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ExamPro MCQ Tests

MCQ Test: Abnormal Paps

Number of questions in this MCQ test: 16
Suggested time for this MCQ test: 20 minutes

The GARDASIL quadrivalent HPV recombinant vaccine is indicated for prevention of all of the following conditions except ?
Cervical cancer
Condyloma accuminata
Vulvar intraepithelial neoplasia (VIN), grade 2 and 3
Laryngeal papilloma
Cervical intreapithelial neoplasia (CIN), grade 2 and 3
GARDASIL quardrivalent HPV recombinint vaccine should be administered intramusculary according to what schedule ?
0, 2 6 months
0, 1 ,6 months
0, 6, 12 months
0, 3, 6 months
0, 12, 60 months
What percent of cervical cancers result from infection with HPV genotpes 16 and 18 ?
20%
50%
70%
90%
What percent of genital warts results from infection with HPV genotypes 6 to 11 ?
20%
50%
70%
90%
The quadrivalent Human Papilloma Virus (HPV) vaccine protects against all of the following HPV DNA geontypes except?
16
6
18
11
33
A 43-year-old woman is found to have an abnormal Pap smear showing HSIL. She undergoes colposcopy showing all of the following epithilial abnormalities. The patient is very apprehensive and will allow only one biopsy. If you can do only one biopsy, which of the following would you biopsy:
White epithelium
Coarse mosaicism
Punctation
Abnormal (cork- screw) vessels
A 17-year-old nulliparous woman has an abnormal Pap smear. Colposcopy with biopsies document CIN limited to the ectocervix without endocervical involvement. All of the following are true EXCEPT:
In adolescents, the rate of resolution of CIN I is extremely high (>60%)
CIN I should be followed by repeat smears at 6 and 12 months, or with high risk HPV testing in 12 months
CIN 2 in adolescents should always be treated with excision or ablation
CIN 3 in adolescents should be treated with excision or ablation
Assuming CIN 2/ CIN 3 have been ruled out by colposcopy, the risk of developing CIN 2 or greater during the next two years is about 10%
A 30-year-old multigravida is found to have an abnormal smear at 20 weeks of pregnancy. Which of the following IS NOT TRUE:
A pregnant patient with ASC-H, HSIL, atypical glandular cells or adenocarcinoma is situ should undergo colposcopy without endocervical curettage
Purpose of colposcopy is to exclude invasive disease
Managemant of pregnancy is different in patients with low- vs. high-grade dysplasia
If colposcopy shows an area of cork-screw vessels on the cervix, this should be biopsied
Patients with an ASC or LSIL smear have a low-risk of having invasive disease
A 40-year-old HIV-positive G3P3 is found to have an abnormal PAP smer signed out as LIL. Colposcopy with cervical biopsies demonstrated CIN. Which of the following is NOT TRUE:
Treatment of high-grade CIN should be pursued despite high recurrence rates
Women who are HIV-positve are more likely to have positive surgical margins at excisional procedures, which may cause higher rates of recurrence
Standard ablative or excisional treatment is recommended for women who are HIV-positive with documented CIN 2 or CIN 3
Since CIN 1infrequently progresses in women with women with HIV, observation appears safe provided there are no other indications for treatment
HIV-positive patients, not currently treated with antiretroviral, with newly diagnosed CIN 3 may initially be treated for dysplasia only with initiation of antiretrovitals
A 27-year old woman undergoes a LEEP excision of the cervical tranformation zone CIN 2 or CIN3. All of the following are true with EXCEPTION of :
The risk of cervical cancer after treatment of CIN 2 or CIN 3 is equal to that of the general patient population
After LOOP excision, the patient can be followed with high-risk HPV testing in 6 months after the LOOP excision procedure; A negative result would allow annual screening therafter.
Following a positive margin with LOOP excision, reexcision may be elected, but if undertaken should be done with knowledge that the most common outcome is absence of residual dysplasia
Risk of recurrent dysplasia is 5 to 12% in women with positive LEEP margins
Risk of recurrent dysplasia with negative LEEP margins is 2 to 3%
A 40-year-old lawyer has an "routine annual" examination with a Pap smear and HPV testing for high-risk Types (DNA with Pap). The Pap smear was interpreted as negative for intraepithelial lesion/malignancy. However, the HPV test for high-risk types was positive. Which of the following is recommended?
Repeat Pap smear in one year
Repeat HPV testig for high-risk types in one year
Repeat Pap smear and HPV testing for high-risk types in 6 to 12 months
Immediate colposcopy
Endocervical currettage
All of the following are true concerning HPV testing EXCEPT:
The test is based on a polymerase chain reaction (PCR) techinique
Most patients with a positve result have a transient infection
Can be used in conjuction with Pap smear for cervical cancer screening exclusively in women over the age of 30
A patient with an ASC-US Pap smear and a negative reflex HPV test (for high-risk types) can have her next smear in one year
Over 80% of patients with a LSIL smear will have a positive HPV test for high-risk types
A 25-year-old G1P1 had an abnormal Pap smear signed out as ASC-H. She underwent a colposcopy with endocervical curettage and ectocervical biopsies. All of the biopsies were negative for dysplasia or carcinoma. Suggested management at this point would be:
Loop excision
Cold-knife conization
HPV testing for high-risk types in 12 months
HPV testing for high-risk types in 2 months
A 17-year-old woman is found to have atypical aquamous cells of undetermined significance (ASC-US) on her Pap smear. Reflex testing for high-risk HPV types is positive. According to current guidelines, which of the following would be considered reasonable subsequent follow up:
Singel high-risk HPV types test in 12 months
Cervical cytologies done at 6-months intervals
Colposcopy
Any of the above
Each of the following is true about adenocarcinoma in situ of the cervix EXCEPT:
Rarely co-exists with squamous dysplasia
Requires conization to rule out invasive diease
Skip lesions have been reported in patients with negative conization margins
"Young" patieants desiring conservative therapy with uterine preservation, need to have negative cone margins
Patients completing childbearing (and negative cone margins) are probably best treated with hysterectomy
An 18-year-old woman is found to have a Pap smear signed out as atypical squamous cells, cannot rule out high-grade squamous intraepitheliam lesion (ASC-H). Which of the following is the most approriate next step?
Reflex test for high-risk HPV types
Testing for high-risk HPV types in 12 months
Repeat Pap smears every 6 months for next year with colposcopy in case of abnormal result
Repeat Pap smear in 12 months
Colposcopy

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