Chart-28

50 –year- old female patient with irregular vaginal bleeding.

Cervical smear taken.

A. Interpret the given cervical pap smear and give your diagnosis 

Smear shows squamous epithelial cells with high nuclear/cytoplasmic ratio, irregular nuclear borders and multinucleation.

Diagnosis – Cervical squamous intraepithelial lesion/Cervical intraepithelial neoplasia

B. What is the common cause?

Human Papilloma virus – types 16 and 18

C. Mention the risk factors

1. Persistent infection with a high oncogenic risk HPV, e.g., HPV 16 or HPV18

2. Multiple sexual partners

3. A male partner with multiple previous or current sexual partners

4. Young age at first intercourse

5. High parity

6. Immunosuppression

7. Certain HLA subtypes

8. Use of oral contraceptives