anjushree
Forum Guru
Topics: 64
Posts: 386
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55yr old postmenopausal F presents for routine exam.she denies any use of HRT,any menopausal sym.she has no H/o of any abnormal vag bleeding,no any abnormal pap smear .married to asame partner.currentlysexually active with same partner on regular basis .Her Pap came as AGUS--ATYPICAL GLANDULARCELL OF US .Most approp next step
re-pap in 4 to6 mon
HPV testing
hystere ctomy
cone biopsy
colposcopy,end biopsy,ECC
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| vanshita
Forum Guru
Topics: 26
Posts: 883
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colposcipy end biopsy ECC
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| leen
Forum Guru
Topics: 79
Posts: 294
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I think it A?????
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| Geroo
Forum Guru
Topics: 114
Posts: 799
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I think HPV testing
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| sarika
Forum Guru
Topics: 195
Posts: 1,200
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yup ..i think its HPV dna testing...if that comes positive then depending upon reliability of the patients u can either schedule them for follow up re-pap smear within 4-6 mon or if they r nonreliable u should go ahead with colposcopy and biopsy.
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| hallachi
Forum Junior
Topics: 11
Posts: 63
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the ans is 'E' for sure
explanations..if u get an AGUS on pap smear it means it could be benign OR malignent
to rule out the malignet lesion the first step is COLPOSCOPY with ECC until unless you find atypical endometrial cells plus abnormal bleeding in over 35 year old lady (in this case you prefer endometrial biopsy).
u can get more info from the web site.
www.fpnotebook.com/GYNE
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| ram3
Forum Guru
Topics: 48
Posts: 525
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after a pap smear comes back with these results next step is always
colposcopy
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| werther
Forum Senior
Topics: 11
Posts: 110
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...the presence of glandular cells in a pap smears mandates to rule out two possible adenocarcinomas (squamous is 100% of excocervical):
1. Endocervical canal (ECC)
2. Endometrium (endo bx)
Colposcopy will help, but will likely not help in defining diagnosis.
Answer is completely E.
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| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,268
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E would be my best shot too
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| klimt
Forum Guru
Topics: 27
Posts: 605
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there was an explanation in UW that said:
ASCUS - repeat Pap in 6 m
CIN I, II, III - LEEP
invasive cancer - hysterectomy +/- radiation
so I'd go for A. Even if colposcopy is generally the universal ans for abnormal Paps (still US doesn't necessarily mean abnormal), biopsy is only done if there are abnormal white areas observed during the colposcopy and not routinely
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| klimt
Forum Guru
Topics: 27
Posts: 605
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plus, FA says at obgyn rapid review:
do colposcopy + curretage only if two consecutive findings of AGCUS
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| Justice
Forum Fanatic
Topics: 117
Posts: 2,324
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colposcopy, end biopsy, ECC
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| MAGY17
Forum Elite
Topics: 30
Posts: 234
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AGUS
<35 Y/O------->COLPOSCOPIA AND SAMPLING OF ENDOCERVICAL CANAL
>35 Y/O---------->endometrial biopsy
Edited by Aashi on 07/08/07 - 11:58 AM. Reason: Pls DONOT type in ALL CAPS..this is a forum rule.
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| dr19
Forum Senior
Topics: 12
Posts: 120
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Blueprints obs-gyn says....with the advent of HPV DNA testing,it is now recommended that wOmen with an ASC-US should be tested immediately for HPV.
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| cirus
Forum Guru
Topics: 108
Posts: 740
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ASCUS:
# observation is only conditioned with pts compliance as to come after 3 ms for repeating pap
# If pt is unreliable or u simply don't know, the next step is Colposcopy & ECC
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