Pap smear is useful in the diagnosis of all EXCEPT :
Gonorrhoea Papsmear is a screening test for diagnosis of cervical Intraepithelial Neoplasia (CIN) and Carcinoma cervix. Besides these it is also helpful in detecting : Trichomonas vaginalisdeg * Candidiasisdeg Bacterial vaginosisdeg * Actinomycosisdeg Herpes simplex virus infectiondeg * Inflammatory changes Cellular changes associated with radiation * Cellular changes associated with intrauterine devices. Glandular cell status post hysterectomy * Atrophy (i.e., post surgery) With respect to CIN and Ca cervix : Papsmear can diagnose epithelial cell abnormalities. (Both squamous and glandular). Squamous cell abnormalities detected Atypical squamous cell Low grade squamous intraepithelial lesions encompassing HPV/mild dysplasia / CIN 1 High grade squamous intraepithelial lesion encompassing CIN II/CIN III/CIS Squamous cell carcinoma Glandular cell abnormalities detected --1 Atypical endocervicaliendometrial glandular cells ouring/not ouring neoplasm Endocervical adenocarcinoma in situ Adenocarcinoma It should be done in : All women > 20 yearsdeg (Harrison 17/e, p 491) All women 3 years after the onset of sexual activitydeg Women with unhealthy cervixdeg Women with intermenstrual bleeding or dischargedeg High risk cases like women exposed to early sexual life, multiple sexual paners, multipara or women with HIV, HPV or herpes simplex virus infectiondeg Smokers.
Gonorrhoea
Trichomonas vaginalis
Human papilloma virus
Inflammatory changes