Self-assessment quiz

1. The changes seen in this Pap smear from a 28-year-old woman represent:

A) A low-grade squamous intraepithelial lesion (SIL)
B) Invasive squamous cell carcinoma
C) Features consistent with Chlamydia infection
D) Benign cellular changes (repair)
E) Atypical glandular cells of undetermined significance (AGUS)









2. Which of the following makes a Pap smear unsatisfactory for evaluation based on Bethesda System criteria?

A) Lack of pertinent clinical information
B) A smear with 90% of the cells obscured by inflammation and rare atypical squamous cells
C) Air-drying artifact and foreign material (lubricant) obscuring greater than 75% of the cells
D) The slide is broken in half
E) There are numerous endocervical groups, but squamous cells cover only 10% of the slide surface

3. All of the following statements about the organisms present in the lower center portion of the field are true except:

A) Aggregates of PMNs around epithelial cells may accompany infection.
B) These organisms are almost always accompanied by Leptothrix.
C) Slight nuclear enlargement, hyperchromasia and small perinuclear halos are characteristic features seen in squamous cells.
D) When SIL cannot be ruled out, the pathologist may recommend a repeat smear following treatment.
E) A nucleus must be seen to confirm the identity of the organism




4. The College of American Pathologists requires all of the following for accreditation of a cytology laboratory except:

A) At least 10% of each cytotechnologist's negative Pap smears are rescreened
B) The laboratory's ASCUS/SIL ratio must be no greater than 2
C) Whenever a new high-grade SIL is reported, all available previous negative Paps within the preceding 5 years are reviewed.
D) Glass slides are retained by the laboratory for at least 5 years, FNA slides for at least 10 years (unless these rules are superseded by more stringent state and federal regulations)
E) The presence of a written workload policy with appropriate documentation

5. Which of the following features is most suspicious for an epithelial cell abnormality in an atrophic Pap smear?

A) Poorly preserved parabasal-type cells
B) A granular, "dirty" background
C) Scattered small, orangeophilic cells with pyknotic nuclei
D) Squamous cells with crisp, coarse chromatin and occasional mitoses
E) Syncytia-like aggregates and "blue blobs"



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