Swati Mehrotra, MD Gynecologic Cytopathology Questions

Transcription

1 Swati Mehrotra, MD Gynecologic Cytopathology Questions Question #1 A liquid based pap smear is considered to have adequate cellularity according to Bethesda 2001 if a. It has 6000 squamous cells and no detectable endocervical cells b. It has over 8000 squamous cells with over 75% obscured by inflammation c. It has 2000 well visualized squamous cells and five groups of endocervical cells with each group having more than 10 endocervical cells d. It has only endocervical cells and blood Question #2 The following specimen is unsatisfactory for evaluation a. A LBP with 8000 cells of which 25% cells are obscured by inflammation b. A LBP with 2000 cells and changes suggestive of herpes simplex virus c. A LBP with 2000 cells and changes suggestive of LGSIL d. A conventional smear with cells and no endocervical cells Question #3 The following is required as per Bethesda 2001 a. Report benign endometrial cells in a woman who is 45 years old b. Report benign endometrial cells in a women who is 45 years old only if she is in her second half of menstrual cycle c. Report benign endometrial cells in a 26 year old if in the second half of menstrual cycle d. Report benign appearing endometrial cells only in post menopausal women

2 Question #4 A technical supervisor of the cytopathology laboratory should be a. Certified by the American Society of Clinical Pathology b. Can be a clinical pathologist and laboratory director c. Should be an anatomic pathologist d. Should be a cytotechnologist with 3 years of full time experience in the last 10 years Question #5 Slides, requisitions and reports in a cytology laboratory should be retained for a. 10, 2, 10 years b. 2, 5, 5 years c. 5, 2, 10 years d. Indefinitely, 2, 5 years Question # 6 Watery diathesis is commonly seen in a. Endocervical adenocarcinoma b. Squamous cell carcinoma c. Extra uterine adenocarcinomas d. Endometrial adenocarcinomas Question #7 Neuroendocrine cervical carcinomas are most commonly associated with a. HPV 16

3 b. HPV 18 c. HPV 45 d. HPV 31 Question #8 Which of the following is the most widely used surrogate marker of HPV? a. Ki67 b. Cyclin E c. P16 INK4a d. Antibodies to MCM2 and TOP2a Question#9 As per the ASCCP guidelines women over 30 years of age a. Should have an annual pap smear b. Should have a pap smear every three years if three consecutive cytologies have been negative c. Should have a HRHPV test annually and a pap every three years d. Do not need to have a pap test as very little chance of getting dysplasia Question #10 HPV Viral Oncogenes most important for neoplastic transformation of cells are a. Viral capsid protein L1 b. Viral oncogenes E6 and E7 c. Oncogenes p53 and Rb d. Viral oncogene E1 and E4

4 Question #11 An 18 year old with HSIL on pap and positive HRHPV should be triaged by as per ASCCP guidelines a. Immediate LEEP b. Colposcopy c. Both d. None Question #12 A 28 year old post partum woman would be expected to have a maturation index of B. 10:30:70 C. 60:20:20 D. 80:20:0 Question #13 Choose the correct scenario a. The bivalent HPV vaccine is required to be administered to all males 9 to 26 years of age b. The quadrivalent HPV vaccine is recommended for all females aged 9 to 26 years provided they are still virgins c. The quadrivalent HPV vaccine is recommended for all females aged 9 to 26 years provided their prevaccine HPV test is negative d. The quadrivalent HPV vaccine is recommended for all females aged 9 to 26 years regardless of their sexual history, however the efficacy is highest in women with no history of prior sexual activity

5 Question #14 The best diagnosis for the following findings on a Pap smear from a 27 y/o woman as per the Bethesda Lexicon is (Cytologic findings: >10 mature squamous cells/ 40x field average Five endocervical / metaplastic cell identified Endometrial cells present Scattered clue cells seen) a. Satisfactory for evaluation, transformation zone component present, Negative for intraepithelial lesion or malignancy b. Unsatisfactory for evaluation due to lack of transformation zone c. Satisfactory for evaluation, transformation zone component not identified, Negative for intraepithelial lesion or malignancy d. Satisfactory for evaluation, transformation zone component not identified, Negative for intraepithelial lesion or malignancy and endometrial cells present e. Question #15 Which of the following statements are true except a. HPV is a sexually transmitted disease b. Women 15 to 21 have a high incidence of HPV infection c. Women 15 to 21 should be aggressively triaged for HPV infections and dysplasia d. The risk of invasive cervical cancer in women 15 to 21 is 1 2/ 1000,000/ year

6 e. The American College of Obstetrics and Gynecology (ACOG) recommends initiation of screening for cervical cancer at 21 years of age.

7 ANSWERS GYN Cytopathology Swati Mehrotra, MD 1. A 2. B 3. A 4. C 5. C 6. D 7. B 8. C 9. B 10. B 11. B 12. D 13. D 14. C 15. C