Pap Smear Technique

Disclaimer : All the explainations and pictures were taken from lecture note power point presentation on “Demo on Pap Smear for Year 4 Family Medicine Posting” by Dr Rosediani Muhamad, Department of Family Medicine, Universiti Sains Malaysia. It is not a work done by the blog author. Thank you


Part one: Step in preparing Pap Smear Slides




1. Use frosted end slide
2. Use pencil 2B to label client’s name and registration number and mark as “N” on the frosted end slide
3. Mark second portion as “C” for ectocervical sample and “E” for endocervical sample (use diamond pen to label on glass slide)
4. Fill up the cytology form



Part two: How to perform Pap Smear



1. Wash your hands and wear gloves
2. Examine the client in a dorsal position
3. Do not use lubricant
4. Wash speculum using sterile water or normal saline




5. Introduce a bivalve speculum into the vagina carefully



6. Expose the cervix clearly– avoid damage to cervix and inspect the area for any abnormalities



7. If the is discharge, swab the discharge using cotton wool



Part three: Taking Pap Smear from Ectocervix


1. Take The specimen from cervix using long end of Ayre’s spatula
2. Turn it carefully (360˚ -1 complete circle) around the cervix
3. Place Specimen on the area “C” on the slide



Part four: Taking Pap Smear from Endocervix



1. Take second specimen from endocervix using cytobrush
2. Insert it into the os until you cannot see the brush
3. Turn it carefully around the cervical canal as before (360˚)
4. Place the endocervical specimen on the area “E” similar as describe before



Part five: Procedure after doing Pap Smear



1. Dip the slide immediately into Coplin jar contains a fixating agent -95% ethyl alcohol for 30 minutes, or
2. spray the slide using alcohol spray fixative. Ensure that the whole specimen is sprayed with the fixative



Part six: Procedures when sending Pap Smear Slides

1. Ensure that the slide is labeled properly and correctly
2. Place the slide/slides inside the slide mailer
3. Send to the lab immediately or within a period of a week depends on your lab’s regulation.


Extra note: Reasons for unsatisfactory smears

1. Lubricant e.g. hibitane ,is used before the smears are taken
2. Dirty slide
3. Delay in dipping the slide in the fixating agent
4. Amount of specimen is inadequate
5. Bloody smear

Approach to Palpitation- Family Medicine Case Discussion 2010

Palpitation

Department of Family Medicine Case Discussion

Puan Rahimah a 54 years old Malay lady comes with her son to see you in the clinic with the complaint of palpitation for the past 6 months.

She is married with 4 children and her husband is a pensioner

Questions

1) What question would you ask in assessing patient who presented with palpitation.

2) Based on safe diagnostic strategy, state differential diagnoses.

3) What is your diagnosis for this lady?

4) What investigation would you do for her?

5) How would you treat her?

For my discussion note on this case, please view or download it from my slideshare file

Approach to palpitation family medicine case discussion 2010

View more documents from AR Muhamad Na’im.

Approach to Headache- Family Medicine Case Discussion 2010

Headache

Department of Family Medicine Case Discussion

A 22 years old female university student complained of headache for a week. The headache was continuous, almost daily

She denied any other problem exept for the stress in her studies. Physical examination was not remarkable.

Questions

1) What relevant history would you ask?

2) What are the differential diagnosis

3) What are the red flags of headache

4) What is the most probable cause of this patient’s headache

5) How will you treat this patient

For my discussion note on this case, please view or download it from my slideshare file

Approach to headache family medicine case discussion 2010

View more documents from AR Muhamad Na’im.