Pap smear and procedure

Obtaining sample of exfoliated cells (dead cells that are shed) of cervix and simple test to look at cervical cells
Also called Papanicolaou tests  or cervical cytology
The specimen should be obtained 2 weeks after the first day of LMP taken by brushing or scraping
Purpose of pap smear test
.To detect early cancer of the cervix
To determine estrogen activity related to menopause or endocrine abnormalities.

2. Introduction

+ Obtaining sample of exfoliated cells (dead cells that
are shed) of cervix and simple test to look at cervical
cells

« Also called Papanicolaou tests or cervical cytology

+ The specimen should be obtained 2 weeks after the
first day of LMP taken by brushing or scraping.

3. Purpose of pap smear test

+ To detect early cancer of the cervix

* To determine estrogen activity related to menopause
or endocrine abnormalities.

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5. Screening frequency

* Yearly until three consecutive normal pap smears,
then may decrease frequency to every 2-3 years

+ Annual screening for high-risk women is highly
recommend.

6. When to stop routine screening

+ Age 70 and “adequate recent screening”

> Three consecutive negative pap smears
> No abnormal pap smears in last 10 years
> Hysterectomy for benign lesion

7. Instruments for pap smear

+ Examination table with foot supports
« Examination light

+ Metal or plastic speculum

+ Examination gloves

+ Cervical spatula and cytobrush

+ Liquid-based cytology container or glass slide and
fixative

10. Preparation before taking pap smear

* Patient must be advise to make an appointment
other than during menstruation

* Before appointment :

> Avoid intercourse for 2 days

> Refrain from douching for 1 day

> Cease the use of vaginal medication for
at least 48 hours

11. Pre-procedure

* Inform and explain the procedure to patient
+ Advice patient to void
* Provide privacy

+ Assistant position Lithotomy to her on examining

table

* Drape patient permit minimal exposure

12. During procedure

« Explain the procedure as needed

* Encourage patient to take deep breaths which helps
in pelvic muscle relaxation

* Give support to patient
+ Assist doctor in doing pap smear

+ Help to focus torch light in perineal area of patient

14. Post procedure

+ Observe any discharge from vagina

+ Perineal care is needed

« Assist patient to change from lithotomy position to
supine position

° Documentation

* Send the specimen to laboratory with form

15. 59 uam ous
Cancer

* Normal: Negative means there is no identifiable
infection

+ ASCUS : Presence of a high-risk infection with HPV
+ Low-Grade changes : Frequently due to infection

with HPV, which in some instances can be a risk for
cervical cancer.

* High-Grade changesn: very atypical cells that may
result in cancer

+ Squamous cell carcinoma or adenocarcinoma : cancer
is evident and requires immediate attention.

16. References

* https//www.emedicinehealth.com/pap_smear/article_e
m.htm

* Attps://www.mayoclinic.org/tests-procedures/pap-
smear/about/pac-20394841