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Year2 Repro exam II > Pap smear > Flashcards

Flashcards in Pap smear Deck (50):
1

42 y.o G2P2 with LMP one week ago. tubal ligation as birth control. annual exam
hypothyroid, 22pack year, +FMH breast CA
no mammogram, last PAP 5 yrs prior
2 c sections for LGA babies
+gestational DM
+vaginal discharge on exam
next step?

wet prep
KOH
pap

2

if pap shows atypical squamous cells high grade
next step?

colposcopy and Bx

3

Sx bacterial vaginosis

odor
no inflammation or itching

4

risk factors bacterial vaginosis

sexual activity, douching

5

what causes bacterial vaginosis

overgrowth of anaerobic bacteria- gardnerella

6

What is Amsel criteria

3 of following:
-homogenous white to gray discharge
-pH >4.5
- + whiff test with KOH
- clue cells on wet mount

7

pregnancy risks of bacterial vaginosis

preterm
PROM
amniotic fluid infection
chorioamnionitis
post partum endometritis

8

bacterial vaginosis Tx

metronidazole
clindamycin
tindazole

9

Tx asymptomatic patient with bacterial vaginosis

not recommended but most people Tx

10

yeast on wet mount

pseudohyphae

11

Sx yeast

itching, red cervix

12

bubbly discharge of vaginal fluid

trichomonas

13

koilocyte

HPV

14

what do you look for in cells on pap smear

increased nuclear to cytoplasmic ratio
abnormal cell structure
koilocyte indication

15

cervical cancer associated with

sex
(precursors: HPV etc)

16

most common sexually transmitted infection

HPV

17

how many types HPV sexually transmitted

40 types

18

how is HPV Dx

DNA hybrid testing

19

clinical infection of HPV

warty growths- condylomata accuminata (6 and 11)
on vulva, vagina, cervix, urethra, perianal

20

HPV asociated with what genital neoplasias

cervical, vaginal, vulvar CA

21

HPV infection normal course

spontaneously clears within 2 years

22

high risk HPV

16 18 30

23

what is ASCUS

atypical squamous cells of udetermined significance

24

What is ASC-H

atypical squamous cells, high grade

25

what is AGUS

atypical glandular cells of undetermined significance (endocervical cells)

26

what is LSIL

low grade squamous intraepithelial lesion

27

HSIL

high grade squamous intraepithelial lesion

28

work up of abnormal pap

age dependent degree abnormality

29

risk factors for abnormal pap

no recent pap
smoking
age of 1st intercourse
number of patients
HIV or any other reason to be immunocompromised

30

how does smoking increase risk cervical cancer

destroys epithelial cells

31

what is colposcopy

looking at cervix with microscope and usually take biopsy

32

biopsy can tell you what about cervix pathology

CIN I II III and invasive

33

what is CIN I

mild dysplasia

34

what is CIN II

moderate dysplasia

35

what is CIN III

severe dysplasia, carcinoma in situ

36

what occurs in CIN I prognosis

70% regress

37

what occurs in CIN II prognosis

30% regress, 30% stay same, 30-40% progress

38

Tx CIN II

excise usually

39

how does cervical cancer spread

lymph nodes

40

radical hysterecotmy includes what part of vagina

top third

41

what are indications for conization

CIN II III
endocervical disease on colposcopy
inadequate colposcopy
depth on invasion

42

contributing factor to cervical cancer death

lack of screening

43

highgest incidence cervical CA

30-50

44

screening for ages 21-29

cytology every 3 years
HPV testing not used as screen

45

screening for ages 30-64

cytology and HPV testing (co testing) every 5 years

46

reason for cotesting

increased detection CIN3
enhances detection adenocarcinoma

47

normal pap with HPV high risk positive what is next step

colposcopy

48

when to stop screening in women

age 65 with negative screening before
3 consecutive neg paps or 2 consecutive neg HPV tests

49

When not to stop screening at age 65

history CIN 2 or 3
change of partners

50

vaccine against HPV 16 18 reduces risk of what

CIN3