Pap Smear

Front 1

PAP results:
Inflammation

Back 1

evaluate for GC/CT-if treated, repeat PAP in 3-6mo
if persistant inflammation of unknown etiology--get colposcopy

Front 2

PAP results:
atrophy w/inflammation

Back 2

common finding in postmenopausal women or w/estrogen defiency,
treat w/estrogen if symptomatic, no change in PAP intervals

Front 3

PAP results:
ASCUS-H

Back 3

REFER ALL TO COLPOSCOPY! (can't r/o HSIL)

Front 4

PAP results:
LSIL

Back 4

REFER to coloposcopy or rescreen in 4-6mo (50% of LSIL will spontaneously resolve)
if pregnant--COLPOSCOPY
if postmenopausal- HPV testint or REPEAT PAP 6/12mo.

Front 5

LSIL

Back 5

includes lesions-mild dysplasia and w/koilocytic atypia (indicative of HPV)

Front 6

PAP results:
HSIL

Back 6

Colposcopy

Front 7

PAP results:
Atypical glandular cells

Back 7

Coloposcopy and endocervical canal biopsy

Front 8

PAP results:
endometrial cells

Back 8

in cycling pre-menopausal women--benign,
post-menopausal women require an endometrial biopsy

Front 9

Pap result: satisfactory but limited ...
management?
no hx of abnormal PAP

Back 9

repeat in 1 year

Front 10

Pap result: satisfactory but limited ...
management?
hx of abnormal PAP

Back 10

repeat PAP in 6-12weeks.

Front 11

PAP result: benign cellular changes r/t fungal infx

Back 11

evaluate and treat yeast
repeat PAP in 6-12 weeks only if "inflammation" noted on PAP

Front 12

PAP result: benign cellular changes r/t trichomonas

Back 12

either evaluate with a wet mount or treat to prevent transmission
repeat PAP at nl interval unless "inflammation" noted

Front 13

PAP result: benign cellular changes consisten with actinomyces spp

Back 13

IF IUD in place: evaluate for PID
either remove, treat and repeat PAP in 3 mo
if no PID rePAP in 3 mo.

Front 14

PAP result:
Cellular changes associated with HSV

Back 14

No culture needed. Next PAP at routine interval. Discuss implications of asymptomatic viral shedding.

Front 15

PAP result:
Inflammation

Back 15

check for GC/CT
if neg. repeat PAP in 3-6mo. to r/o preinvasive CA.
if second PAP shows inflammation--COLPOSCOPY

Front 16

PAP result:
Atrophy with Inflammation

Back 16

common finding in postmenopausal women +estrogen deficiecy,
treat if symptomatic,
no change to PAP intervals

Front 17

PAP result:
ASC-US

Back 17

1)If +high risk HPV--COLPOSCOPY
if -high risk HPV-repeat PAP in one year
or 2)rescreen in 6mo, repeat every 6mo until 3 consecutive normals, then back to routine screening
3)send to COLPOSCOPY

Front 18

PAP result:
ASC-US
for Adolescents

Back 18

repeat PAP in 6-212 months or repeat HPV testint in 12 months

Front 19

PAP result:
ASC-US
for post-menopausal women

Back 19

treat with vaginal estrogen for 4-6 wks, repeat PAP one week after completion of therapy.
if ASCUS or higher--COLPOSCOPY

Front 20

PAP result: ASCUS
adolescents

Back 20

repeat PAP in 6 and 12 mo., if ASCUS or higher COLPOSCOPY

Front 21

PAP result: ASC-H

Back 21

COLPOSCOPY for everyone