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29 Cards in this Set
- Front
- Back
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ACOG pap smear guidelines
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inc risk factors = inc screening (HIV, immsup, DES)
stop cervical cancer screening at age 65 or 70 (if >3 cytology results in past 10 yrs |
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ascus
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atypical squamous cells of uncertain significance
atypical glandular undeter sig squamous intraepithelial lesion |
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risk factors for cervical cancer
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multiple sexual partners (#1), smoking, early sexual intercourse, HIV infection
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koilocytes in cervical condyloma
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N/C ratio increased (bigger nucleus); perinuclear halo
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natural course of HPV infection
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70% spont regres, 14% progress, 6% persist
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high risk strains
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HPV 16 (E6 gene product inhibits p53 supressor gene) and HPV 18 (E7 gene product inhibits RB suppressor gene)
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colposcopy
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cervical biopsy + endocervical curettage; performed in pts w cervical abnormalities (ASCUS)
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schillings
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glycogen in cervical cells will keep iodine and will color brown; cells that do not pick up the iodine = dysplastic cells
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purpose of endocervical curretage
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identify occult lesions; can detect lesions in the endocervix
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ascus in young pt vs older patient
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young = relatively low risk
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low grade squamous intraepithelial lesions
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asymptomatic; 80% are HPV positive so HPV testing is not used in management
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high grade squamous intraepithelial lesions
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asymptomatic or postcoital bleeding; 70% chance of severe/moderate dysplasia
as you have inc grades of abnormalities = more likely to have cancer |
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when to perform breast exam
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after period; if before there might be hormone induced lumps
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mc breast cance rin woman <30
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fibroadenoma;
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thick white clumpy cottage chese like vaginal discharge
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pathognomonic of candidal vaginitis
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yellow frothy discharge; cervical petechiae described as strawberry cervix
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trichomoniasis
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mucopurulent cervical discharge and cervical friability (bleeding w gentle palpation) are suspect for cervicitis
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chalmydia/gonorrohea
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wet prep
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wet prep: gold standard for dx vaginitis and will almost always make the dx of candidal vaginitis, bacterial vaginosis and trichomonis
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whiff test
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application of KOH produces an immediate pungent amine (fishy) odor in presence of bacterial vaginosis and often trichomoniasis as well
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ph > 5
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suggests bacterial vaginosis or trichominiasis (<4.5 = candida)
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ph <4.5
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candida vaginitis (vs pH > 5.0 = bacterial vaginosis or trichomoniasis)
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why pregnancy test before tx std
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dont want to give teratogenic drugs
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hyphae with buds
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candida vaginitis
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trichomoniasis
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have to tx BOTH partners
varginal discharge w fishy odor that worsens after intercourse speculum exam reveals yellow, frothy vaginal cervix, ph > 5.0, diagnostic wet mount = flagellated corkscrew motility on wet prep tx w metronidazole |
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mucopurulent cervicitis
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n. gonorrhea or chlamydia
thick white discharge, whether pt has recently changed partner or whether she has sexual intercourse w multiple partners; also if she changed detergent or laundry or hygiene routine |
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chalmydia
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PMN on wetmount (typical of mucopurulent discharge);
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blind newborn and stds
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gonorrhea
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sore throat; rectal pn or discharge
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gonorrhea
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pt w chills
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septicemia
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