國際華人病理學會

 IACP Anatomic Pathology Quiz

Gynecologic Pathology- Pap Smear I

Zhongxin Yu, M.D., M.S.

Department of Pathology, University of Oklahoma Health Science Center

You Lu, M.D.

AmeriPath Oklahoma

Last update: September 30, 2005

Number of questions: 18

PDF File Each question has only one answer.

Click on these thumbnails to go to the questions with these images:

 

1.   Which of the following human papillomavirus (HPV) types account for approximately two thirds of observed cervical cancer cases? Answer

A.    6 and 11.

B.   16 and 18.

C.   31 and 33.

D.   35 and 39.

 

2.   All of the following managements are recommended for women with atypical squamous cells of undetermined significance (ASC-US) except: Answer

A.      DNA testing for high-risk types of HPV.

B.     Loop electrosurgical excision procedure (LEEP).

C.     Repeat cervical cytology.

D.     Immediate colposcopy.

 

3.   FDA approved HPV DNA testing by Hybrid Capture 2 in combination with cervical cytology as a screening tool for cervical cancer can be used in which of the following? Answer

A.      Women older than 30 years.

B.     Women younger than 30 years.

C.     All patients.

D.     No patients.

 

4.   The largest cells are typically found in which of the following? Answer

A.      Low grade squamous intraepithelial lesion (LSIL).

B.     High grade squamous intraepithelial lesion (HSIL).

C.     Squamous cell carcinoma.

D.     Adenocarcinoma.

 

5.   All of following features are helpful in diagnosing dysplasia except: Answer

A.      Prominent nucleolus.

B.     Nuclear enlargement .

C.     Nuclear hyperchromasia

D.     Coarsening and clumping of chromatin.

 

6.   HPV DNA testing is recommended in women with which of the following? Answer

A.      Low grade squamous intraepithelial lesion (LSIL).

B.     Atypical squamous cells of undetermined significance (ASC-US).

C.     Atypical squamous cells that cannot exclude high-grade squamous intraepithelial lesions (ASC-H).

D.     Atypical glandular cell cytology.

 

7.   High grade squamous intraepithelial lesion (HSIL) is characterized by which of the following? Answer

A.      Large cell size.

B.     Prominent nucleolus.

C.     Keratinization.

D.     Higher nuclear/cytoplasmic ratio.

 

8.   Which of the following is characterized by flat cohesive sheets of cells with low N/C ratio, prominent nucleoli, and without a conspicuous component of atypical single cells? Answer

A.     Low grade squamous intraepithelial lesion (LSIL)

B.    High grade squamous intraepithelial lesion (HSIL).

C.    Squamous cell carcinoma.

D.    Repair/regeneration.

 

9.   Which of the following is the most likely diagnosis if cells are multinucleated, the nuclei mold one another, and nuclear material marginates? Answer

A.      Radiation effects.

B.     Repair and/or regeneration.

C.     Low grade squamous intraepithelial lesion (LSIL).

D.     Herpes simplex.

 

10. Non-keratinizing squamous cell carcinoma is characterized by which of the following? Answer

A.      Rarely occurring tumor diathesis.

B.     Mainly isolated cancer cells.

C.     Nuclear area which is greater than in dysplastic cells.

D.     Macronucleoli.

 

11. Keratinizing squamous cell carcinoma of the cervix is characterized by which of the following? Answer

A.      Tumor diathesis.

B.     Prominent syncytial groupings.

C.     Cellular pleomorphism.

D.     Relatively small uniform cells.

 

12. Which of the following cytologic features of malignant cells is most important in distinguishing benign from malignant lesions? Answer

A.      Nuclear enlargement.

B.     Nuclear hyperchromasia.

C.     Nucleolar enlargement.

D.     Decreased cohesion.

 

13. Based on good and consistent scientific evidence, the risk of having HSIL within 2 years in women with high-risk HPV who have ASC-US/LSIL cytology but are not found to have HSIL at their initial colposcopy is? Answer

A.      90%.

B.     50%.

C.     10%.

D.     Less than 1%.

 

14. The following image is obtained from the Pap smear from a 30 years old female. The cytologic features are most consistent with a diagnosis of which of the following? Answer

A.      Low grade SIL.

B.     High grade SIL.

C.     Parabasal cells.

D.     Atypical glandular cells of undetermined significance (AGUS).

 

15. The following image is obtained from the Pap smear from a 45 years old female. The cytologic features are most consistent with a diagnosis of which of the following? Answer

A.      Low grade SIL.

B.     High grade SIL.

C.     Atypical glandular cells of undetermined significance (AGUS).

D.     Tubal metaplasia.

 

16. The following image is obtained from the Pap smear from a 35 years old female. The cytologic features are most consistent with a diagnosis of which of the following? Answer

A.      Low grade SIL.

B.     High grade SIL.

C.     Herpes cytopathic effect.

D.     Atypical glandular cells of undetermined significance (AGUS).

 

17. The following image is obtained from the Pap smear from a 30 years old female. The cytologic features are most consistent with a diagnosis of which of the following? Answer

A.      Low grade SIL.

B.     High grade SIL.

C.     Herpes cytopathic effect .

D.     Repair.

 

18. The following image is obtained from the Pap smear from a 75 years old female. The cytologic features are most consistent with a diagnosis of which of the following? Answer

A.      Squamous cell carcinoma.

B.     High grade SIL.

C.     Adenocarcinoma, endometrial.

D.     Repair.


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