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Case 3 Case 4

Patient 32, married, multiparous 3 vaginal deliveries, control goes to gynecological because he contacted from the office at your Pap.
, the patient is concerned and when interviewed by the midwife, it invites you to have a NIE cervicopatía I associated with HPV.
The patient does not understand what it is and asks for an explanation in simple terms.

Do I have cancer?, If I have no chance now Do I have cancer? What chance? "The PAP is false positive? What about false negatives?
What to do? How did this happen to me?

I would answer in a tone that allows you to calm down ... The PAP came
altered, found an injury that needs to be observed from time to time and is caused by a virus called human papilloma virus, which was probably infected via sexual transmission. The spread of this virus is very common in the lives of men and women, independent of socio-economic strata and is related to the number of sexual partners, this means that the higher number of sexual partners, the more likely it is to have an infection by this virus.

QUESTION 1:
• How will you inform. the patient of the above?
• How do you communicate that acquired the virus? • Does
ud. obligation to do so?, in what cases would be required?
No, do not have cancer but there is a slight chance that the injury from becoming cervical cancer, so it should be monitored by taking regular PAP. It may happen that the injury is gone, this is called a transient infection.

QUESTION 2:
• A patient with an STD is more likely to have another.
• Is this an STD?
Yes, it is a sexually transmitted infection, although cases have been described by fomites transmission, this has not yet been proven in a hundred percent. Keep in mind how common is this infection in a person's life and that many of these infections are transient type, this not to stigmatize those affected by HIV patients.

QUESTION 3: The patient wants you. I explained to the husband, who has accompanied her and is in the waiting room. What does that tell you.? Your request
understanding that this situation rests with the couple, not just the patient. Well we avoid misunderstandings and misconceptions about the condition and the cause of infection of the patient.

QUESTION 4: The patient tells him that this does not happen to their daughters, want them vaccinated. She asks: Is there a vaccine to protect them, dr.?
What tells you.?
Yes, there is a vaccine that protects against the papilloma virus types that cause cervical cancer. The cost of this vaccine is quite high and not covered by FONASA, ie the user must pay 100% of the cost of it.