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Oral board studying Prep book > Office-Cervical cancer > Flashcards

Office-Cervical cancer Flashcards

(89 cards)

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1
Q

What is the recommended screening for cervical cancer?

A

Age 21-30= every 3 years
Age 30-65= every 5 years with HPV co-testing or 3 years with pap alone

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2
Q

What is the recommendation for pap screening after a benign total hysterectomy?

A

Pap smears stop

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3
Q

What is the recommendation for pap screening after a total hysterectomy with history of CIN2/3

A

Pap smear q 3 years until 25 years after initial post treatment surveillance

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4
Q

What is the recommendation for ASCUS Pap smear?

A

Age 21-24= repeat cytology in 1 year
Age 25-65= HPV testing if positive colposcopy

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5
Q

What is the recommendation for ASC-H?

A

Colposcopy

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6
Q

What is the recommendation for LSIL?

A

Age 21-24= repeat cytology in 1 year
Age 25-65= colposcopy

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7
Q

What is the recommendation for HSIL?

A

Age 21-24= colposcopy
Age 25-65= LEEP or colposcopy

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8
Q

What does LSIL stand for?

A

CIN 1

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9
Q

Is LSIL a precursor to cervical cancer?

A

No unless left untreated over extended period of time

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10
Q

What is CIN2?

A

Precancerous lesion that can either regress to CIN1 or progress to CIN3

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11
Q

How do you manage CIN2?

A

Age 21-24= colposcopy and cytology at 6 & 12 months
25-65= LEEP

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12
Q

When is a ECC indicated for colposcopy?

A
  1. Colposcopy unsatisfactory
  2. Pap shows ASC-H, HSIL, AGC, AIS
  3. Contemplating ablative therapy
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13
Q

What is management of abnormal pap for women age 25 years or older based on?

A

Present risk of CIN3 or higher rather than on cytology or HPV results alone

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14
Q

What is management if the immediate CIN3+ risk is >/= 4%?

A

Colposcopy or treatment

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15
Q

What is the management if the immediate CIN3+ risk is <4%?

A

Consider the 5 year CIN3+ risk

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16
Q

What is the management if the immediate CIN3+ risk is 4-24%?

A

Colposcopy

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17
Q

What is the management if the immediate CIN3+ risk is 25-59%

A

Colposcopy or expedited treatment

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18
Q

What is the management if the immediate CIN3+ risk is 60-100%?

A

Expedited treatment

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19
Q

What is the management of the 5yr CIN3+ risk is >/=0.55%

A

Repeat testing in 1 year

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20
Q

What is the management if the 5yr CIN3+ risk is 0.15-0.54%?

A

Repeat testing in 3 years

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21
Q

What is the management of the 5yr CIN3+ risk is <0.15?

A

Repeat testing in 5 years

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22
Q

After treatment of HSIL, CIN2, CIN3 or AIS what is the recommended surveillance?

A

Surveillance at 3 year intervals for at least 25 years

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23
Q

Women 25 y/o or older
Prior pap: Unknown or NILM, HPV neg
Current pap: NILM, HPV negative
What is recommended management?

A

Repeat in 5 years

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24
Q

Women 25 y/o or older
Prior pap: Unknown or NILM, HPV neg
Current pap: NILM, HPV positive
What is recommended management?

