USMLE Step 2 CK Lecture Notes 2019: Obstetrics/Gynecology (Kaplan Test Prep)

Figure II-4-4. Histologic   Appearance  of  Cervical    Dysplasia   with

Progressive Severity

Diagnostic approach to an abnormal Pap smear

Accelerated repeat  Pap:    an  option  for findings    of  ASC-US  in  patients    of  any

age,    and the preferred   option  with    either  ASC-US  or  LSIL    in  patients    age 21–

24. Repeat the Pap in 12 months.
    If repeat cytology is negative, repeat Pap in another 12 months.
    If repeat cytology is anything other than negative, proceed to colposcopy
    and biopsies.
    HPV DNA testing: the preferred option for findings of ASC-US in patients
    age ≥25. It is acceptable but not preferred in patients ages 21–24.
    If liquid-based cytology was used on the initial Pap, one can use this