Pap Smear, Cervical Dysplasia, Cervical Cancer (Wootton)

Question 1

Cervical cancer and CIN are caused by?

Answer 1

HPV

Question 2

Why HPV types cause the majority of cancers?

Which ones are responsible for 70% of cervical cancers?

Which types are associated with genital warts and with low grade lesions?

Answer 2

1) 16,18, 31 and 45
2) 16 and 18
3) 6 and 11

Question 3

What are common risk factors for cervical neoplasia?

Answer 3

1) Multiple sexual partners
2) Smoking
3) Organ transplant
4) DES exposure
5) High parity

Question 4

What populations should not have a pap smear done?

Answer 4

1) Under 21

2) After hysterectomy

Question 5

What is the pap smear guideline for patients ages 21-29 that had an initial normal test?

Answer 5

Cytology alone every 3 years

Question 6

What is the pap smear guideline for patients ages 30-65?

Answer 6

HPV and cytology co-testing every 5 years

Question 7

What is the pap smear guideline for patients ages 65 and older?

Answer 7

No screening following adequate negative prior screening

Question 8

Low grade squamous intraepithelial lesion correlates with?

High grade squamous intraepithelial lesion correlates with?

Answer 8

1) CIN 1

2) CIN 2, CIN 3, and Carcinoma in situ

Question 9

What is gold standard for diagnosis and treatment planning with low grade and high grade intraepithelial lesion findings?

Answer 9

Colposcopy with directed biopsy

Question 10

With a colposcopy, the cervix is washed with a 3% acetic acid which dehydrates cell and large nuclei of abnormal cells turn what color?

Answer 10

White (acetowhite changes)

Question 11

With a colposcopy, what findings are you looking for?

Answer 11

1) Acetowhite changes
2) Punctuations
3) Mosaicism
4) Abnormal vessels
5) Masses

Question 12

What are some ablative (destroy cervical tissue) treatment options?

What are some excisional treatment options?

Answer 12

1) Cryotherapy and laser ablation

2) Cold knife cone and Loop electrode excisional procedure (LEEP)

Question 13

A cold knife cone excisional technique is done when __1__ is positive.

Excisional techniques are also done when there is unsatisfactory __2__ or if there is a substantial discrepancy between __3__ and __3__.

Answer 13

1) Endocervical curettage
2) Colposcopy
3) Pap and biopsy (ie High grade pap and negative colposcopy)

Question 14

What is there an increased risk of with excisional procedures?

Answer 14

Preterm premature rupture of membranes (PPROM)

Question 15

91% of cervical cancer is caused by?

Answer 15

HPV

Question 16

What type of cancer makes up 80% of cervical cancer cases?

What type makes up 15% of cases?

Answer 16

1) Squamous cell carcinomas

2) Adenocarcinoma