Reference Manual - IARC Screening Group

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Performing Breast and Pelvic ExaminationsSPECULUM EXAMINATIONCHECKLIST FOR PELVIC EXAMINATIONSSTEP/TASK1. Insert the speculum fully and open the blades. Look at the vaginal walls andnote any inflammation, ulcers or sores. Check for any discharge.2. Look at the cervix and os and note the color, position, smoothness ordischarge. If the cervix bleeds easily or there is mucopus, obtain a specimenfor tests.3. Remove the speculum and place in 0.5% chlorine solution fordecontamination.SKILL/ACTIVITY PERFORMED SATISFACTORILYBIMANUAL EXAMINATION1. Separate the labia with two fingers of the abdominal hand and insert the tips ofthe index and middle fingers of the pelvic hand into the vagina.2. Gradually insert fingers fully or until the cervix is touched.3. Palpate the uterus and check for:• Size• Shape• Location• Consistency• Mobility• Tenderness4. Locate ovaries and determine size and consistency.5. Check the size, shape consistency, mobility and tenderness of any masses inthe adnexa.SKILL/ACTIVITY PERFORMED SATISFACTORILYRECTOVAGINAL EXAMINATION1. If changing gloves, immerse both hands in 0.5% chlorine solution, thenremove them by turning them inside out.• If disposing of gloves, place them in a leakproof container.• If reusing the gloves, submerge them in 0.5% chlorine solution fordecontamination.2. Slowly insert middle finger of the pelvic into the rectum and index finger intothe vagina.3. Check for tenderness or masses between the uterus and rectum.4. Immerse both gloved hands in 0.5% chlorine solution, remove gloves byturning them inside out and dispose of them in a leakproof container.SKILL/ACTIVITY PERFORMED SATISFACTORILYCOMPLETING THE PELVIC EXAMINATION1. If rectovaginal examination was not performed, immerse both gloved hands in0.5% chlorine solution, then remove gloves by turning them inside out.• If disposing of gloves, place them in a leakproof container.• If reusing the gloves, submerge them in 0.5% chlorine solution fordecontamination.2. Wash hands thoroughly and dry them.3. Help the woman to sit up on the examining table and ask her to get dressed.CASESG-44 Cervical Cancer Prevention Guidelines for Low-Resource Settings
Performing Breast and Pelvic ExaminationsCHECKLIST FOR PELVIC EXAMINATIONSSTEP/TASK4. Discuss any abnormal findings and what, if anything, she needs to do. If theexamination was normal, tell her that everything is normal and healthy.SKILL/ACTIVITY PERFORMED SATISFACTORILYCASESCervical Cancer Prevention Guidelines for Low-Resource Settings G-45
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Cervical Cancer PreventionGuideline
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TABLE OF CONTENTSPREFACE AND ACKNOW
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How to High-Level Disinfect Surgica
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Table C-2Figure C-1Preparing a Dilu
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PREFACE AND ACKNOWLEDGMENTSThis ref
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ONEINTRODUCTIONMAGNITUDE OF THE PRO
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IntroductionFigure 1-3. Incidence o
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Introductionprevalence areas, a sta
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Table 1-2. Reduction in Cumulative
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Introductiontheir performance was t
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Introductionlesions, or a false pos
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IntroductionCompared to other metho
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Introductionsignificantly to women
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IntroductionBelinson JL et al. 2001
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IntroductionMitchell MF et al. 1998
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IntroductionYlitalo N et al. 1999.
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TWOHUMAN PAPILLOMAVIRUS AND CERVICA
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Human Papillomavirus and Cervical C
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THREEPATHOPHYSIOLOGY OF CERVICAL CA
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With the onset of puberty, whichis
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Pathophysiology of Cervical Cancerp
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Pathophysiology of Cervical CancerP
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Pathophysiology of Cervical CancerI
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Pathophysiology of Cervical CancerR
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FOURTALKING WITH WOMEN ABOUTCERVICA
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Talking with Women About Cervical C
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FIVEPREVENTING INFECTIONS INHEALTHC
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Preventing Infections in Healthcare
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SIXCLIENT ASSESSMENT AND VIA TESTIN
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Client Assessment and VIA TestingFi
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Client Assessment and VIA TestingIN
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Client Assessment and VIA Testingst
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Client Assessment and VIA Testingsp
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Client Assessment and VIA Testingth
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SEVENTREATMENT AND FOLLOWUPBACKGROU
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Treatment and Followupregardless of
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Treatment and FollowupFigure 7-1. L
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Treatment and FollowupTable 7-6. Co
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Treatment and FollowupFigure 7-2 is
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Treatment and Followup• Regulator
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Treatment and FollowupCRYOTHERAPY P
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Treatment and FollowupStep 6 Point
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Treatment and FollowupNote: When CO
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Treatment and FollowupStep 5Advise
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Treatment and FollowupBerget A, B A
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APPENDIX ATESTS FOR CERVICAL CANCER
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Tests for Cervical Cancer Screening
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APPENDIX BSCREENING TEST QUALITIES
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Screening Test Qualities and Their
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APPENDIX CINFECTION PREVENTION PROC
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Infection Prevention Processesfor m
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Infection Prevention Processeswith
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Infection Prevention ProcessesFigur
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Table C-4. Preparing and Using Chem
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Infection Prevention ProcessesStora
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Infection Prevention Processes• h
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APPENDIX DTECHNICAL OVERVIEW OF THE
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Technical Overview of the Cryothera
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Figure D-5. Removing Protector Tube
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Technical Overview of the Cryothera
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Figure D-11. Gas Cylinder Secured t
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APPENDIX ETROUBLESHOOTING WITH THEC
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Page 153 and 154: APPENDIX FPROCESSING SURGICAL GLOVE
Page 155 and 156: Processing Surgical GlovesTable F-1
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Page 159 and 160: APPENDIX GPERFORMING BREAST AND PEL
Page 161 and 162: Performing Breast and Pelvic Examin
Page 163 and 164: Figure G-2. Breast Puckering or Dim
Page 165 and 166: Figure G-5. Checking for Nipple Dis
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Page 205 and 206: APPENDIX HPERCEIVED BARRIERS TO PRO
Page 207 and 208: AVAILABILITY OF BASIC SUPPLIES AND
Page 209 and 210: GLOSSARYAcetic AcidAcetowhite Chang
Page 211 and 212: PatulousSquamocolumnarJunction (SCJ
Page 213 and 214: ADDITIONAL READINGAlliance for Cerv
Page 216: innovating to save liveswww.jhpiego
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Reference Manual - IARC Screening Group

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