An 18-year-old woman comes to the clinic for an annual gynecologic examination. She has no complaints. Her last menstrual period was 1 week ago and cycles have been normal lasting 5 days with minimal cramping. She has had 2 sexual partners in her lifetime, and currently has a boyfriend of 6 months. She has no history of sexually transmitted diseases (STDs), abnormal Papanicolaou (pap) smears, or other medical problems. Her only medication is oral contraceptives and she does not take any supplements. Sterile speculum examination reveals thin white vaginal discharge and no cervical lesions or discoloration. Cervical ectropion is present surrounding the external os. She has no cervical motion tenderness, but a small amount of contact bleeding during the endocervical sampling for the Pap smear. There are no adnexal or uterine masses with the pelvic examination and no elicited pelvic pain. Pap smear, chlamydia, and gonorrhea cultures are sent to the laboratory. Laboratory results are reviewed when completed and reveal negative endocervical chlamydia and gonorrhea tests, and a Pap smear positive for atypical squamous cells of undetermined significance (ASC-US). What ASC-US management options would be best advice for this patient?
A. Follow-up in 1 year for repeat Pap smear
B. Follow-up in 6 months with liquid based cytology and human papillomavirus (HPV) DNA testing
C. Have a colposcopy with directed biopsy performed
D. Have the atypical squamous cells removed by loop electrosurgical excision procedure (LEEP)
E. Undergo a cone biopsy to assess for malignancy
SENT BY- DR. ISMAIL, LUCKNOW
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2 comments:
A
since she has multiple sexual partners she should undergo colposcopy and biopsy. I'm not sure
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