Remember this is a Cellular system focus, do not attempt diagnose and / or treat. Think about what is happening at the cellular level.

Create a pathophysiology flow chart/ mind map.

In that flow chart 1- illustrate and differentiate the pathophysiology of HGSIL in relation to normal cells,   2- Illustrate the pathophysiology of HPV and how it may cause cell changes and what those changes could be  3-  in that, demonstrate the relationship between the LSIL, HGSIL and HPV. 

USe this information 

CC: 32-year-old African American female in to follow up her pap smear 2 weeks ago.

HPI: No overall complaints. She was in to see you last week for a repeat pap. She had a pap 14 months before that which she was told was +LSIL. She states she occasionally has spotting in between periods and sometimes after sexual intercourse. Her last menstrual period was six weeks ago. Her periods are often irregular since she got a Nexplanon for pregnancy prevention two years ago. She has been married for three years and doesn't have children at this time nor seeking pregnancy.

PMH: Other than her irregular pap 14 months ago, no other chronic medical conditions. She has had no surgeries or hospitalizations

Meds:  Nexplanon for about 2 years, occasional multivitamin.

FH: Her dad is 68 and has hypertension, and her mom is 64 has diabetes type 2 and hypertension. Her older sister is 34 and has asthma. She has two older brothers, ages 36 & 37 both with diabetes. She is not aware of any cancers in her family.

SH: She is married, no children and works full time as a legal aid. She lives in a rented apartment with her husband and a dog. She has a large extended family that lives nearby.  She is a one pack a day smoker for 15 years. She has occasional alcohol, no illicit or street drugs ever. She has moderate stress with her job.

Allergies: NKDA, environmental, food or material allergies.

ROS:

General: denies weight changes, fever, fatigue or night sweats.

Skin: denies changes in moles or any new lesions

Cardio: denies chest pain, palpitations, orthopnea, DOE, or edema.

denies cough or shortness of breath

GI: denies abdominal pain, diarrhea or Constipation

GU: see HPI

VS: BP 137/89 P: 70 RR: 15 T: 98.6 Ht:  64in Wt: 189  BMI: 33

PE: General: alert, overweight adult female, in no acute distress 

Lab results:  Cytology: HGSIL  HPV:  + High risk HPV present