Explain Ellen’s Pap smear results (pathophysiology) and the action(s) that will be taken next to follow up this abnormality

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Ellen is a 35-year-old female whose latest Pap smear result reports HSIL with positive HPV. Ellen reports no h/o of STIs or previous abnormal Pap smear results. She had only two previous Pap tests 7 and 14 years ago. Ellen is G1P0 with a TAB at age 25. She and her partner are undecided whether they want to have children.

She has been monogamously married to a female partner for the last 5 years, but she considers herself bisexual and has previously engaged in sexual activities with males and females.

Ellen denies any significant medical history or current health problems. Her LMP was 5 days ago, and her VS are WNL.

Her BMI is 24.7. Her pregnancy test is negative.

Write a brief SOAP note regarding this patient. Make sure to include your answers to these questions in your SOAP note.

1. Subjective:

a. What other relevant questions should you ask regarding the HPI?

b. What other medical history questions should you ask?

c. What other social history questions should you ask?

2. Objective:

a. What other procedures or tests (lab or diagnostic) would you

perform or order for this patient? Why?

3. Assessment/ Diagnosis:

a. What would be an appropriate diagnosis for her? Explain Ellen’s Pap smear results (pathophysiology) and the action(s) that will be taken next to follow up this abnormality, including patient education

(Explain the procedure to the patient).

4. Plan:

a. What will you prescribe for this patient? Why?

b. What patient education is important to include for this patient?

c. Is there any education or advice you would give to Ellen regarding

her current female partner?

d. What pharmacological and non-pharmacological education and

advice can you give Ellen to help with her HSIL condition?

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