Obstetrics & Gynecology>>>>>Benign and Malignant Disorders of the Breast and Pelvis
Question 5#

A 45-year-old G1P1 presents for her routine annual examination. The patient is a healthy smoker who has no medical problems. Her surgical history is significant for a cesarean delivery with bilateral tubal interruption. You perform a Pap smear, which returns showing high grade squamous intraepithelial lesion (HSIL). She undergoes colposcopy, which is inadequate.

What is the next step in management?

a. Repeat Pap smear in 6 months
b. HPV testing
c. Cone biopsy
d. Repeat Pap smear with co-testing in 1 year
e. Repeat the colposcopy in 4 to 6 months

Correct Answer is C

Comment:

An adequate colposcopy requires that the entire squamocolumnar junction and all lesions be visualized, and that the biopsies of the lesion explain the abnormal cytology. Since her colposcopy was not adequate, an excisional procedure is required.