Before Your First: Colposcopy and LEEP

Why: ASCCP guidelines (there is an app! Or PDF)

Cervical dysplasia — caused by HPV

CIN I–CIN3 is a progression

Risk factors: Smoking, other STIs including HIV, immunodeficiency

Histology: Increased Nuclear: cytoplasmic ratio when abnormal

Acetic Acid: exact mechanism unknown, the higher N:C ratio cells (aka abnormal cells) reflect more light and appear white.

Lugols: Iodine rich-reacts with glycogen in normal squamous cells so they appear dark.  Non-staining cells are abnormal.

HPV — changes

Colpo:

Increased vascularity, punctations, mosaicism, surface contour changes

LEEP:

Stain abnormality and know where abnormal biopsy was taken

Single pass is ideal–tag a side for orientation

+/- Top Hat depending on ECC result

CKC:

Higher up in cervical canal, but more complications

No electricity– okay if pregnant