02/03/24 – CIN - Take test (14)

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1) A 35-year-old female, P3L3, has CIN III on colposcopic biopsy. What would you do?

1 point

a. LEEP

b. Conization

c. Hysterectomy

d. Cryotherapy

Clear selection

2) A 35-year-old woman presents for her routine Pap smear. Results reveal CIN I (mild dysplasia). She has no history of abnormal Pap smears in the past. What is the most appropriate next step in management?

1 point

a. Repeat Pap smear in 6 months

b. Colposcopy with biopsy

c. Immediate loop electrosurgical excision procedure (LEEP)

d. Human papillomavirus (HPV) testing

e. Referral to gynecologic oncologist

Clear selection

3) A 28-year-old woman presents with persistent abnormal bleeding between menstrual cycles. She has a history of CIN II (moderate dysplasia) diagnosed 2 years ago, for which she underwent a loop electrosurgical excision procedure (LEEP). The current Pap smear shows atypical squamous cells of undetermined significance (ASCUS). What is the most appropriate next step in management?

1 point

a. Repeat Pap smear in 6 months

b. Colposcopy with biopsy

c. Immediate repeat LEEP

d. HPV testing

e. Hysterectomy

Clear selection

4) A 45-year-old woman presents with postcoital bleeding, and a history of untreated CIN III (severe dysplasia) diagnosed 3 years ago. She has not followed up with recommended surveillance. Physical examination is unremarkable. What is the most appropriate next step in management?

1 point

a. Repeat Pap smear in 6 months

b. Colposcopy with biopsy

c. Immediate cone biopsy

d. HPV testing

e. Referral for radiation therapy

Clear selection

5) A 50-year-old woman presents for her routine gynecologic examination. She has a history of treated CIN I (mild dysplasia) diagnosed 10 years ago, for which she underwent cryotherapy. Her current Pap smear is normal. What is the most appropriate next step in management?

1 point

a. Repeat Pap smear in 3 years

b. Colposcopy with biopsy

c. HPV testing

d. Endometrial biopsy

e. Referral for hysterectomy

Clear selection

6) A 30-year-old woman presents with persistent HPV infection and CIN II (moderate dysplasia) on colposcopy-directed biopsy. She desires future fertility. What is the most appropriate next step in management?

1 point

a. Immediate cone biopsy

b. Repeat colposcopy in 6 months

c. Loop electrosurgical excision procedure (LEEP)

d. Medical management with topical agents

e. Referral for hysterectomy

Clear selection

7) A 40-year-old woman presents with a history of untreated CIN III (severe dysplasia) diagnosed 5 years ago. She has been lost to follow-up. She now complains of postmenopausal bleeding. Physical examination reveals an exophytic cervical lesion. What is the most appropriate next step in management?

1 point

a. Repeat Pap smear in 6 months

b. Colposcopy with biopsy

c. Immediate cone biopsy

d. HPV testing

e. Referral for radiation therapy

Clear selection

8) A 32-year-old woman presents with persistent abnormal bleeding and a history of CIN I (mild dysplasia) diagnosed 4 years ago. She has not followed up with recommended surveillance. Physical examination is unremarkable. What is the most appropriate next step in management?

1 point

a. Repeat Pap smear in 6 months

b. Colposcopy with biopsy

c. Immediate loop electrosurgical excision procedure (LEEP)

d. HPV testing

e. Referral for radiation therapy

Clear selection

9) A 35-year-old pregnant woman presents with a history of CIN II (moderate dysplasia) diagnosed 1 year ago. She is currently in her second trimester of pregnancy. What is the most appropriate next step in management?

1 point

a. Colposcopy with biopsy during pregnancy

b. Immediate loop electrosurgical excision procedure (LEEP) during pregnancy

c. Postpartum colposcopy with biopsy

d. HPV testing during pregnancy

e. Referral for hysterectomy during pregnancy

Clear selection

10) A 21-year-old female with no medical history who smokes a pack of cigarettes per day has a pap smear that shows HGSIL (high-grade intraepithelial neoplasia). What is the best next step for this patient?

1 point

a. Counsel patient about smoking cessation and repeat pap in 6 months

b. Repeat pap and order high-risk human papillomavirus testing

c. Proceed with colposcopy with directed biopsies and endocervical sampling and counsel about smoking cessation

d. Counsel patient about smoking cessation and perform retesting in 1 year

Clear selection

11) A 28-year-old woman, G2P1 at 28 weeks gestation, presents for routine care. She had a Pap test on her last visit, which showed a high-grade squamous intraepithelial lesion. The patient's current pregnancy has been uncomplicated so far. The woman can feel fetal movement and is not having vaginal bleeding or contractions. Physical examination shows a gravid uterus. The cervix is long, closed, and posterior. What is the best next step in the management of this patient?

1 point

a. Colposcopy

b. Loop electrosurgical excision procedure

c. Repeat Pap test postpartum

d. Human papillomavirus (HPV) testing

Clear selection

12) A 35-year-old lady has postcoital bleeding. What is the management?

1 point

a. Clinical examination and pap smear

b. Visual examination with Lugol iodine

c. Visual examination with acetic acid

d. Colposcopy

Clear selection

13) A 45-year-old lady complains of contact bleeding. She has a positive Pap smear. What is the management?

1 point

a. Colposcopy directed biopsy

b. Cone biopsy

c. Repeat Pap smear

d. Hysterectomy

Clear selection

14) A young lady has mild erosion of cervix, and the Pap smear shows dysplasia. What is the next step?

1 point

a. Antibiotics

b. Colposcopy

c. Cryosurgery

d. Conization

Clear selection

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