1. Top Pap smear Questions

2. 1-When should Pap screening begin? Age 21 y/o,3yrs after first intercourse

3. 2-What are screening methods&intervals(for Pap &HPV)? Cytology : 1-Conventional(20%FN ) : 2 - Liquid-based Surepath Thinprep Focal point -HPV co-test(cytology+HPV test) -primary hrHPV testing(16+18+pool results of 12 other hrHPV) -Every 3yrs(conventional or liquid-based)

4. 3-When can women C/C Pap smear? Aged> 65 with adequate negative prior screening & no history of CIN2 or higher within the last 20 yrs

5. 4-What are RF for HPV INFXN? A-Multiple sex partners B-High-risk partners C-Cigarette smoking D- Immunodificiency E-HX of STD F- Early age at first intercourse

6. 5- What are the three HPV vaccines? A- Gardasil (quadravalent )for protection against HPV 16,18,6,11 B- Cervarix (bivalent) for protection against HPV 16,18 C- Gardasil 9(9-valent)for protection against HPV 16,18,6,11,31,33,45,52,58

7. 6- What are the 6 components of the Pap smear ? A- Description (Conventional or liquid – based ) B- Description of Adequacy ( Satisfactory ) C- General Category (negative or positive for epithelial cell Abnormality ) D- Interpretation / Result E- Description of ancillary testing (hr HPV Test ) F- Educational notes & Suggestion (optional)

8. 7- What are some non-neoplastic Pap smear findings?? Yes. A-INFXN: Trichomonas, fungi (Candida), BV, HSV 2,non- specific B- Reactive: Inflammation, radiation, IUD C- Atrophic change

9. 8- Do women who have been vaccinated against HPV still need to be screened for cervical cancer? Yes. Current HPV vaccines do not protect against all HPV types that cause cervical cancer

10. 9- Can HPV infections be prevented? A- Not sexually active B- Vaccine C- Condom

11. 10- What are the aims of Pap smear? A-Detection of precancerous cervical lesions B- Detection of inflammatory & infectious cervical lesions ( especially HPV) C-Detection of cervical cancer D- Hormonal evaluation E- Follow up of cervical cancer

12. 11- When is the best Time to get a Pap smear in a month? A- Mid-cycle or two weeks after the last LMP B- 12 weeks or 3 months postpartum

13. 12-How to prepare for a Pap Test? Avoid intercourse,Douching & vaginal inserts for 24 to 48 h

14. 13-What is the relationship between HPV & cervical cancer ? A- It is more important than association between cigarette smoking & lung cancer B- Extremely common ( most common viral infection of the reproductive tract) C- Over 100 types of HPV, At least 15 HR type D- HPV 16, 18 cause 70% of cervical cancer & precancerous cervical lesions E- Skin – to – skin genital contact is a well-recognized mode of Transmission

15. 14-Does having HPV or abnormal cervical cells affect chances of getting pregnant or have healthy babies? A- No B- But if one needs treatment, it could affect fertility or carrying a baby to term

16. 15- Is there any test for men to find out if they have HPV? A – No B- Genital warts

17. 16- Do one need to check LR HPV Test ? A- No disease progression B- No change Treatment

18. 17- Do need to continue Pap test in patients with history of endometrial caner? - No

19. 18- Who should not have the Pap Test? A- <21 Y/O B- No sexual activity C- Had total hysterectomy for non-cancer lesions D- Aged >65 years with adequate screening history E- Dialysis Patients with limited life expectancies without sign & symptom (ASN)

20. 19- What are the most important references for Pap Test? A- American Society for Clinical Pathology (ASCP) B- American Cancer Society (ACS) C- American Society for Colposcopy & Cervical Pathology (ASCCP) D- U.S. Preventive Services Task Force (USPSTF) E- American College of Obstetricians &Gynecologists (ACOG) F- National Cancer Institute (NIH) G- Society of Gynecologic oncology (SGO)