Papanicolaou Testing (Internal Medicine)

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SAMPLE EXCERPT
- Full procedure text, video and illustrations available with the full product
PRE-PROCEDURE
INDICATIONS
  • Annual screening should begin in all women by age 21, or 3 years after initiation of intercourse.
  • Screening intervals may be lengthened in women over the age of 30 who have three consecutive normal test results.
CONTRAINDICATIONS
  • No absolute contraindications for Pap testing are known.
  • Relative contraindications include acute vaginitis, cervicitis, pelvic inflammatory disease, and menstrual bleeding.
EQUIPMENT
  • Vaginal speculum
  • Water-soluble lubricant
  • Large swabs
  • Wooden or plastic spatula
  • Cervical spatula, brush, and broom
  • Endocervical brush
  • Cervical “broom” (optional) (e.g., Cervex-Brush, Rovers Medical Devices, The Netherlands)
  • Microscope slides and fixative
  • Swabs and transport media for infectious disease screening (e.g., gonorrhea, Chlamydia)
  • Material for liquid-based Pap testing (if used at your institution)
ANATOMY
  • The cervix is the inferior third of the uterus. Its most inferior portion extends into the vagina.
  • Squamous cells cover the outer periphery of the external cervix.
  • Columnar cells are located more centrally in the endocervical canal.
  • The region at greatest risk for cervical cancer is the transformation zone.

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
COMPLICATIONS
  • Minor bleeding
  • False-negative results
RESULT ANALYSIS
  • All Pap test reports should describe the adequacy of the sample.
  • Various Pap test reporting systems are summarized in Table 1.
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