Family,./Medicine,./Aquifer,./Test,./Study,./Guide
A,./34-year-
old,./cisgendered,./female,./who,./has,./no,./past,./medical,./problems,./and,./is,./not,./c
urrently,./taking,./any,./medications,./comes,./into,./your,./office,./because,./she,./no
ticed,./a,./tender,./lump,./in,./her,./left,./breast,./starting,./approximately,./one,./month
,./ago.,./She,./is,./worried,./because,./she,./has,./a,./maternal,./aunt,./who,./had,./breast,./c
ancer,./that,./was,./BRCA,./positive,,./though,./her,./mother,./is,./BRCA,./negative.,./
Her,./periods,./have,./been,./regular,./since,./they,./started,./at,./the,./age,./of,./13,./and,./
occur,./every,./32,./days.,./She,./is,./currently,./menstruating.,./She,./has,./three,./chil
dren,,./aged,./12,,./9,,./and,./4.,./On,./exam,,./her,./BMI,./is,./32,,./up,./from,./28,./three,./ye
ars,./ago,,./and,./her,./other,./vital,./signs,./are,./stable.,./On,./breast,./exam,,./you,./note,.
/a,./mobile,./rubbery,./mass,./approximately,./1,./x,./1cm,./that,./has,./regular,./border
s,./and,./is,./tender,./to,./palpation.,./You,./appreciate,./no,./axillary,./adenopathy.,./T
he,./rest,./of,./her,./physical,./exam,./is,./unremarkable.,./Of,./the,./information,./prov
ided,,./which,./of,./the,./following,./puts,./this,./patient,./at,./increased,./risk,./for,./brea
st,./cancer?
The,./bes,./-,./correct,./answer,./✔ ✔ E.,./Weight
A,./64-year-old,./cisgendered,./female,./who,./is,./overweight,./with,./well-
controlled,./hypertension,./comes,./to,./your,./office,./with,./concerns,./of,./a,./lump,./
in,./her,./breast,./that,./she,./noticed,./while,./showering.,./She,./reports,./having,./no,./
pain,,./tenderness,,./or,./skin,./changes.,./A,./pertinent,./review,./of,./systems,./is,./ne
gative.,./Menarche,./began,./at,./the,./age,./of,./10.,./Her,./first,./child,./was,./born,./whe
n,./she,./was,./31,./and,./she,./had,./her,./second,./and,./last,./child,./at,./the,./age,./of,./33.,./S
he,./experienced,./menopause,./at,./the,./age,./of,./44.,./Her,./mother,./died,./of,./colon,./
cancer,./when,./she,./was,./65,./and,./her,./father,./passed,./away,./from,./metastatic,./p
rostate,./cancer,./at,./the,./age,./of,./70.,./She,./has,./no,./history,./of,./tobacco,./use,./ever,
, and,./occasionally,./drinks,./a,./glass,./of,./wine,./with,./dinner.,./Her,./BMI,./is,./34.,./
./
Which,./of,./the,./information,./provided,./thus,./far,./puts,./the,./patient,./at,./decreas
ed,./risk,./for,./breast,./cancer?
The,./best,./option,./is,./indicated,./below.,./Your,./selections,./are,./indicated,./by,./th
e,./shaded,./boxes.
·,./A.,./Age
·,./B.,./Age,./at,./first,./birth
·,./C.,./Age,./at,./menarche
·,./D.,./Age,./-,./correct,./answer,./✔ ✔ D.,./Age,./at,./menopause
A,./63-
year,./old,./cisgendered,./female,./comes,./into,./your,./office,./for,./her,./annual,./pre
ventive,./exam.,./She,./has,./hypertension,./and,./type,./2,./diabetes.,./She,./is,./not,./se
xually,./active.,./Her,./blood,./pressure,./is,./125/80,./and,./her,./physical,./exam,./oth
erwise,./is,./within,./normal,./limits.,./You,./recommend,./influenza,./and,./zoster,./v
accination.,./Her,./last,./colonoscopy,./was,./eight,./years,./ago,./and,./her,./last,./ma
mmogram,./one,./year,./ago;,./both,./were,./normal.,./She,./has,./never,./had,./an,./abn
ormal,./Pap,./test.,./At,./the,./age,./of,./45,./she,./had,./a,./total,./hysterectomy,./for,./fibro
ids.,./Of,./the,./details,./provided,./about,./this,./patient,,./which,./is,./an,./appropriate,./
reason,./to,./explain,./why,./she,./does,./not,./need,./a,./Pap,./test,./today?
The,./best,./option,./is,./indicated,./below.,./Your,./selections,./are,./indicated,./by,./th
e,./shaded,./boxes.
