Women's health: gynecology Exam Question and Answers 2023/2024 final Edition

Routine GYN areas of health - ***-cervical, birth control, menses, menopause, infertility -breast -bone -colon Standard cytologic screening tool for cervical CA - ***Papanicolaou smear (pap) What percent of sexually active women have HPV? - ***~80% HPV strains associated with invasive cervical CA - ***16 & 18 HPV strains associated with genital warts - ***6 & 11 The age window for HPV vaccination - ***11-26 -no research beyond the age of 26 True or False: HPV screening begins at age 21 - ***FALSE -HPV screening starts at age 30 because sometimes younger pts can clear the virus. Cervical dysplasia - ***-a neoplastic process that has not violated the epithelial basement membrane -Cervical Intraepithelial Neoplasia (CIN) Carcinoma in situ - ***-high grade dysplasia involving the full-thickness of the epithelium ~15-33% progress to CA Cervical cancer - ***invasion through basement membrane ASCUS - ***Atypical Squamous Cell of Undetermined Significance -could be from inflammation, recent coitus CIN-2 & CIN-3 - ***-high grade dysplasias (moderate & severe, respectively) -cancer precursors How cervical cancer spreads - ***direct extension, or lymphatic dissemination Treatment of invasive carcinoma of cervix - ***Radical hysterectomy & pelvic lymphadenopathy -possibly with radiation & chemo Is it significant to have *atypical glandular cells* on cytology? - ***Y E S 50% of patients with these will have significant underlying pathology Adenocarcinoma in situ (ACIS) - ***-precursor of cervical adenocarcinoma