Pap Smear Cases/Practice
Questions

Case #1

A
70 year old Hispanic female recently moved to New York from the Dominican
Republic and is referred to you for general medical care. 
In your discussion with her you find out she has 5 children, the first
one when she was 17 years old, but has never had a Pap smear.

Question
#1:  Should your patient be offered
a Pap smear?

Question
#2:  Does
she have known risk factors for cervical cancer?  What other questions would you ask her to evaluate for risk
factors?

Case #2

Your
36 year old patient comes in for follow-up of her hypertension and results of
her Pap smear.  She has been very compliant with her medical care and
follow-up and has had annual pelvic exams and Pap smears that have always been
within normal limits.  The cytology report comes back stating
“Satisfactory for evaluation:  epithelial cell abnormality-LGSIL”

Question: What
would you recommend to this patient for follow-up and further evaluation?

Case #3

You have a follow-up appointment with a 53 year old
women with a history of an abnormal Pap smear 5 years ago who had been followed
by colposcopy with follow-up Pap smears every 4 months the first year, then
every 6 months the next year, and annually thereafter. 
Her Pap smear comes back “Satisfactory for evaluation, but limited by
inflammation”

Question #1:  What
other history may be useful in evaluating the inflammation in this patient?

Question #2:  What
therapy would you offer this patient and when/if should her Pap smear be
repeated?