A

Repeat in 1 year

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25
Women 25 y/o or older Prior pap: Unknown or NILM, HPV neg Current pap: ASCUS, HPV negative What is recommended management?
Repeat in 3 years
26
Women 25 y/o or older Prior pap: Unknown or NILM, HPV neg Current pap: ASCUS, HPV positive What is recommended management?
Repeat in 1 year
27
Women 25 y/o or older Prior pap: Unknown or NILM, HPV neg Current pap: LSIL, HPV negative What is recommended management?
Repeat in 1 year
28
Women 25 y/o or older Prior pap: Unknown or NILM, HPV neg Current pap: LSIL, HPV positive What is recommended management?
Repeat in 1 year
29
Women 25 y/o or older Prior pap: Unknown or NILM, HPV neg Current pap: ASC-H/AGC What is recommended management?
Colposcopy
30
Women 25 y/o or older Prior pap: Unknown or NILM, HPV neg Current pap: HSIL, HPV negative What is recommended management?
Colposcopy
31
Women 25 y/o or older Prior pap: Unknown or NILM, HPV neg Current pap: HSIL, HPV positive What is recommended management?
Colposcopy/treatment
32
Women 25 y/o or older Prior pap: ASCUS, HPV neg Current pap: NILM, HPV negative What is recommended management?
Repeat in 5 year
33
Women 25 y/o or older Prior pap: ASCUS, HPV neg Current pap: NILM, HPV positive What is recommended management?
Repeat in 1 year
34
Women 25 y/o or older Prior pap: ASCUS, HPV neg Current pap: ASCUS, HPV negative What is recommended management?
Repeat in 1 year
35
Women 25 y/o or older Prior pap: ASCUS, HPV neg Current pap: ASCUS, HPV positive What is recommended management?
Repeat in 1 year
36
Women 25 y/o or older Prior pap: ASCUS, HPV neg Current pap: LSIL, HPV negative What is recommended management?
Repeat in 1year
37
Women 25 y/o or older Prior pap: ASCUS, HPV neg Current pap: LSIL HPV positive What is recommended management?
Repeat in 1 year
38
Women 25 y/o or older Prior pap: ASCUS, HPV neg Current pap: ASC-H/AGC What is recommended management?
Colposcopy
39
Women 25 y/o or older Prior pap: ASCUS, HPV neg Current pap: HSIL, HPV negative What is recommended management?
Colposcopy
40
Women 25 y/o or older Prior pap: ASCUS, HPV neg Current pap: HSIL, HPV positive What is recommended management?
colposcopy/treatment
41
Women 25 y/o or older Prior pap: LSIL, HPV neg Current pap: NILM, HPV negative What is recommended management?
Repeat in 1 year
42
Women 25 y/o or older Prior pap: LSIL, HPV neg Current pap: NILM, HPV positive What is recommended management?
colposcopy
43
Women 25 y/o or older Prior pap: LSIL, HPV neg Current pap: ASCUS, HPV negative What is recommended management?
Repeat in 1 year
44
Women 25 y/o or older Prior pap: LSIL, HPV neg Current pap:ASCUS, HPV positive What is recommended management?
colposcopy
45
Women 25 y/o or older Prior pap: LSIL, HPV neg Current pap: LSIL, HPV negative What is recommended management?
Repeat in 1 year
46
Women 25 y/o or older Prior pap: LSIL, HPV neg Current pap: LSIL, HPV positive What is recommended management?
colposcopy
47
Women 25 y/o or older Prior pap: LSIL, HPV neg Current pap: ASC-H/AGC What is recommended management?
Colposcopy
48
Women 25 y/o or older Prior pap: LSIL, HPV neg Current pap: HSIL, HPV negative What is recommended management?
Colposcopy
49
Women 25 y/o or older Prior pap: LSIL, HPV neg Current pap: HSIL, HPV positive What is recommended management?
Colposcopy/treatment
50
Women 25 y/o or older Prior pap: NILM, HPV positive Current pap: NILM, HPV negative What is recommended management?
Repeat in 1year
51
Women 25 y/o or older Prior pap: NILM, HPV positive Current pap: NILM, HPV positive What is recommended management?
Colposcopy
52
Women 25 y/o or older Prior pap: NILM, HPV positive Current pap: ASCUS, HPV negative What is recommended management?
Repeat in 1 year
53
Women 25 y/o or older Prior pap: NILM, HPV positive Current pap: ASCUS, HPV positive What is recommended management?
Colposcopy
54
Women 25 y/o or older Prior pap: NILM, HPV positive Current pap: LSIL, HPV negative What is recommended management?
Repeat in 1 year
55
Women 25 y/o or older Prior pap: NILM, HPV positive Current pap: LSIL, HPV positive What is recommended management?
