Page 1 of 2: OSCE-Buster: Abnormal Cervical Smear - counseling

sajida · Credits: 105317 My Scrapbook My Reading List 6 Books

Hello Mrs x I am Dr xy a senior house officer in the dept of Gynae and Obs , We have got the results of ur cervical smear back and i am afraid that we have detected some abnormal cells , Let me explain what it means

MILD CIN1

some of the cells from the cx that is ur neck of womb have shown some changes , This could be due to infection, so we will check and treat if there is any infection ,.It is necessary to repeat the cervical smear and then we will decide the further course of action . I would like to reassure u that this is not a cancer

MODERATE CIN11

some of the cells from the cx have undergone changes, so we would like to do another test called colposcopy .here we have a direct look at the cx a microscope at the same time a biopsy can be taken.We will let u know about the biopsy as soon as the report is back, I would like to reassure u that this is not a cancer but it would might develop into cancer if left alone untreated , The treatment of abnormal cell is quite a minor one and if the treatment is done early enough ,it almost always lead to complete cure but u need to have a smear test every year to check that everything is still fine

R u getting me

SEVERE CIN111
some of the cells from the cx have undergone changes, so we would like to do another test called colposcopy .here we have a direct look at the cx a microscope at the same time a biopsy can be taken.We will let u know about the biopsy as soon as the report is back, I would like to reassure u that this is not a cancer but it would might develop into cancer if left alone untreated , The treatment of abnormal cell is quite a minor one and if the treatment is done early enough ,it almost always lead to complete cure but u need to have a smear test every year to check that everything is still fine

If not all the cells r removed I am afraid that we would need to do further tests to know the etent of the disease . You might have to have a hystrectomy then , I am sorry about the bad news , I am going to arrange for u to have a biopsy, I will give u the some leaflets to read , if u have further doubts donot hesitate to ask
thank u very much

sangy · Credits: 2202 My Scrapbook

thank u very much

PlabManchester · Credits: 1782 My Scrapbook

at start ask patient if she is comfortable, and if someone is accompanying her. proceed if she is comfortable.
you may start by saying that she came in for the tests, and the test results are available..

bindasnikhilg · Credits: 44921 My Scrapbook

ohh god never herd docs speaking so sugar candy coated language to patients here,hehehhe.

thnx 4 ur inputs anyway

maziar · Credits: 574 My Scrapbook

Hi Dr Sajida but I think CIN I II & III are histologic diagnoses rather than cytology
Thanks

akanksha · Credits: 41247 My Scrapbook My Reading List 14 Books

jus adding to sajida's contribution (great contributions, sajida. hats off to u!)

Hello Mrs.X I am Dr.A, a senior house officer in the dept of Gynae and Obs , We have got the results of ur cervical smear back and i am afraid that we have detected some abnormal cells , Let me explain what it means -

MILD CIN1

this means that some of the cells from the cx that is ur neck of womb have shown some changes , This could be due to infection, so we will check and treat if there is any infection.

It is necessary to repeat the cervical smear and then we will decide the further course of action .

I would like to reassure u that this is not a cancer

MODERATE/Severe CIN

This means that some of the cells from the cx have undergone changes, so we would like to do another test called colposcopy.

Wat is colposcopy, doctor?

Colposcopy is a more detailed examination of the cervix. Here we have a direct look at the cx with a magnifier.
At the same time, we might take some tissue from the cervix(biopsy) to have a more detailed look at the cells under the microscope.

We will let u know about the biopsy results as soon as the report is back.

Does this abnormal result mean that i hav cancer?

Well Mrs.X, I would like to reassure u that this is not a cancer but it would might develop into cancer if left alone untreated.

Can these abnormal cells will ever become normal? is there any treatment available?

Yes, Mrs. X! I assure you that most of the abnormal cells usually come back to normal usually by itself, or once the infection is controlled. But yes, u definitely need to undergo few more smears so that we can check that the cells are getting normal.

In case, the cells remain abnormal we might offer u some treatments. The treatment of abnormal cell is quite a minor one and if the treatment is done early enough, it almost always lead to complete cure.

The types of treatments include:

-Cryotherapy - Here, the abnormal areas on your cervix will be 'freezed' so that the abnormal cells gets destroyed.

-Laser treatment - this destroys or cuts away abnormal cells.

-Loop Diathermy - here, a thin wire loop cuts through and removes the abnormal area of cells.

Do I need to get admitted in hospital for these?

No Mrs. X! These treatments are done as an out-patient and do not take long.

Will I need to go thru thes throughout my life?

No Mrs.X, These treatments are usually successful and are usually needed only once.

However, u definitely need to come to us for follow up and regular smears for the next few years to check that the treatment has been successful.

When can I resume my normal daily schedules after these? will it affect my sex life? will i grow infertile because of these?

It takes a few weeks for the cervix to heal after treatment. Once it has healed, a normal sex life can be resumed. I understand ur apprehensions Mrs. X, but these treatments do not affect fertility.

Wat if smears show abnormal cells even after i undergo thes treatments?

Well, it can happen sometimes that abnormal cells grow too fast or we are not able to completely remove or destroy them. In such cases, ur smear can show abnormal cells even after these minor treatments. If that occurs, I am afraid to say Mrs. X, that we might need to remove ur womb in toto (hysterectomy).
However, that is a very rare possibility, and i assure you that most patients get benefit from minor treatments only.

Babs · Credits: 530 My Scrapbook

Good stuff from all of you.
Keep it up.

samouel · Credits: 398 My Scrapbook

As far as i know CINI,II,III are histological not cytological abnormalities so they are a biopsy result not a cervical smear result.most people are confused about that.

samouel · Credits: 398 My Scrapbook

As far as i know CINI,II,III are histological not cytological abnormalities so they are a biopsy result not a cervical smear result.most people are confused about that.

kami0011 · Credits: 881 My Scrapbook

in cin1 we do a repeat smear when?

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