Quiz 3 Pap, HPV

Question 1

HPVs affect _____ and _______

Answer 1

Skin and mucus membranes.

Question 2

Highest risk HPV are 16,18,31,33,45,52,58 and are associated with ________

Answer 2

Cervical dysplasia and cancer.

Question 3

Guardisil vaccine for HPV covers ______

Answer 3

All high risk HPV - 16, 18, 31, 33, 45, 52, 58

Question 4

Vaccines are ______ prevention. Screenings are ______ prevention. Examples of tertiary prevention?

Answer 4

Primary - preventing the disease all together
Secondary - surveillance for possible disease presence
Weight management, lipid management, smoking cessation, diet mods in a post-MI patient - minimizing the effects of a present disease and increasing quality of life.

Question 5

Organ transplants increase the risk for cervical cancer development because __________. These other comorbidities increase risk for HPV associated ca:

Answer 5

Patient is on immunosuppressive medication which allows HPV to be more severe (body immune system unable to combat)
HIV/AIDS, autoimmune disease, cancer - these all have medical therapies that suppress the immune system.

Question 6

The vaginal mucosa has ______ epithelial cells while the cervix has ___________ epithelial cells. The transformation zone is where these two layers meet and mix. Want to sample this zone for paps.

Answer 6

Stratified squamous
Columnar. (C + C = columnar + cervix)

Question 7

What does Metaplasia mean?

Answer 7

Change of 1 type of differentiated cell into another type.

Question 8

USPSTF recs for cervical ca screening:
Age 21-29
Age 30-65

Answer 8

21-29 = cytology alone q3years if normal.
30-65 = cytology and hrHPV OR hrHPV alone q5y OR cytology alone q3y.

Question 9

Most important part of the Pap?

Answer 9

The label.

Question 10

T/F: Cytology is like a biopsy.

Answer 10

False. Cytology is looking at the appearance of cells on a slide (scraping). Biopsy is histopathology.

Question 11

When you’re reading the results of your pap, you MUST check to see if _________ cells were included in the sample of cells looked at. Otherwise _______

Answer 11

Transformation zone - this is where the most cancer starts to grow.
Sample may not be adequate or taken from the right spot and you may have missed a possible cancerous/pre-cancerous cells.

Question 12

If your pap sample comes back with the label AGC what could this mean?

Answer 12

Sample taken during menstruation - repeat 2-3 months later (time for cells to adequately turnover since you just scraped the top off).

Question 13

What dose a NILM pap result mean?

Answer 13

Negative for intraepithelial lesion or malignancy - benign and WNL.

Question 14

What is the difference between ASC-US and ASC-H pap results?

Answer 14

ASC-US = atypical squamous cells of undetermined significance —> specific diagnosis cannot be made - further triage needed.
ASC-H = atypical squamous cells cannot exclude HSIL —> cytological changes suggestive of High grade squamous intraepithlial lesion (HSIL) but lack criteria for definitive interpretation.

Question 15

What does LSIL pap result mean?

Answer 15

Low grade squamous intraepithelial lesion - mild dysplasia and HPV.

Question 16

HSIL pap result means?

Answer 16

High-grade squamous intraepithelial lesion - technically NOT cervical cancer, it’s an early form that could progress to cancer but usually has not penetrated through the basement membrane and absence of invasion to surrounding tissue.

Question 17

If PAP comes back abnormal, what are the options?

Answer 17

More frequent paps, culpo with biopsy, treatment for ca.

Question 18

Cervical, vaginal and vulvar cancer screening in immuno-compromised?

Answer 18

Pap w/in 1 yr of sex
Pap at the time of dx of immunosuppression.
Cytology annually x3 years, then q3 until 30.
Cytology and hrHPV q3y at 30
Inspection/palpation annually.
Paps don’t stop at 65
HPV vaccine.