Abnormal Pap Smear

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Case 1: 24 months later • The patient returns a year later and her Pap smear is ASC-US. • Appropriate next steps in management are? Case 1: Cervix following application of acetic acid 12. Perform reflex HPV testing now Yes No 13. Repeat Pap in another 12 months Yes No 14. Recommend colposcopy Yes No Case 1: Colposcopic Findings 14. Colposcopic exam suggests a high grade abnormality. Y N 15. Endocervical curettage and cervical biopsy should be performed. Y N Case 1: Biopsy Results • Cervical biopsy shows CIN 1 • Endocervical curettage is negative for abnormal cells Case 1: Follow-up CIN 1 CIN I Adolescent • Appropriate next steps in management are: 15. Repeat Pap in 12 months Y N 16. Recommend cryotherapy Y N 17. Recommend LEEP Y N A II
Case 1: different scenario • What if her biopsy came back CIN II • Appropriate management options are: The adolescent: CIN II/III Can observe 18. Repeat Pap in 12 months Y N 19. Repeat Pap and colpo in 6 months Y N 16. Recommend cryotherapy Y N 17. Recommend LEEP Y N BIII Adolescent summary • Age less than 21 • LSIL, ASCUS and CIN 1 are all followed with repeat pap smears at 1 year x 2. • Colposcopy for abnormal pap is only done when: • HSIL paps • 24 months of < HSIL paps and no colposcopy • Allow for TIME to repair the transient HPV changes before doing colposcopy • HPV is no longer recommended for adolescents Adolescent summary • CIN I – follow with pap (
Page 1 and 2: Objectives Abnormal Pap Smear 2006
Page 3: Case 1: Follow up LSIL Pap The adol
Page 7 and 8: Case 3: Biopsy Results • Cervical
Page 9: Case 6 • Eunice is a 58 year old

Abnormal Pap Smear

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