·,./A.,./She,./experienced,./menopause,./more,./than,./10,./years,./ago
·,./B.,./She,./had,./a,./total,./hysterectomy,./for,./fibroids
·,./C.,./She,./has,./never,./had,./an,./abnormal,./Pap,./test
,·,./D.,./She,./is,./63,./years,./old
·,./E.,./She,./is,./not,./sexually,./active,./-,./correct,./answer,./✔ ✔
B.,./She,./had,./a,./total,./hysterectomy,./for,./fibroids
A,./47-year-
old,./cisgendered,./female,./comes,./into,./your,./office,./for,./a,./health,./care,./mainte
nance,./exam.,./She,./has,./hypertension,./and,./type,./2,./diabetes.,./She,./is,./not,./sex
ually,./active,./and,./has,./not,./yet,./experienced,./menopause.,./There,./is,./no,./famil
y,./history,./of,./cancer.,./Her,./blood,./pressure,./is,./118/78,,./her,./BMI,./is,./34,,./and,./
the,./remainder,./of,./her,./physical,./exam,./is,./within,./normal,./limits.,./Her,./vacci
nations,./are,./up,./to,./date,,./and,./she,./has,./a,./Pap,./test,./today,./and,./will,./have,./labs,
./drawn.,./According,./to,./USPSTF,,./which,./of,./the,./following,./is,./the,./best,./reco
mmendation,./to,./give,./her,./concerning,./mammography?
The,./best,./option,./is,./indicated,./below.,./Your,./selections,./are,./indicated,./by,./th
e,./shaded,./boxes.
·,./A.,./Should,./have,./started,./at,./age,./40,./and,./every,./year,./thereafter
·,./B.,./Should,./have,./started,./at,./age,./40,./and,./every,./two,./years,./thereafter
·,./C.,./Should,./have,./started,./at,./age,./45,./and,./every,./year,./thereafter
·,./D.,./Start,./at,./age,./50,./and,./every,./year,./thereafter
E.,./Start,./at,./age,./50,./and,./every,./two,./years,./thereafter,./-,./correct,./answer,./✔
✔ E.,./Start,./at,./age,./50,./and,./every,./two,./years,./thereafter
A,./25-year-old,./patient,./presents,./to,./the,./office,./for,./follow-
up,./on,./anxiety,./and,./tobacco,./dependence.,./She,./reports,./she,./is,./doing,./well,./
on,./her,./new,./medication,./to,./help,./with,./both,./her,./mood,./and,./smoking,,./thou
, gh,./she,./continues,./to,./smoke.,./She,./recently,./started,./her,./first,./sexual,./relatio
nship,./with,./a,./new,./female,./partner.,./She,./received,./a,./tetanus,./vaccine,./at,./the,
./age,./of,./18,,./and,./she,./received,./her,./flu,./vaccine,./this,./year.,./Her,./blood,./press
ure,./is,./122/70,,./and,./her,./physical,./exam,./is,./within,./normal,./limits.,./You,./revi
ew,./her,./recent,./Pap,./test,,./which,./was,./negative.,./Which,./of,./the,./following,./in
dicates,./the,./vaccines,./she,./should,./receive,./today?
Choose,./the,./single,./best,./answer.
The,./best,./option,./is,./indicated,./below.,./Your,./selections,./are,./indicated,./by,./th
e,./shaded,./boxes.
·,./A.,./HPV,./vaccine,./alone
·,./B.,./HPV,./vaccine,./and,./pneumococcal,./conjugate,./vaccine,./(PCV13)
·,./C.,./HPV,./vaccine,./and,./pneumococcal,./polysaccharide,./vaccine,./(PPSV23
)
·,./D.,./HPV,./vaccine,./and,./Zoster,./vaccine
·,./E.,./No,./vaccines,./are,./needed,./-,./correct,./answer,./✔ ✔
C.,./HPV,./vaccine,./and,./pneumococcal,./polysaccharide,./vaccine,./(PPSV23
)
A,./55-year-
old,./male,./with,./no,./significant,./past,./medical,./history,./presents,./for,./a,./routine
,./physical,./exam.,./He,./last,./saw,./a,./doctor,./five,./years,./ago.,./Social,./history,./is,./
remarkable,./for,./a,./35-pack-
year,./tobacco,./history,./since,./the,./age,./of,./20.,./He,./indicates,./that,./his,./wife,./an
d,./children,./have,./urged,./him,./to,./quit,./smoking,./for,./the,./last,./few,./months.,./W
hen,./you,./ask,./him,./if,./he,./has,./considered,./quitting,,./he,./replies,,./"I,./just,./don't,./
A,./34-year-
old,./cisgendered,./female,./who,./has,./no,./past,./medical,./problems,./and,./is,./not,./c
urrently,./taking,./any,./medications,./comes,./into,./your,./office,./because,./she,./no
ticed,./a,./tender,./lump,./in,./her,./left,./breast,./starting,./approximately,./one,./month
,./ago.,./She,./is,./worried,./because,./she,./has,./a,./maternal,./aunt,./who,./had,./breast,./c
ancer,./that,./was,./BRCA,./positive,,./though,./her,./mother,./is,./BRCA,./negative.,./
Her,./periods,./have,./been,./regular,./since,./they,./started,./at,./the,./age,./of,./13,./and,./
occur,./every,./32,./days.,./She,./is,./currently,./menstruating.,./She,./has,./three,./chil
dren,,./aged,./12,,./9,,./and,./4.,./On,./exam,,./her,./BMI,./is,./32,,./up,./from,./28,./three,./ye
ars,./ago,,./and,./her,./other,./vital,./signs,./are,./stable.,./On,./breast,./exam,,./you,./note,.
