Repro; Wells- Pap Smears- Nsv

Front 1

What is the screening tool for cervical cancer?

Back 1

Pap Smear

Front 2

The cervix is located at what portion of the uterus?

Back 2

Inferior extension

Front 3

In development, what type of cells line the uterivaginal canal

Back 3

Columnar epithelium

Front 4

What is the Original Transformation zone?

Back 4

The point where columnar and squamous cells meet

Front 5

Where is theOriginal transformation zone located

Back 5

At the endocervical canal

Front 6

At what point are cells vulnerable to neplasm

Back 6

When columnar cells convert to squamous cells

Front 7

At reproductive stage where is the SCJ located

Back 7

It moves out of the endocervical canal

Front 8

Why does columnar cell change to squamous cells when they move out of the endocervical canal

Back 8

Because they get exposed to the Vaginal acid

Front 9

What is the transformations zone

Back 9

Its the zone b/w the original SCj and the new SCJ

Front 10

What are the 2 types pf cytologic specimens for PAP smear

Back 10

1) conventional PAP
2) Liquid based PAP (more accurate)

Front 11

Squamous intraepitheial adnrmalies are associted with what?

Back 11

HPV

Front 12

How does one get Mild dysplasia after exposure to HPV

Back 12

produces proteins that direct the host cell to undergo maturation and cell death. Cells exfoliate, disintegrates and release large numbers of intact viral particles. (DNA has not gotten into the genome)
**80% of pts with mild dysplasia go back to normal**

Front 13

How does one get Moderate and severe dysplasia after exposure to HPV

Back 13

• Moderate dysplasia and severe dysplasia, there is an actual disruption of the HPV DNA and it is integrated into the host cell genome. Results in transformation and proliferation of the immature basal or parabasal cells. (DNA is more incorporated)

Front 14

What kind of dysplasia covers 2/3 of the epithelial surface

Back 14

Moderate

Front 15

What kind of dysplasia covers the entire epithelial surface but stops at the basal layer

Back 15

Severe

Front 16

Exposure to what is necessary for development of cervical neoplasm

Back 16

HPV

Front 17

Genital warts are related to what strains of HPV

Back 17

6,11

Front 18

What strainsa re covered by the gardisil vaccine

Back 18

6,11,16,18

Front 19

What are cellular changes defines as?

Back 19

• Cellular changes are reactive and reparative secondary to life events (tampons, intercourse, BV, yeast, aging and decreased estrogen). Give Gradual Estrogen for a week and then repeat pap smear.

Front 20

WHen do you begin perfrming PAP smears?

Back 20

• Begin screening 3 yrs. after the onset of vaginal intercourse and no later than 21yrs.
• Screening done annually until the age of 30. If there are 3 normal PAP’s in a row, may go to every 2–3yrs.

Front 21

If a pts report states that they have mild dysplasia, what should you next step be?

Back 21

Colposcopy with biopsy

Front 22

Do you need to do colposcpy and Biopsy together for ASCUS

Back 22

YES

Front 23

If you do a biopsy for the pt who had mild grade dyplasia and find that they have LSIL, what do you do next

Back 23

• If biopsy confirms LSIL, two options:
1. Follow with PAP every 4-6 months. When three consecutive normal PAP can go to annually.
2. Treatment with cryosurgery (freeze cervix), laser ablation(laser dessicates abnormal part) or excision (laser cuts abnormal part), LEEP (Loop Electrosurgical Excision Procedure-cuts abnormal parts off), CKC (Cold Knife Conization), then follow up PAP’s.

Front 24

If you do a biopsy for the pt who had mild grade dyplasia and find that they have HSIL, what do you do next

Back 24

• Colposcopy with endocervical biopsies.
• Biopsies need to match.

Front 25

How would you trest carcinoma in sity

Back 25

CKC, NO ABLATION PROCEDURE

Front 26

What should be your next step in the following cases:
1) If invasive disease,
2) If no invasive disease and AGC NOS, no abnormal pathology,
3) If no invasive disease AGC NOS and biopsy is CIN or AIS, 4) If no invasive disease and AGC favors dysplasi

Back 26

1) refer to the GYN/ONC.
2) can go to PAP every 4-6 months until 3 consecutive normal.
3) excisional biopsy is indicated.
4) next step is a Cold Knife Conization

Front 27

Which procedure is safe to do in a pregnant woment to screen for abnormalities

Back 27

Colposcopy with exctocervical biopsy if indicated.

Front 28

Which procedure is NOT safe to do in a pregnant woment to screen for abnormalities

Back 28

Endocervical Biopsy- it can disturb the pregnancy

Front 29

You should ALWAYS do what test before doing any colposcopy procedure

Back 29

ALWAYS do a pregnancy test prior to a colposcopy.