Self-assessment quiz (cont.)

6. Which of the following statements about atypical glandular cells on a Pap smear are true?

A) Abundant cytoplasm and multinucleation are features more commonly found in endometrial cells than in endocervical cells
B) The presence of hyperchromatic, crowded groups with fine, wispy cytoplasm and lack of keratinization reliably indicates a glandular lesion as opposed to a squamous lesion
C) The presence of mitoses, enlarged and hyperchromatic nuclei with prominent nucleoli and smooth, regular nuclear membranes is incompatible with a diagnosis of reactive atypia
D) The differential diagnosis of AGUS includes normal cells from high in the endocervical canal, tubal metaplasia, endometrial sampling and high-grade squamous lesions
E) The Pap smear is a reliable technique for screening for endometrial carcinoma




7. Select the one best statement about this field:

A) High-grade dysplasia is identified.
B) Endocervical adenocarcinoma in situ is present
C) Benign cellular changes associated with Candida are seen
D) Air-drying artifact is present
E) There are cellular changes associated with herpesvirus infection

For the next two questions, answer A) if statements 1,2 and 3 are correct; B) if 1 and 3 are correct, C) if 2 and 4 are correct, D) if only 4 is correct, and E) if all statements are correct.

8.

1. Hyperkeratosis and parakeratosis usually are associated with a squamous intraepithelial lesion
2. Cytolysis characteristically occurs in intermediate cells and may be seen in diabetes and pregnancy.
3. Both cervical and vaginal sampling are required for accurate hormonal interpretation (maturation index)
4. Nuclear enlargement, parakeratotic-like cells, syncytial groups and a "dirty", granular background are features of both atrophy with inflammation and invasive squamous cell carcinoma
5. Squamous cells with binucleation and nuclear enlargment to twice the diameter of normal intermediate cells are diagnostic of low-grade SIL

9.

The following statements pertain to high-grade squamous lesions (HGSIL):

1. The cells of HGSIL are typically smaller than those seen in low-grade lesions
2. Nucleoli are usually absent
3. Most cases of HGSIL are associated with high-grade human papillomavirus (HPV) types and are aneuploid
4. High-grade dysplasia may occur in cells with metaplastic features or in cells with a densely keratinized, "mature" cytoplasm
5. Irregular nuclear contours and hyperchromasia are characteristic

10. The correct diagnosis is:

1. High-grade SIL
2. Follicular cervicitis
3. Atypical squamous metaplasia (ASCUS)
4. Benign cellular changes due to Trichomonas infection
5. Lymphoma

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