Mary L
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abnormal cervical cytology quiz

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Mary L
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Abnormal Cervical Cytology

Question 1 of 17

1

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Women between the ages of 21-29 should be tested with ( cytology alone every 3 years, cytology and HPV every 5 years, cytology alone every 5 years, cytology + HPV every 3 years ).
Women between the ages of 30-65 should be tested with ( cytology + HPV cotesting every 5 years, cytology alone every 5 years, cytology + HPV cotesting every 3 years, cytology + HPV cotesting every 7 years ) or ( cytology alone every 3 years., cytology alone every 5 years, cytology + HPV cotesting every 3 years, cytology + HPV cotesting every 4 years. )

Explanation

Question 2 of 17

1

According to ASCCP guidelines, women no longer need to be screened for cervical cancer if they are >65 with ___________________ or they have had a total hysterectomy __________________________.

Select one of the following:

  • with adequate screening history; for benign disease

  • with adequate screening and normal paps; for benign disease

  • with negative prior screening and no hx of CIN 2 or >; for benign disease and no hx of high grade CIN

  • with adequate screening hx; for benign disease and no hx of high grade CIN

Explanation

Question 3 of 17

1

The following populations are not appropriate to screen according to standard ASCCP guidelines:

Select one or more of the following:

  • w/ HIV

  • who are immunosuppressed

  • hx of colpo or LEEP

  • exposed to DES in utero

  • previously treated for CIN 2, CIN 3, or cancer

  • previously treated for CIN 1

Explanation

Question 4 of 17

1

According to the Bethesda system, any of the following may result in an unsatisfactory pap specimen EXCEPT:

Select one of the following:

  • Obscuring blood inflammation or other process

  • insufficient squamous cells (< approx 5000)

  • specimen not labeled

  • absent or insufficient endocervical cells/transformation zone noted

Explanation

Question 5 of 17

1

Actinomyces is a common finding for women with

Select one of the following:

  • BV

  • IUD

  • HPV

  • Cancer

Explanation

Question 6 of 17

1

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If a client has an unsatisfactory cytology, and is HPV unknown or HPV neg (>30 yrs old), you should ( repeat cytology after 2-4 months, recommend a colposcopy, repeat cytology after 6 months, repeat cytology immediately ). If result is HPV positive (age >30), you can either ( repeat cytology in 2-4 months, repeat cytology immediately, repeat after 6 months, offer a LEEP ) or offer a coloposcopy.

Explanation

Question 7 of 17

1

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If a client's cytology is NILM, but EC/TZ is absent/insufficient: If the client is age 21-29 or HPV neg, you can ( follow routine screening, repeat cytology immediately, repeat cytology in 2-4 months, repeat cytology in 1 year ). If the client is >30 and HPV is unknown, ( HPV testing, repeat cytology immediately, repeat cytology in 1 year, repeat cytology in 3 years ) is preferred, but ( repeat cytology in 3 yrs, repeat cytology in 1 year, repeat cytology immediately, HPV ) is acceptable. If the client is >30 and HPV positive, you can ( repeat cytology and HPV testing in 1 yr, repeat cytology alone in 1 year, recommend colpo, repeat cytology & HPV in 5 years ) or perform ( genotyping, colposcopy, LEEP )

Explanation

Question 8 of 17

1

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Ages 21-24 with either ASCUS or LSIL: it is preferred to ( repeat cytology in 12 months, perform reflex HPV testing, repeat cytology and HPV in 12 months, recommend colpo ), but acceptable to ( perform reflex HPV test for ASCUS only, perform reflex HPV testing for LSIL only, perform reflex HPV for ASCUS or LSIL, recommend colpo ).

Explanation

Question 9 of 17

1

If a woman's results indicate Atypical Squamous Cells, Cannot exclude High-grade Squamous Intraepithelial Lesion (ASC-H), you recommend

Select one of the following:

  • HPV cotesting

  • colpo, if HPV +

  • colpo, regardless of HPV status

  • LEEP

Explanation

Question 10 of 17

1

A 23 yo woman has a pap result of HSIL and a colpo negative for CIN 2, 3. Repeat paps done every 6 months in the following 24 months a continue to show HSIL, though repeat colpos do not identify CIN 2, 3. You recommend:

Select one of the following:

  • LEEP or other diagnostic excisional procedure

  • continued monitoring with colpo and cytology at 6 month intervals

  • routine screening

Explanation

Question 11 of 17

1

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Management of Low-grade Squamous Intraepithelial Lesions (LSIL): If there is no HPV result of a positive HPV result, the recommendation is ( colposcopy, diagnostic excisional biopsy, repeat cotesting in 1 year ). If the HPV result is negative, it is preferred to ( repeat cotesting in 1 year, perform diagnostic excisional procedure, colposcopy ), but acceptable to ( perform colposcopy, perform diagnostic excisional procedure, repeat cotesting in 3 years ).

Explanation

Question 12 of 17

1

For a pregnant patient with LSIL, colposcopy is preferred, but it is acceptable to wait until at least 6 weeks post partum to perform colposcopy.

Select one of the following:

  • True
  • False

Explanation

Question 13 of 17

1

Women with a HSIL result can follow up with either a _____________ or a _________________; except for women who are 21-24 or pregnant, who should follow up with a _____________________.

Select one of the following:

  • colpo/leep; colpo only

  • colpo/cotesting; colpo only

  • colpo/leep; leep only

Explanation

Question 14 of 17

1

Your 25 yo pt with PCOS has a pap result of Atypical Glandular Cells (AGC) without atypical endometrial cells. You recommend

Select one of the following:

  • a colposcopy with endocervical sampling AND endometrial sampling

  • colposcopy with endocervical sampling only

  • leep

Explanation

Question 15 of 17

1

You have 25 yo PCOS pt w/initial pap of AGC. Follow up pathology is negative for CIN 2,3, AIS (endocervical adenocarcinoma in situ), or cancer. You follow up with ____________. If these results are also negative, you may follow up with ______________.

Select one of the following:

  • cotesting at 12 & 24 months: cotesting every 3 years

  • cotesting every 6 months for 2 years: cotesting every 5 years

  • cotesting at 12 & 24 months; cotesting every 5 years

  • cotesting every 6 months for 2 years; cotesting every 3 years

Explanation

Question 16 of 17

1

Your 33 yo pt's pap results indicate ASCUS and HPV 16+. A follow up colpo reveals CIN1. Your next step is ___________________ and if those results are negative then you may ________________________________________.

Select one of the following:

  • cotesting at 12 months; do age appropriate retesting 3 years after initial result .

  • cotesting every 6 months for 2 years; do age appropriate retesting 3 years after initial result

  • diagnostic excisional biopsy; do repeat cotesting every year for 3 years

  • cotesting at 12 months; repeat cotesting every 3 years

Explanation

Question 17 of 17

1

Your 28 yo pt has a pap indicating ASC-H or HSIL. Follow- up results indicate CIN1. All of the following are appropriate next steps, except:

Select one of the following:

  • repeat co-testing at 12 month intervals for 5 years, then age specific testing if all results are negative

  • repeat cotesting at 12 & 24 months, then age-specific retesting at 3 years

  • Diagnostic excisional procedure

  • review of cytological, historical, and colposcopic findings

Explanation

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