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Bethesda Classification System results came back with Squamous cell carcinoma or adenocarcinoma. The next step would be to:
promptly refer to gyn cancer specialist
A post-menopausal woman with endometrial cells evident on pap results. She is not on hormone replacement therapy. What is the follow up for this patient?
AGUS (atypical glandular cells of undetermined significance) leads to what follow up?
- endocervical curettage (ECC)
- possible endometrial bx
- fractional dilation and curettage or hysteroscopy
Treatment for a low grade intraephithelial leasion is:
- colposcopy and cervical bx with endocervical curettage.
- If ECC is negative, pap smears and colposcopy every 6 months
Normal cervical cells include:
- squamous cells
- endocervical cells
- squamo-columnar junction
Risk factors for cervical cancer include:
- intercourse prior to 20 yo
- more than 3 partners in a lifetime
- intercourse with men who have had multiple partners
- smoking/smoking history
- presence or history of HPV
Cervical screening guidelines
- initiate at 21
- 21-29 - every 1 to 2 years based on risk assessment
- 30-65 - every 2 to 3 years based on risk assessment
- 66 > if 3 consecutive negatives and no abn paps: 10 yrs
- 66> with abnormal pap: biannual until 2 consecutive
- normals, then continue routine.
Pap test interpretation is based on what standard?
Bethesda classification System (1991)
Catagories of BCS reporting:
- Specimen adequacy (satis., less than optimal, unsatis)
- Negative for intraepithelial lesions or malignancy (WNL,
- Benign cellular changes)
- Epithelial cell abnormalities
Negative for intraepithelial lesion or malignancy: what other results could there be?
- Trichomonas vaginalis
- Fungal organisms (candida)
- Bacterial vaginosis
- Actinomyces species
- Herpes simplex
- Reactive cellular changes
- Glandular cells (s/p hysterectomy)