ACTUAL QUESTIONS & VERIFIED ANSWERS 100%
CORRECT 2025
1. Primary Amenorrhea ANS >> The failure of any menses to appear is termed
"primary amenorrhea," and evaluation is commenced either (1) at age 14 years if
neither menarche nor any breast development has occurred or if height is in the
lowest 3% for ethnicity, or (2) at age 16 years if menarche has not occurred
2. Secondary Amenorrhea ANS >> Secondary amenorrhea is defined as the
absence of menses for 3 consecutive months in women who have passed
menarche.
3. Primary Amenorrhea symptoms and physical exam ANS >> Patients with
primary amenorrhea require a thorough history and physical examination to look
for signs of the conditions noted above. Headaches or visual field abnormalities
implicate a hypothalamic or pituitary tumor. Signs of pregnancy may be present.
Blood pressure elevation, acne, and hirsutism should be noted. Short stature may
be seen with
an associated GH or thyroid hormone deficiency. Short stature with manifestations
of gonadal dysgenesis indicates Turner syndrome. Olfactory deficits are seen in
Kallmann syndrome. Obesity and short stature may be signs of Cushing syndrome.
Tall stature may be due to eunuchoidism or acromegaly. Hirsutism or virilization
1 N/ N
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,suggests excessive testosterone.
An external pelvic examination plus a rectal examination should be performed to
assess hymen patency and the presence of a uterus.
4. Primary Amenorrhea labs ANS >> The initial endocrine evaluation should
include serum FSH, LH, PRL, total and free testosterone, TSH, FT4, and beta-
hCG (preg- nancy test).
Girls who have a normal uterus and high FSH without the classic features of Turner
syndrome may require a karyotype to diagnose X chromosome mosaicism
5. Secondary Amenorrhea labs ANS >> thyroid function tests, prolactin, FSH,
LH, total testosterone, serum estradiol, Pregnancy test
6. ACS and ACOG guidelines 21-29 years ANS >> ACS start at 25 ANS >>
Primary HPV alone q 5 years or
co-testing q 5 years or
cytology alone q 3 years
ACOG start at 21 ANS >>
cytology alone q 3 years
7. ACS and ACOG guidelines 30-65 years ANS >> ACS ANS >>
Primary HPV testing alone q 5 years or
co-testing q 5 years or
cytology alone q 3 years
ACOG ANS >>
co-testing q 5 years or
2 N/ N
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, cytology alone q 3 years or N N N N N
primary HPV testing alone q 5 years
N N N N N N
8. Pap and HPV testing over 65 years ANS >> not recommended and not
N N N N N N N N NN N N N
recommended if hysterectomy
N N N
9. Bethesda Classification ANS >> Squamous cell abnormalities
N N N NN N N
10. ASCUS ANS >> · ASCUS - atypical squamous cells of undetermined
N N NN N N N N N N N
significance
N
11. · LSIL OR LGSIL ANS >> · LSIL OR LGSIL - low grade squamous
N N N N N NN N N N N N N N
intraepithelial lesion o CIN 1 ANS >> HPV or mild dysplasia
N N N N N N N NN N N N
12. · HSIL or HGSIL ANS >> · HSIL or HGSIL - high grade squamous intraepitheli
N N N N N NN N N N N N N N N
lesionN
o CIN 2 ANS >> moderate dysplasia
N N N NN N
o CIN 3 ANS >> severe dysplasia
N N N NN N
13. Changes in glandular cells (AGCUS), presence of endometrial cells, ade-
N N N N N N N N N
nocarcinoma, etc. recommends? ANS >> · Need endometrial bx
N N N N N NN N N N
14. Pap Infection treatment? ANS >> Infection ANS >> treatment based on
N N N N NN N N NN N N
causative agent; re- peat PSP 3-4 months after treatment
N N N N N N N N N
15. · For specific abnormal findings such as ASCUS ANS >> · For specific
N N N N N N N N N NN N N
abnormal findings such as ASCUS
N N N N N
o HPV testing N
o Repeat PSP smear N N
o Colposcopy
3 N/ N
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