Colposcopy
56
Women 25 y/o or older Prior pap: NILM, HPV positive Current pap: ASC-H/AGC What is recommended management?
Colposcopy
57
Women 25 y/o or older Prior pap: NILM, HPV positive Current pap: HSIL, HPV negative What is recommended management?
Colposcopy/treatment
58
Women 25 y/o or older Prior pap: NILM, HPV positive Current pap: HSIL, HPV positive What is recommended management?
Colposcopy/treatment
59
What is the management for a colposcopy result with
Repeat in 1 year
60
What is the management of colposcopy result of CIN 1?
Repeat in 1 year
61
What is the management of colposcopy result of CIN2?
Treatment
62
What is the management of colposcopy result of CIN3?
Treatment
63
How do you manage current pap post colposcopy with CIN 1 or lesser?
Look at the prior cytology whether it was low grade or high grade
64
How do you manage current pap post colposcopy with prior cervical treatment due to CIN2/3?
Look at prior HPV results
65
Prior colposcopy CIN 1 or less Prior pap Low grade Current pap low grade What is management?
Repeat pap in 1 year
66
Prior colposcopy CIN 1 or less Prior pap Low grade Current pap high grade What is management?
Colposcopy
67
Prior colposcopy CIN 1 or less Prior pap high grade Current pap low grade What is management?
Colposcopy
68
Prior colposcopy CIN 1 or less Prior pap high grade Current pap high grade What is management?
Colposcopy or treatment
69
Prior colposcopy CIN 2 or greater Prior HPV negative Current pap low grade What is management?
Repeat in 1 year
70
Prior colposcopy CIN 2 or greater Prior HPV negative Current pap high grade What is management?
Colposcopy
71
Prior colposcopy CIN 2 or greater Prior HPV positive Current pap low grade What is management?
Colposcopy
72
Prior colposcopy CIN 2 or greater Prior HPV positive Current pap high grade What is management?
Colposcopy or treatment
73
What is the management after treatment of HSIL?
Follow up in 6 months with HPV testing or colposcopy/ECC
74
What is the longterm followup after treatment of HSIL?
Annual HPV or contesting until 3 consecutive negative results Then every 3 years for 25 years
75
What is the management for AGC or AIS on cytology?
Colposcopy and ECC Endometrial sampling if >35 y/o or older
76
What is the management of benign endometrial cells on cytology in premenopausal woman?
No evaluation
77
What is the management of benign endometrial cells on cytology in postmenopausal woman?
EMB
78
What is the management for women under 25 with a pap result of ASCUS HPV negative?
Repeat in 3 years
79
What is the management for women under 25 with a pap result of ASCUS HPV positive?
Repeat in 1 and 2 years
80
What is the management for women under 25 with a pap result of ASCUS HPV unknown?
Repeat in 1 and 2 years
81
What is the management for women under 25 with a pap result of LSIL?
Repeat in 1 and 2 years
82
What is the recommendation for CIN2/CIN3 histology in pregnant patient?
Colposcopy , testing every 12-24 weeks Postpartum follow per guidelines
83
When is treatment for high risk cytology warranted in pregnant patient?
Suspected or biopsy proven invasive disease
84
What is the recommendation for AIS result in pregnant patient?
Refer to gyn onc
85
What is the recommended screening for Pap smears in HIV positive patient?
Start screening within 1 year of sexual activity Screen annually for life Colposcopy for ASCUS HPV positive or higher results
86
What is the recommended screening for patient who received hysterectomy for high grade cervical disease?
Annual for 3 years After 3 negative annual screens Screen every 3 years for 25 years
87
What is the advantage of a cone vs a LEEP?
Less likely to have positive margins
88
What is a disadvantage of cone v LEEP?
High incidence of bleeding, infertility, cervical incompetence, spontaneous abortion, preterm labor
89
What factors should make you opt for cone biopsy over LEEP?
1. Completed family 2. Inadequate colposcopy 3. Discrepancy between pap and colposcopy results 4. CIS 5. Positive ECC 6. Positive margins on LEEP specimens 7. AIS

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