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Women between the ages of 21-29 should be tested with [blank_start]cytology alone every 3 years[blank_end].
Women between the ages of 30-65 should be tested with [blank_start]cytology + HPV cotesting every 5 years[blank_end] or [blank_start]cytology alone every 3 years.[blank_end]
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cytology alone every 3 years
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cytology and HPV every 5 years
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cytology alone every 5 years
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cytology + HPV every 3 years
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cytology + HPV cotesting every 5 years
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cytology alone every 5 years
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cytology + HPV cotesting every 3 years
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cytology + HPV cotesting every 7 years
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cytology alone every 3 years.
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cytology alone every 5 years
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cytology + HPV cotesting every 3 years
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cytology + HPV cotesting every 4 years.
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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 __________________________.
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with adequate screening history; for benign disease
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with adequate screening and normal paps; for benign disease
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with negative prior screening and no hx of CIN 2 or >; for benign disease and no hx of high grade CIN
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with adequate screening hx; for benign disease and no hx of high grade CIN
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The following populations are not appropriate to screen according to standard ASCCP guidelines:
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w/ HIV
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who are immunosuppressed
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hx of colpo or LEEP
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exposed to DES in utero
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previously treated for CIN 2, CIN 3, or cancer
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previously treated for CIN 1
Frage 4
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According to the Bethesda system, any of the following may result in an unsatisfactory pap specimen EXCEPT:
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Obscuring blood inflammation or other process
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insufficient squamous cells (< approx 5000)
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specimen not labeled
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absent or insufficient endocervical cells/transformation zone noted
Frage 5
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Actinomyces is a common finding for women with
Frage 6
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If a client has an unsatisfactory cytology, and is HPV unknown or HPV neg (>30 yrs old), you should [blank_start]repeat cytology after 2-4 months[blank_end]. If result is HPV positive (age >30), you can either [blank_start]repeat cytology in 2-4 months[blank_end] or offer a coloposcopy.
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repeat cytology after 2-4 months
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recommend a colposcopy
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repeat cytology after 6 months
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repeat cytology immediately
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repeat cytology in 2-4 months
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repeat cytology immediately
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repeat after 6 months
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offer a LEEP
Frage 7
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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 [blank_start]follow routine screening[blank_end]. If the client is >30 and HPV is unknown, [blank_start]HPV testing[blank_end] is preferred, but [blank_start]repeat cytology in 3 yrs[blank_end] is acceptable. If the client is >30 and HPV positive, you can [blank_start]repeat cyto and HPV test in 1 yr[blank_end] or perform [blank_start]genotyping[blank_end]
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follow routine screening
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repeat cytology immediately
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repeat cytology in 2-4 months
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repeat cytology in 1 year
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HPV testing
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repeat cytology immediately
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repeat cytology in 1 year
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repeat cytology in 3 years
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repeat cytology in 3 yrs
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repeat cytology in 1 year
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repeat cytology immediately
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HPV
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repeat cytology and HPV testing in 1 yr
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repeat cytology alone in 1 year
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recommend colpo
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repeat cytology & HPV in 5 years
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genotyping
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colposcopy
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LEEP
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Ages 21-24 with either ASCUS or LSIL: it is preferred to [blank_start]repeat cytology in 12 months[blank_end], but acceptable to [blank_start]perform reflex HPV testing[blank_end].
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repeat cytology in 12 months
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perform reflex HPV testing
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repeat cytology and HPV in 12 months
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recommend colpo
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perform reflex HPV test for ASCUS only
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perform reflex HPV testing for LSIL only
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perform reflex HPV for ASCUS or LSIL
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recommend colpo
Frage 9
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If a woman's results indicate Atypical Squamous Cells, Cannot exclude High-grade Squamous Intraepithelial Lesion (ASC-H), you recommend
Frage 10
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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:
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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 [blank_start]colposcopy[blank_end]. If the HPV result is negative, it is preferred to [blank_start]repeat cotesting in 1 year[blank_end], but acceptable to [blank_start]perform colposcopy[blank_end].
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colposcopy
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diagnostic excisional biopsy
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repeat cotesting in 1 year
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repeat cotesting in 1 year
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perform diagnostic excisional procedure
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colposcopy
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perform colposcopy
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perform diagnostic excisional procedure
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repeat cotesting in 3 years
Frage 12
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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.
Frage 13
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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 _____________________.
Frage 14
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Your 25 yo pt with PCOS has a pap result of Atypical Glandular Cells (AGC) without atypical endometrial cells. You recommend
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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 ______________.
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cotesting at 12 & 24 months: cotesting every 3 years
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cotesting every 6 months for 2 years: cotesting every 5 years
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cotesting at 12 & 24 months; cotesting every 5 years
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cotesting every 6 months for 2 years; cotesting every 3 years
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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 ________________________________________.
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cotesting at 12 months; do age appropriate retesting 3 years after initial result .
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cotesting every 6 months for 2 years; do age appropriate retesting 3 years after initial result
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diagnostic excisional biopsy; do repeat cotesting every year for 3 years
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cotesting at 12 months; repeat cotesting every 3 years
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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:
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repeat co-testing at 12 month intervals for 5 years, then age specific testing if all results are negative
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repeat cotesting at 12 & 24 months, then age-specific retesting at 3 years
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Diagnostic excisional procedure
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review of cytological, historical, and colposcopic findings