Cervical Cancer

Front 1

defined as disordered growth of the lower third of the epithelial lining.

Back 1

CIN 1

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CIN may be suspected because of an abnormal cytologic smear, but the diagnosis is established by

Back 2

cervical Bx

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There are three acceptable initial evaluation steps for patients with minimally abnormal cervical cytology smears (eg, ASC-US):

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accelerated serial cytology smears, triage to colposcopy based on a positive HPV testing result, or immediate referral to colposcopy.

Front 4

There are three acceptable initial evaluation steps for patients with minimally abnormal cervical cytology smears (eg, ASC-US):

Back 4

accelerated serial cytology smears, triage to colposcopy based on a positive HPV testing result, or immediate referral to colposcopy.

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All patients with ASC-H, LSILs, HSILs, atypical glandular cells (AGCs), or smears suspicious for cancer should be referred for

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immediate colposcopy.

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All patients with ASC-H, LSILs, HSILs, atypical glandular cells (AGCs), or smears suspicious for cancer should be referred for

Back 6

immediate colposcopy.

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reflex HPV testing is the preferred approach for

Back 7

For patients with ASC-US

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reflex HPV testing is the preferred approach for

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For patients with ASC-US

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If cytology and HPV testing are positive as far as with a pap

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triaging to colposcopy is as outlined above.

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If cytology and HPV testing are positive as far as with a pap

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triaging to colposcopy is as outlined above.

Front 11

The Schiller test is based on the principle that

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normal mature squamous epithelium of the cervix contains glycogen, which combines with iodine to produce a deep mahogany-brown color.

Front 12

The Schiller test is based on the principle that

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normal mature squamous epithelium of the cervix contains glycogen, which combines with iodine to produce a deep mahogany-brown color.

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the primary technique for the evaluation of an abnormal cervical cytology smear.

Back 13

Colposcopy

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the primary technique for the evaluation of an abnormal cervical cytology smear.

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Colposcopy

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the primary technique for the evaluation of an abnormal cervical cytology smear.

Back 15

Colposcopy

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Indications for colposcopy are:

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1. Abnormal cervical cytology smear or HPV testing;

2. Clinically abnormal or suspicious-looking cervix;

3. Unexplained intermenstrual or postcoital bleeding;

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Indications for colposcopy are:

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1. Abnormal cervical cytology smear or HPV testing;

2. Clinically abnormal or suspicious-looking cervix;

3. Unexplained intermenstrual or postcoital bleeding;

Front 18

Indications for colposcopy are:

Back 18

1. Abnormal cervical cytology smear or HPV testing;

2. Clinically abnormal or suspicious-looking cervix;

3. Unexplained intermenstrual or postcoital bleeding;

Front 19

Indications for colposcopy are:

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1. Abnormal cervical cytology smear or HPV testing;

2. Clinically abnormal or suspicious-looking cervix;

3. Unexplained intermenstrual or postcoital bleeding;

Front 20

Following expert colposcopic evaluation, if it is unsatisfactory

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diagnostic conization of the cervix (Fig 50-2) is indicated if colposcopy is unsatisfactory, if the lesion extends into the cervical canal beyond the view afforded by the colposcope, if there is dysplasia on the endocervical curettage, if there is a significant discrepancy between the histologic diagnosis of the directed biopsy specimen and the cytologic examination, if adenocarcinoma in situ is suspected, or if microinvasive carcinoma is suspected.

Front 21

Operation Barbarossa?

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Plan to take over the USSR

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what % of patients with untreated CIN I are diagnosed with CIN II/III over a 2-year follow-up.

Back 22

9-16%

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what % of patients with untreated CIN I are diagnosed with CIN II/III over a 2-year follow-up

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9-16%

Front 24

Prior to any therapeutic intervention an assessment has to be made as to whether a patient qualifies for ablative therapy (eg, satisfactory diagnostic evaluation has excluded invasive disease) or if she requires an excisional procedure (conization) for further diagnostic work-up. In most cases, conization is also the appropriate therapeutic intervention.

Back 24

Prior to any therapeutic intervention an assessment has to be made as to whether a patient qualifies for ablative therapy (eg, satisfactory diagnostic evaluation has excluded invasive disease) or if she requires an excisional procedure (conization) for further diagnostic work-up. In most cases, conization is also the appropriate therapeutic intervention.

Front 25

Prior to any therapeutic intervention an assessment has to be made as to whether a patient qualifies for ablative therapy (eg, satisfactory diagnostic evaluation has excluded invasive disease) or if she requires an excisional procedure (conization) for further diagnostic work-up. In most cases, conization is also the appropriate therapeutic intervention.

