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Dr.Niraj Mahajan
Dr.Niraj Mahajan
Dr.Niraj Mahajan

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CIN and HPV Vaccine

By AdminPosted On 05-Oct-2016

1. Transformation Zone is

a) Area between Internal os and external os. b) Area between original SCJ and new SCJ. c) Area of ectropion d) Area distal to ectropion upto cervico-vaginal junction

Correct Answer: b) Area between original SCJ and new SCJ. Bound by the original SCJ at the distal end and proximally new SCJ. The transformation zone is an area of changing cells, and it is the most common place on the cervix for almost all precancerous and cancerous changes. This is the area of the cervix in which Pap smear and biopsy samples are taken.

2. Colposcopy for CIN

Colposcopy (Diagnostic test) is not available in majority (99.9%) of hospitals. PAP smear comes positive as HSIL, which part of the cervix one should take biopsy from, if colposcope is not available?

a) Anterior Lip of the cervix
b) Posterior Lip of the cervix
c) Anywhere on the cervix
d) Four quadrant biopsy
e) VIA guided biopsy

Correct Answer: e) Either VIA or VILI to be performed before proceeding for LEEP procedure or cone biopsy to identify pre-malignant lesion or CIN, which can be clearly identified by VIA or VILI.

3. HSIL / CIN

31-year-old woman Pap test and colposcopy guided cervical biopsy showed HSIL. The patient was counseled to undergo a loop electrosurgical excision procedure (LEEP). Which of the following represents the potential long-term complications from this procedure?

a) Abscess and chronic pelvic inflammatory disease
b) Cervical incompetence and cervical stenosis
c) Constipation and fecal incontinence
d) Hernia and intraperitoneal adhesions
e) Urinary incontinence and urinary retention

Correct Answer: b) Cervical incompetence and cervical stenosis
The immediate risks of LEEP are bleeding and infection. The possible long-term risks include cervical incompetence and cervical stenosis. These may seem like exact opposites, but LEEP can
lead to both of them because, to a certain extent, it injures the cervix. Abscess and chronic pelvic inflammatory disease are not known to be long-term complications of the procedure. The procedure does not involve entry into the peritoneal cavity; therefore, there should be no risk of hernia or intraperitoneal adhesions.

4. HPV Vaccine

Prevaccination assessments, such as Pap testing, or screening for high-risk HPV-DNA, or type-specific HPV tests, or HPV antibody tests to establish the appropriateness of HPV vaccination are not recommended.

a) True
b) False

Correct Answer: a) True. Prevaccination assessments, such as Pap testing, or screening for high-risk HPV deoxyribonucleic acid (DNA), or type-specific HPV tests, or HPV antibody tests to establish the appropriateness of HPV vaccination are not recommended at any age.

5. HPV Vaccine Recommendations

What is the recommendation of providing human papilloma virus (HPV) vaccine to women who already have/ had HPV?

a) Vaccine should be administered
b) No, as already immunized
c) Administer vaccine after 5 years
d) Administer vaccine after 3 years

Correct Answer: a) Vaccine should be administered. Although women should be advised that vaccination will have no therapeutic effect on an existing HPV infection or abnormal Pap test or genital warts, HPV vaccination will effectively provide protection against HPV infection types not already acquired. All women aged of 9–26 are recommended to receive HPV vaccination, regardless of prior history of HPV infection. 

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Dr. Niraj Mahajan

MD- Gynecologist, Laparoscopic Surgeon, Uro-gynecologist , Infertility specialist & Cosmetic Gynecologist.

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