N 512-19A Assignment 1 Genetic Disease and Neoplasia See Van, a 35-year-old married Hmong-American woman recently underwent an annual Papanicolaou test (Pap smear) at her Certified Nurse Midwife’s practice, and the results were abnormal

N 512-19A Assignment 1 Genetic Disease and Neoplasia

See Van, a 35-year-old married Hmong-American woman recently underwent an annual Papanicolaou test (Pap smear) at her Certified Nurse Midwife’s practice, and the results were abnormal. Her provider diagnosed her with low-grade cervical dysplasia. What alterations at the cellular level would you expect to see with this diagnosis? Provide and discuss with your colleagues S. V.’s prognosis. Support your discussion with citations from the textbook, external credible literature and/or reliable electronic sources.

 Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Participation Guidelines & Grading Criteria.

Example Discussion Approach

 Cervical dysplasia is abnormal changes in cells on a cervix; these changes are not cancer but considered precancerous (U.S. National Library of Medicine, 2020).

As a nurse practitioner (NP), especially a Certified Nurse Midwife, performing a Papanicolaou test (Pap smear) is a common task. After receiving the results of S. Van’s Pap smear, I would need to gather more history (if not already known) including any history of human papillomavirus (HPV) and number of sexual partners. S. Van is married; therefore, assumption of multiple sexual partners is low however, cannot be assumed.

Having multiple sexual partners and/or being infected with HPV can lead to cervical 

cancer (Rebar, 2019). I would also need to know if S. Van has human immunodeficiency virus (HIV). HIV infected women have a higher incidence of HPV-related cervical dysplasia progression to invasive cervical cancer (Hammer, 2019) which would change a treatment course.

Alterations expected to be seen at a cellular level for low-grade cervical dysplasia include changes in size and shape of intraepithelial cells (Kimmel, n.d.). According to Voltaggio et al. (2016), proliferation of basal‐like cells extend no more than one‐third of the way up the epithelial thickness. In the upper two‐thirds of an epithelium, cells differentiate, gain cytoplasm, and nuclear enlargement occurs. Nuclei are hyperchromatic, often have nuclear membrane irregularities, and cells frequently develop halo‐like vacuoles around the nucleus (Voltaggio et al. 2016).

Given S. Van’s age, marital status, and ethnicity my prediction is her chance of developing cervical cancer is low. According to Rebar (2019), Hispanic women are at the greatest risk of developing cervical cancer; S. Van is Hmong. In most cases, mild cervical dysplasia resolves on its own and no treatment is needed (Laughlin-Tommaso, 2020). However, S. Van may want to have further testing such as a colposcopy or biopsy for further determination (Rebar, 2019). I would also suggest testing S. Van for HPV in case she was unknowingly infected with a virus which could be the cause of an abnormal Pap smear.

Reference

Hammer, G., & McPhee, S. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed). McGraw-Hill Laughlin-Tommaso, S. (27 June 2020). Cervical dysplasia: Is it cancer? Mayo Clinic.

https://www.mayoclinic.org/diseases-conditions/cervical-cancer/expert-answers/cervic al-dysplasia/faq-20058142

Rebar, C., Heimgartner, N., & Gersch, C. (2019). Pathophysiology made it incredibly easy (6th ed). Wolters Kluwer