ AGC | endomet/endocerv bx, then colpo
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| Tx of cervical abnormalities | Cyrotherapy of Cervix; LEEP; Laser; Cervical Conization
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| Risks of tx of cervical abnormalities | Antibodies to sperm; Cervical Stenosis; Incompetent Cervix; Missing a significant lesion
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| most common symptom of endometrial neoplasia: | AUB
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| indications for endometrial ca testing | AUB >35-40 yo; AGC on Pap (also needs Colposcopy); Benign Endometrial Cells on pap if woman post menopausal
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| endometrial ca RF | Postmenopausal; FH/PMH ca (ov, BrCa, colon, endomet); Tamoxifen; PCOS; Obesity; Estrogen Tx w/o progestin; Prior Endometrial Hyperplasia; DM
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| endomet bx advantages | in office; minimal dilation; anesthesia not req; prophylactic Abx not req; low cost
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| endomet bx CI | PG; infxn; diathesis, cerv stenosis or ca (refer)
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| endomet bx: most common AE: | Cramping
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| average uterine length = | 6-8 cm
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| Simple/Complex Endometl Hyperplasia: causes unopposed estrogen: Premenopause | Obesity; PCOS; eating disorders; Thyroid; Herbals; other anovulation
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| Simple/Complex Endometl Hyperplasia: causes unopposed estrogen: Postmenopause | Obesity; HRT; herbals w/estrogen (soy); Ovar/ adrenal estrogen producing tumor
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| 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
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| When & how often should women get Paps? | Q2 yrs starting at age 21. Q3 yrs (+HPC) if Pap neg & HPV neg, starting at age 30
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| If SCC found on Pap: | resection, and/or chemo or radiation
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Created by:
Abarnard
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