Back 25

Prior to any therapeutic intervention an assessment has to be made as to whether a patient qualifies for ablative therapy (eg, satisfactory diagnostic evaluation has excluded invasive disease) or if she requires an excisional procedure (conization) for further diagnostic work-up. In most cases, conization is also the appropriate therapeutic intervention.

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If the intraepithelial lesion is confined to the ectocervix, treatment with

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cryotherapy, laser ablation, or a superficial excision by the loop electrosurgical excision procedure (LEEP) is appropriate.

Front 27

If the intraepithelial lesion is confined to the ectocervix, treatment with

Back 27

cryotherapy, laser ablation, or a superficial excision by the loop electrosurgical excision procedure (LEEP) is appropriate.

Front 28

If the intraepithelial lesion is confined to the ectocervix, treatment with

Back 28

cryotherapy, laser ablation, or a superficial excision by the loop electrosurgical excision procedure (LEEP) is appropriate.

Front 29

If the lesion extends into the endocervical canal, the endocervical curettage contains dysplastic epithelium, or the colposcopic examination is otherwise unsatisfactory, the endocervical canal must be included in the treatment by a deeper LEEP or cone biopsy (Fig 50-6). A conization procedure is also indicated in cases of a significant discrepancy between cervical cytology and colposcopy/biopsy results, in cases of suspected microinvasive carcinoma or adenocarcinoma in situ.

Back 29

If the lesion extends into the endocervical canal, the endocervical curettage contains dysplastic epithelium, or the colposcopic examination is otherwise unsatisfactory, the endocervical canal must be included in the treatment by a deeper LEEP or cone biopsy (Fig 50-6). A conization procedure is also indicated in cases of a significant discrepancy between cervical cytology and colposcopy/biopsy results, in cases of suspected microinvasive carcinoma or adenocarcinoma in situ.

Front 30

If the lesion extends into the endocervical canal, the endocervical curettage contains dysplastic epithelium, or the colposcopic examination is otherwise unsatisfactory, the endocervical canal must be included in the treatment by a deeper LEEP or cone biopsy (Fig 50-6). A conization procedure is also indicated in cases of a significant discrepancy between cervical cytology and colposcopy/biopsy results, in cases of suspected microinvasive carcinoma or adenocarcinoma in situ.

Back 30

If the lesion extends into the endocervical canal, the endocervical curettage contains dysplastic epithelium, or the colposcopic examination is otherwise unsatisfactory, the endocervical canal must be included in the treatment by a deeper LEEP or cone biopsy (Fig 50-6). A conization procedure is also indicated in cases of a significant discrepancy between cervical cytology and colposcopy/biopsy results, in cases of suspected microinvasive carcinoma or adenocarcinoma in situ.

Front 31

procedure of choice for treating CIN II and CIN III because of its ease of use, low cost, and provision of tissue for histologic evaluation.

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LOOP ELECTROSURGICAL EXCISION PROCEDURE - LEEP

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procedure of choice for treating CIN II and CIN III because of its ease of use, low cost, and provision of tissue for histologic evaluation.

Back 32

LOOP ELECTROSURGICAL EXCISION PROCEDURE - LEEP

Front 33

procedure of choice for treating CIN II and CIN III because of its ease of use, low cost, and provision of tissue for histologic evaluation.

Back 33

LOOP ELECTROSURGICAL EXCISION PROCEDURE - LEEP

Front 34

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 34

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 35

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 35

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 36

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 36

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 37

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 37

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 38

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 38

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 39

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 39

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 40

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 40

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 41

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 41

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 42

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 42

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 43

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 43

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 44

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 44

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 45

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 45

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 46

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 46

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 47

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 47

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 48

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 48

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 49

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 49

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 50

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 50

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 51

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 51

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 52

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 52

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 53

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 53

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 54

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 54

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 55

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 55

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 56

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 56

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 57

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 57

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 58

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 58

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 59

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 59

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 60

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 60

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 61

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 61

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 62

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 62

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 63

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 63

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 64

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 64

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 65

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 65

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 66

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 66

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 67

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 67

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 68

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 68

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 69

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 69

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 70

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 70

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 71

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 71

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.

Front 72

If a woman has completed childbearing, recurrent dysplasia can be treated by

Back 72

a simple hysterectomy after invasion has been ruled out. Women with a history of cervical dysplasia have a higher incidence of vaginal dysplasia. These women continue to need Pap smears after hysterectomy.