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14 Cards in this Set
- Front
- Back
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20. How should pts w/ASC-H, LSIL, or HSIL be evaluation?
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a. Should proceed directly to colposcopy.
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21. How should pts w/ASC-US be evaluated?!?!?
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a. Should undergo HPV testing to determine if colposcopy is indicated or not.
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22. How should pts w/AGC be evaluated?
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a. With Colposcopy, cervical biopsy, and endocervical sampling because of the potential for both cervical and endometrial adenocarcinoma.
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23. How should pts 35 and older and those under 35 with risk factors of endometrial hyperplasia or endometrial cancer be evaluated?
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a. With Endometrial biopsy.
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24. Reflex HPV testing?
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a. Reflex testing is testing once another result is achieved to r/o something.
b. I.e. Pts w/ASC-US should be reflex tested for HPV. c. Reflex testing can be achieved either using the residual liquid from the liquid-based pap or using a separate sample collected at the time of initial PAP for HPV testing. d. Reflex testing eliminated the need for the pt to return for repeat resting and it allows the clinician to predict a pt’s risk for a high-grade lesion. |
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25. How should the woman w/ASC-US pap who is positive on reflex testing for HPV be evaluated?
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a. Colposcopy.
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26. How should the woman w/ASC-US pap that is negative on reflex testing for HPV be evaluated?
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a. She can be followed by another PAP AND high-risk HPV screen in 1 year!
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27. Is HPV testing recommended for ASC-H, LSIL, and HSIL?
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a. No!!!!! Bc nearly all of these lesions will be positive for high-risk types.
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28. Tx of CIN 1?
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a. Can be followed by repeat cytology (every 6 months X2) or Repeat HPV testing (in 1 year).
b. If any of these are positive, the pt should have a repeat colposcopy and biopsy. c. If all normal, pt can return to annual pap smears. |
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29. Tx of CIN II and III?
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a. Surgical excision bc of their potential to progress to cervical cancer.
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30. Tx of CIN 1 that persists for more than 2 years?
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a. Surgical excision.
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31. Surgical standard of care for CIN II and III?
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a. LEEP (Loop electrosurgical excision procedure) or
b. Lletz (large loop excision of the transformation zone). c. Leep, loop and Lletz all refer to the same procedure that involves removing a cone-shaped piece of cervical portio (conization), typically w/cauterized fine-wire loop or w/a laser. |
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32. Follow up after tx for CIN II and III?
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a. Pts should be followed every 6 months w/repeat PAP or repeat PAP and colp for 1 year.
b. If all remains normal, the pt can return to routine screening for at least 20 yrs. |
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33. Most common sx of cervical cancer?
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a. Postcoital bleeding.
i. Other signs: abnormal bleeding, watery discharge, pelvic pain or pressure, and rectal or urinary tract symptoms. |
