Crumbaker_Pap Guidelines ASCCP

Question 1

(Aquifer)

according to USPSTF, at what age should cervical cancer screening begin?

Answer 1

at age 21

Question 2

(Aquifer)

according to USPSTF, how frequently should pts have cervical cancer screening between ages 21 - 29?

Answer 2

three years

“screening should be performed every three years with cytology alone”

Question 3

(Aquifer)

according to USPSTF, how frequently should pts have cervical cancer screening between ages 30-65?

Answer 3

every 5 yrs w/ high risk HPV testing alone

every 5 yrs with cotesting (HPV & cytology)

or
every 3 years with cytology alone

Question 4

(Aquifer)

when do pts stop cervical cancer screening?

Answer 4

pts older than 65 yrs, who have had adequate screening w/in last 10 years may choose to stop cervical cancer screening

(“adequate screening” is defined as 3 consecutive normal pap tests with cytology alone, or 2 normal pap tests if combined with HPV testing, or 2 normal HPV tests alone)

Question 5

(Aquifer)
sensitivity of Pap test = ?

specificity of Pap test = ?

Answer 5

sensitivity = 30-80%

specificity = 86-100%

however, cancer deaths from cervical cancer decreased markedly in the US after the pap test was introduced

Question 6

(UpToDate)

what is CIN 3+ ?

Answer 6

Cervical
Intraepithelial
Neoplasia 3

+ = adenocarcinoma in situ, and cancer

Question 7

What are Dr. Crumbaker’s five B’s of pospartum care? and one additional ‘P’ component?

Answer 7

Breastfeeding
Bowels
Bladder
Bleeding
Birth control

Pap Smear

Question 8

What are Dr. Crumbaker’s S’s of colic?

Answer 8

Swaddle
Suck (try a pacifier)
Sound (white noise)

and some others I neglected to write down, but one might have to do with an acid reducer for baby?

Question 9

(SmartyPance)

a 23 y/o G1P1 pap test results show LSIL…what is done next?

Answer 9

recheck pap in 1 year

(“Based on the latest ASCCP guidelines, women ages 21-24 yrs of age w/ LSIL should undergo repeat cytology at 12 months. Those 25 and up with LSIL should undergo colposcopy.”)

Question 10

(SmartyPance)

what is the first diagnostic evaluation indicated for cervical dysplasia?

Answer 10

a colposcopy-directed biopsy