Page 2 of 2: OSCE-Buster: Abnormal Cervical Smear - counseling

dr999 · Credits: 2055 My Scrapbook

after 6 months time we repeat smear test in CIN1

pb767125 · Credits: 220 My Scrapbook

CIN I, II , III AND SQUAMOUS CELL CARCINOMA CAN BE DIAGNOSED CYTOLOGICALLY...

tezb · Credits: 6176 My Scrapbook

Your knowledge of CIN isn't the focus of this OSCE station.

CIN is a histological diagnosis and cervical smear is cytology...

The station should be about counselling the patient.

You need to

1) Introduce yourself

2) Explain why the patient has been recalled to see you
Smear test results have shown some abnormal cells in the neck of the womb

3) Address the patients concerns
Ask what the patient understands
This is NOT a diagnosis of cancer. There is a possibilty of cancer but it is unlikely. Smear Test merely shows there are some abnormal cells at the neck of the womb that if left untreated may develop into a cancer later in life.

4) Explain what the next steps are
Explain the patient will visit a Gynaecology department and be seen by either a gynaecologist or a specialist nurse who will undertake further investigations. This is most likely to be colposcopy.
Colposcopy is a procedure where the gynaecologist can directly look at the cervix and take a sample of cells (biopsy). The procedure is generally painless although the patient may experience some light bleeding afterwards.

Many centres now offer "see and treat" where instead of just taking a biospy, the part of the cervix where the abnormal cells are is removed (with loop diathermy/LLETZ)

5) Address any further concerns the patient has

6) Thank the patient for their time and finish the consultation.

rsukhon · Credits: 358 My Scrapbook

Minimize using medical words, unless explaine it in a simple words

Kai1111 · Credits: 2036 My Scrapbook

Ancient post/thread, but its important me that the cytology terminology isn't being used correctly, or...histopath being used incorrectly....

PAPs come back with the following results:

Atypical Squamous Cells: Unknown Significance (ASC-US) or Cannot exclude HSIL or high-grade changes (ASC-H)
Low Grade Squamous Intraepithelial Lesion (LSIL)
High Grade Squamous Intraepithelial Lesion (HSIL); one subcategory: "with features suspicious for malignancy"
Squamous Cell Carcinoma

ASCUS gets a repeat PAP every 6mos till 2 neg PAPs 6 mos apart..colposcopy if changes do not clear.
ASCH - HPV testing and colposcopy

the others coloposcopy/gyn consult.

My source: PEPID PDA &

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Kai1111 · Credits: 2036 My Scrapbook

More clarification......

Atypia correlates with ASCUS

CIN1 mild dysplasia correlates with LGSIL

CIN 2 mod dysplasia correlates with HGSIL

CIN 3 severe dysplasia correlates with HGSIL

Carcinoma in situ correlates with HGSIL

neerjaneerja40 · Credits: 302 My Scrapbook

The cytology results are usually reported as Mild, Moderate or Severe Dyskaryosis.
CIN is a histological diagnosis.

One Mild Dyskaryosis smear is usually repeated in 6 months, if still abnormal--refer for Colposcopy
If smear shows ASCUS: You may repeat a smear in 6months or order a HPV Test . If HPV test shows high risk type starins --refer for colposcopy. If HPV test is negative, can repeat smear n 6-12 months depending on risk factors

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