Next week…

Next week, PAP and swab results are reported as Normal. She no-shows to her follow-up appointment with you. You think nothing of it. 

18 months later, she experiences a heavy period requiring a visit to the local after hours/ER department. Bleeding stops with IV transexamic acid.

Her Hgb reported at 68 and she is transused 2 units PRBC for pre-syncopal symptoms.

The ER doc does a pelvic exam. He tells her that the cervix looks “funny”. He does a PAP and copies you on the results. He tells Ailsa to see you in 2 weeks for results.

Two weeks later, she comes to your office for those results.

The latest result is: LSIL.

You perform a pelvic exam, because you want to see this “funny” looking cervix for yourself. This is what you see:

Based on your exam today, what is your management plan? (Chose ONE)