/a,./mobile,./rubbery,./mass,./approximately,./1,./x,./1cm,./that,./has,./regular,./border
s,./and,./is,./tender,./to,./palpation.,./You,./appreciate,./no,./axillary,./adenopathy.,./T
he,./rest,./of,./her,./physical,./exam,./is,./unremarkable.,./Of,./the,./information,./prov
ided,,./which,./of,./the,./following,./puts,./this,./patient,./at,./increased,./risk,./for,./brea
st,./cancer?
The,./bes,./-,./correct,./answer,./✔ ✔ E.,./Weight
A,./64-year-old,./cisgendered,./female,./who,./is,./overweight,./with,./well-
controlled,./hypertension,./comes,./to,./your,./office,./with,./concerns,./of,./a,./lump,./
in,./her,./breast,./that,./she,./noticed,./while,./showering.,./She,./reports,./having,./no,./
pain,,./tenderness,,./or,./skin,./changes.,./A,./pertinent,./review,./of,./systems,./is,./ne
gative.,./Menarche,./began,./at,./the,./age,./of,./10.,./Her,./first,./child,./was,./born,./whe
n,./she,./was,./31,./and,./she,./had,./her,./second,./and,./last,./child,./at,./the,./age,./of,./33.,./S
he,./experienced,./menopause,./at,./the,./age,./of,./44.,./Her,./mother,./died,./of,./colon,./
cancer,./when,./she,./was,./65,./and,./her,./father,./passed,./away,./from,./metastatic,./p
rostate,./cancer,./at,./the,./age,./of,./70.,./She,./has,./no,./history,./of,./tobacco,./use,./ever,
, and,./occasionally,./drinks,./a,./glass,./of,./wine,./with,./dinner.,./Her,./BMI,./is,./34.,./
./
Which,./of,./the,./information,./provided,./thus,./far,./puts,./the,./patient,./at,./decreas
ed,./risk,./for,./breast,./cancer?
The,./best,./option,./is,./indicated,./below.,./Your,./selections,./are,./indicated,./by,./th
e,./shaded,./boxes.
·,./A.,./Age
·,./B.,./Age,./at,./first,./birth
·,./C.,./Age,./at,./menarche
·,./D.,./Age,./-,./correct,./answer,./✔ ✔ D.,./Age,./at,./menopause
A,./63-
year,./old,./cisgendered,./female,./comes,./into,./your,./office,./for,./her,./annual,./pre
ventive,./exam.,./She,./has,./hypertension,./and,./type,./2,./diabetes.,./She,./is,./not,./se
xually,./active.,./Her,./blood,./pressure,./is,./125/80,./and,./her,./physical,./exam,./oth
erwise,./is,./within,./normal,./limits.,./You,./recommend,./influenza,./and,./zoster,./v
accination.,./Her,./last,./colonoscopy,./was,./eight,./years,./ago,./and,./her,./last,./ma
mmogram,./one,./year,./ago;,./both,./were,./normal.,./She,./has,./never,./had,./an,./abn
ormal,./Pap,./test.,./At,./the,./age,./of,./45,./she,./had,./a,./total,./hysterectomy,./for,./fibro
ids.,./Of,./the,./details,./provided,./about,./this,./patient,,./which,./is,./an,./appropriate,./
reason,./to,./explain,./why,./she,./does,./not,./need,./a,./Pap,./test,./today?
The,./best,./option,./is,./indicated,./below.,./Your,./selections,./are,./indicated,./by,./th
e,./shaded,./boxes.
