Pap Test and DNA Probes and Cultures

Duration = 4:19

00:00
APGO educational topic number three pap
00:02
smear and DNA probes and culture
00:04
worldwide cervical cancer is the fifth
00:07
leading cause of cancer and the fourth
00:09
leading cause of cancer deaths among
00:10
women in the United States the incidence
00:12
of cervical cancer has decreased by 50
00:15
percent over the last thirty years due
00:16
to increased technology and availability
00:18
of cervical cancer screening the Pap
00:20
test is one of the most effective
00:21
screening tests used in medicine today
00:23
the objectives of this video are to
00:25
describe how to perform a pap smear or
00:27
Pap test describe how to obtain
00:29
specimens to test for sexually
00:30
transmitted diseases and lastly to be
00:33
able to explain the purpose of these
00:34
tests to patients the pap smear or Pap
00:37
test is named after dr. Georges
00:38
Papanicolaou a Greek physician and
00:40
psychologist who discovered that cancer
00:42
could be diagnosed from microscopic cell
00:44
changes his image was featured here on
00:46
the Greek currency let’s spend a day in
00:49
clinic with our gynecologist dr. tess
00:51
Tia de papi
00:51
dr. Pappy is performing a pelvic
00:54
examination on a patient and here is the
00:55
patient cervix
00:56
dr. poppy will use the endocervical
00:59
brush and gynecologic spatula to obtain
01:02
cells from the transformation zone of
01:04
the cervix there are two different
01:06
techniques for pap processing if liquid
01:08
cytology techniques are used the cells
01:10
will be collected in a liquid
01:12
preservative if conventional methods are
01:14
used the cells will be transferred
01:15
directly to a slide thus all samples
01:18
will be stained in a laboratory and read
01:19
by a pathologist for changes associated
01:21
with cervical dysplasia or cervical
01:23
cancer contaminating blood discharge and
01:26
lubrication could interfere with
01:27
specimen interpretation if water-based
01:30
lubrication is used during the speculum
01:32
examination it is important to minimize
01:33
the amount of contact the lubricant has
01:35
with the cervix an advantage of liquid
01:38
based testing that the same sample can
01:39
be used for the Pap test HPV PCR and
01:42
gonorrhea and chlamydia testing although
01:44
gonorrhea and chlamydia testing can be
01:46
performed from the liquid cytology the
01:48
first-line test is nucleic acid
01:50
amplification testing this is a separate
01:52
swab of the endo cervix if a patient is
01:55
not having a pelvic examination
01:56
performed then the nucleic acid
01:58
amplification tests can be performed
01:59
from a urine sample of note this is not
02:02
a clean cat urine but rather a first
02:04
catch urine sample
02:05
so which patients should get tested when
02:08
and for what let’s review some case
02:10
files from a day in clinic with dr.
02:11
poppy
02:12
our first
02:13
patient is I don’t Anita a
02:15
nineteen-year-old gravity zero here for
02:17
her first gynecologic visit I am 19
02:19
years old and have been sexually active
02:21
since age 16 i don’t–i will not need a
02:24
Pap test until age 21 regardless of when
02:27
she first became sexually active it is
02:29
important to discuss contraception and
02:31
to screen for sexually transmitted
02:32
infections women under age 25 should
02:35
have gonorrhea and chlamydia testing at
02:36
least once a year the human
02:38
papillomavirus or HPV is commonly
02:40
contracted by women shortly after
02:42
initiation of sexual intercourse in most
02:44
women the infection is transient and
02:46
does not progress to cervical cancer we
02:48
do not screen for HPV in women under the
02:51
age of 30 because of those two reasons
02:52
and in order to decrease unnecessary
02:54
interventions our second patient is just
02:57
a 1 a 25 year old gravity’ one pair one
02:59
here for her annual examination I had a
03:01
normal cap test three years ago during
03:04
my pregnancy women ages 21 to 30 should
03:07
have a Pap test with cytology only every
03:09
three years since her last Pap test was
03:11
three years ago she is due for one today
03:13
our next patient is HPV two a 50 year
03:16
old gravity’ 2 para 1 coming in for an
03:18
annual examination I have had normal Pap
03:21
tests my whole life women between the
03:23
ages of 30 and 65 should have a Pap test
03:25
with HPV Co testing every 5 years or a
03:28
Pap test with cytology alone every 3
03:30
years remember that even though the Pap
03:32
test is no longer an annual examination
03:34
it is still important to regularly
03:36
perform a bimanual examination and
03:37
visual examination of the external
03:39
genitalia regularly our last patient is
03:42
no need a pap a 68 year-old gravity’ 2
03:44
para 2 here for her annual examination i
03:47
had a hysterectomy and have no history
03:49
of abnormal pap tests women over the age
03:52
of 65 or women who’ve had a total
03:54
hysterectomy no longer need cervical
03:56
cancer screening and will not need Pap
03:58
tests and/or HPV this concludes the
04:00
aapko video on pap smears and DNA probes
04:02
we’ve discussed the function of the Pap
04:04
test
04:04
general testing guidelines and methods
04:06
for obtaining samples