What is HPV?
Double stranded DNA virus
How many high risk HPV types are tested for?
14
What is the age of cervical screening?
25-64
What is the standard recall in cervical screening?
Every 5 years
What does standard cervical screening test for primarily?
High risk HPV
Who is eligible for cervical screening?
Anyone with a cervix aged 25-64
When would you offer a smear test in a woman > 65 years?
If she has never had cervical screening before
Who is referred for colposcopy within 6 weeks in the screening program?
3 x inadequate samples
Low grade change and HrHPV
Who is referred for colposcopy within 2 weeks in the screening program?
High grade (moderate) or above with HRHPV
or with glandular neoplasia
or abnormal appearing cervix
What is applied to the cervix during colposcopy?
Acetic acid and iodine
What is management of CIN 1 (low grade)
Repeat screening at 12 months
If still present after 2 years, offer LLETZ
What is the management of CIN 2+ lesions?
LLETZ
What is the management of biopsy proven high grade changes?
Larger cone excision because of possible risk of skip lesions
Risks with LLETZ
Bleeding
Infection Cervical stenosis
Cervical incompetence with mid-trimester miscarriage or pre-term labour
Alternatives to LLETZ
Cold coagulation
- no histological specimen collected
When do you offer a TOC post LLETZ?
6 months
Post LLETZ when are women recalled if TOC is HrHPV negative?
5 years
Follow up after hysterectomy
How are women with cervical cancer followed up
cytology at 6,12 months then annually for 9 years
Screening in pregnancy
HPV vaccine eligibility and schedule
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Anatomy - Female reproductive system27
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Anatomy - Male reproductive system27
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SRH in plwHIV14
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HSV20
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Anogenital Warts43
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Donovanosis and Chancroid25
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MPox11
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Chlamydia24
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LGV17
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Trichomonas Vaginalis14
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Mycoplasma Genitalium18
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Molluscum Contagiosum10
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Scabies28
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HSV in pregnancy and the neonate55
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Bacterial Vaginosis18
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Phthuris Pubis7
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Hepatitis testing and vaccination19
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Treatment of Viral Hepatitis19
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Cervical Screening21