·,./A.,./She,./experienced,./menopause,./more,./than,./10,./years,./ago
·,./B.,./She,./had,./a,./total,./hysterectomy,./for,./fibroids
·,./C.,./She,./has,./never,./had,./an,./abnormal,./Pap,./test
,·,./D.,./She,./is,./63,./years,./old
·,./E.,./She,./is,./not,./sexually,./active,./-,./correct,./answer,./✔ ✔
B.,./She,./had,./a,./total,./hysterectomy,./for,./fibroids
A,./47-year-
old,./cisgendered,./female,./comes,./into,./your,./office,./for,./a,./health,./care,./mainte
nance,./exam.,./She,./has,./hypertension,./and,./type,./2,./diabetes.,./She,./is,./not,./sex
ually,./active,./and,./has,./not,./yet,./experienced,./menopause.,./There,./is,./no,./famil
y,./history,./of,./cancer.,./Her,./blood,./pressure,./is,./118/78,,./her,./BMI,./is,./34,,./and,./
the,./remainder,./of,./her,./physical,./exam,./is,./within,./normal,./limits.,./Her,./vacci
nations,./are,./up,./to,./date,,./and,./she,./has,./a,./Pap,./test,./today,./and,./will,./have,./labs,
./drawn.,./According,./to,./USPSTF,,./which,./of,./the,./following,./is,./the,./best,./reco
mmendation,./to,./give,./her,./concerning,./mammography?
The,./best,./option,./is,./indicated,./below.,./Your,./selections,./are,./indicated,./by,./th
e,./shaded,./boxes.
·,./A.,./Should,./have,./started,./at,./age,./40,./and,./every,./year,./thereafter
·,./B.,./Should,./have,./started,./at,./age,./40,./and,./every,./two,./years,./thereafter
·,./C.,./Should,./have,./started,./at,./age,./45,./and,./every,./year,./thereafter
·,./D.,./Start,./at,./age,./50,./and,./every,./year,./thereafter
E.,./Start,./at,./age,./50,./and,./every,./two,./years,./thereafter,./-,./correct,./answer,./✔
✔ E.,./Start,./at,./age,./50,./and,./every,./two,./years,./thereafter
A,./25-year-old,./patient,./presents,./to,./the,./office,./for,./follow-
up,./on,./anxiety,./and,./tobacco,./dependence.,./She,./reports,./she,./is,./doing,./well,./
on,./her,./new,./medication,./to,./help,./with,./both,./her,./mood,./and,./smoking,,./thou
, gh,./she,./continues,./to,./smoke.,./She,./recently,./started,./her,./first,./sexual,./relatio
nship,./with,./a,./new,./female,./partner.,./She,./received,./a,./tetanus,./vaccine,./at,./the,
./age,./of,./18,,./and,./she,./received,./her,./flu,./vaccine,./this,./year.,./Her,./blood,./press
ure,./is,./122/70,,./and,./her,./physical,./exam,./is,./within,./normal,./limits.,./You,./revi
ew,./her,./recent,./Pap,./test,,./which,./was,./negative.,./Which,./of,./the,./following,./in
dicates,./the,./vaccines,./she,./should,./receive,./today?
Choose,./the,./single,./best,./answer.
The,./best,./option,./is,./indicated,./below.,./Your,./selections,./are,./indicated,./by,./th
e,./shaded,./boxes.
·,./A.,./HPV,./vaccine,./alone
·,./B.,./HPV,./vaccine,./and,./pneumococcal,./conjugate,./vaccine,./(PCV13)
·,./C.,./HPV,./vaccine,./and,./pneumococcal,./polysaccharide,./vaccine,./(PPSV23
)
·,./D.,./HPV,./vaccine,./and,./Zoster,./vaccine
·,./E.,./No,./vaccines,./are,./needed,./-,./correct,./answer,./✔ ✔
C.,./HPV,./vaccine,./and,./pneumococcal,./polysaccharide,./vaccine,./(PPSV23
)
A,./55-year-
old,./male,./with,./no,./significant,./past,./medical,./history,./presents,./for,./a,./routine
,./physical,./exam.,./He,./last,./saw,./a,./doctor,./five,./years,./ago.,./Social,./history,./is,./
remarkable,./for,./a,./35-pack-
year,./tobacco,./history,./since,./the,./age,./of,./20.,./He,./indicates,./that,./his,./wife,./an
d,./children,./have,./urged,./him,./to,./quit,./smoking,./for,./the,./last,./few,./months.,./W
hen,./you,./ask,./him,./if,./he,./has,./considered,./quitting,,./he,./replies,,./"I,./just,./don't,./
