Why: ASCCP guidelines (there is an app! Or PDF)
Cervical dysplasia — caused by HPV
CIN I–CIN3 is a progression
Risk factors: Smoking, other STIs including HIV, immunodeficiency
Histology: Increased Nuclear: cytoplasmic ratio when abnormal
Acetic Acid: exact mechanism unknown, the higher N:C ratio cells (aka abnormal cells) reflect more light and appear white.
Lugols: Iodine rich-reacts with glycogen in normal squamous cells so they appear dark. Non-staining cells are abnormal.
HPV — changes
Increased vascularity, punctations, mosaicism, surface contour changes
Stain abnormality and know where abnormal biopsy was taken
Single pass is ideal–tag a side for orientation
+/- Top Hat depending on ECC result
Higher up in cervical canal, but more complications
No electricity– okay if pregnant