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Clinical Review Quiz

Cervical Cancer Screening

Peter F. Schnatz, DO, and Timothy V. Johnson, DO

Dr. Schnatz is an associate professor of obstetrics and gynecology and internal medicine, and Director of Medical Student Education, Department of Obstetrics and Gynecology, and Dr. Johnson is a resident in obstetrics and gynecology; both are at the University of Connecticut School of Medicine, Farmington, CT, and Hartford Hospital, Hartford, CT.



The questions below are based on the article
“Update on Cervical Cancer Screening”.


Choose the single best answer for each question.


1. All of the following are important risk factors for the development of cervical dysplasia EXCEPT:
  1. HIV infection
  2. Human papilloma-virus (HPV) infection
  3. Multiple sexual partners
  4. Nulliparity
  5. Smoking
Click here to compare your answer.


2. What percentage of young women with HPV infection will clear the infection within 2 years?

  1. 40%
  2. 55%
  3. 65%
  4. 70%
  5. 92%
Click here to compare your answer.


3. The Pap test with HPV testing, if done every 3 years and if both are negative, has been found to be a reliable and cost-effective method for cervical cancer screening in women who:

  1. Are at least 30 years old
  2. Are at least 21 years old
  3. Have a new cervical dysplasia
  4. Are newly diagnosed with HIV infection
  5. Have recent atypical glandular cell (AGC) cytology on Pap testing
Click here to compare your answer.


4. What follow-up is needed for a patient with atypical squamous cells of undetermined significance (ASC-US) cytology on a Pap test and a negative HPV test?

  1. Repeat HPV testing in 3 years
  2. Repeat HPV testing in 3 months
  3. No follow-up needed
  4. Repeat Pap test in 1 year
  5. Colposcopy
Click here to compare your answer .


5. Because 40% of patients with atypical squamous cells, cannot exclude high-grade dysplasia cytology on a Pap test will have cervical neoplasia grade 2 or greater on further evaluation, which of the following is a necessary component of evaluation?

  1. Repeat cytology
  2. Repeat cytology with HPV test
  3. Colposcopy
  4. Colposcopy with directed biopsy
Click here to compare your answer.


6. In a 38-year-old woman with AGC-favor neoplasia cytology, the initial work-up includes all of the following EXCEPT:
  1. Colonoscopy
  2. Colposcopy with biopsy
  3. Endocervical curettage
  4. Endometrial biopsy
Click here to compare your answer.


7. In a 24-year-old woman with AGC not otherwise specified cytology, the most appropriate initial work-up includes:

  1. Colposcopy and endocervical curettage, with cervical biopsy as needed
  2. Colposcopy with cervical biopsy as needed
  3. HPV testing, triage based on HPV result
  4. Pap and HPV testing in 6 months
  5. Repeat Pap test in 6 months
Click here to compare your answer.


8. Current thought regarding the quadrivalent HPV vaccine includes all of the following EXCEPT:

  1. Ideal delivery of vaccine is before coitarche
  2. Regions with the highest rates of cervical cancer will most benefit
  3. Ethical dilemmas and cost are potential problems with vaccination
  4. The vaccine will protect against dysplasia from HPV type 31
  5. The recombinant, quadrivalent vaccine is derived from virus-like particles and has no infectious potential
Click here to compare your answer.


9. An adolescent has a Pap smear with ASC-US cytology and a positive reflex HPV test. The most appropriate next step would include any of the following EXCEPT:

  1. Colposcopy
  2. Loop electrocautery excision procedure
  3. Repeat cytology in 6 months
  4. Repeat HPV testing in 12 months
Click here to compare your answer.


 

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