NR602 final exam
ASCCP recommended management for an ASCUS pap result with high risk hpv 16 cotest in 26 year old
no abnormal paps - Answer-colposcopy
What is included in the well women of an adolescent? - Answer-health history
menses
gynecologic and pregnancy issues
psychosocial
abuse drugs alcohol use
physical exam
screening tests
immunizations
When does ACOG pap smear start - Answer-21 years old done every three years
ACOG pap for over 30 yrs old - Answer-every five years with HPV test completed
ACOG when can you stop pap smear - Answer-can stop at 65 if negative history for 10 years or if they
had a hysterectomy with no history of cervical cancer
Bethesda pap smear report reads LSIL is what classification? - Answer-CIN 1
A single Pap smear reading of ASCUS in a patient negative for HPV infection should have what as follow-
up? - Answer-routine screening
,a female patient is 35 years old. she has never had an abnormal PAP smear has regular screening since
age 18. If she has a normal PAP smear with HPV testing today, when should she have the next cervical
cancer screening? - Answer-5 years
A young sexually active is having her first pap smear what would you explain? - Answer-pap smear
detects cervical cancer
26 year old pap smear shows negative and positive HPV what do you do? - Answer-repeat HPV and pap
what is not part of criteria for older women to cease pap smears? - Answer-over 55 year old
no menarche in a 15 year old with no medical problems and Tanner stage 1 with a uterus - Answer-
primary amenorrhea
No menses for at least 6 months - Answer-secondary amenorrhea
female athlete triad - Answer-disordered eating, amenorrhea, osteoporosis
labs for female athlete triad - Answer-HCG
serum prolactin
serum TSH,FSH, LH
if amenorhea lasts longer than 6 months do what? - Answer-bone density test
treatment plan for female athlete triad - Answer-increase caloric intake, decrease exercise
prescribe ca and vit d 1200/1500 daily and vitamin e 400 iu daily
,complications of female athlete triad - Answer-osteopenia/osteoporosis (stress fracture)
myocardial atrophy, arrhythmia, hypotension, brady
hypoglycemia, dehydration, electrolytes
lanugo, telogen effluvium hair loss zerosis dry skin, infertility, low body mass, cachexia, respiratory
failure
purpose of progesterone challenge - Answer-endogenous estrogen
primary and secondary amenorrhea originates in hypothalamus - Answer-sheehans syndrome
symptoms of breast cancer ( early) - Answer-None
Non-painful mass (occasionally pain)
Eczematous nipple (Paget's)
Serosanguinous (bloody) nipple discharge
late symptoms of breast cancer - Answer-skin or nipple retraction
axilary lymhadenpathy
breast enlargement
redness, edema, brawny induration
peau d' orange
pain
fixation of the mass to the skin or chest wall
very late findings of breast cancer - Answer-ulceration
supraclavicular lymphadenopathy
edema of the arm, bone, lung, liver, brain or other distant metstases
, Follow up for breast cancer patients - Answer-1. Bilateral mammogram 6 months after complete
radiation post-lumpectomy; Mammogram yearly after
2. Contralateral mammogram annually post-mastectomy (entire breast + pectoralis major fascia)
PE every 3-6 months for 3 years then annually
fibrocystic breast disease - Answer-the presence of single or multiple benign cysts in the breasts
signs and symptoms of fibrocystic breast disease - Answer-occurs 2 weeks before the onset of mensus
and worst right before the menstrual cycle. resolves after menses starts often in women in their 30's.
breast lumps are rubbery and mobile to touch
Tx for fibrocystic breast disease - Answer-Once a benign diagnosis or normal findings have been
established by biopsy or on clinical or imaging findings, simple reassurance will provide many patients
with adequate relief.
For those patients who still seek treatment, symptomatic relief by avoiding trauma and by wearing a bra
with adequate support can be very helpful. The role of caffeine consumption in the development and
treatment of fibrocystic change has never been proven; however, many patients report relief of
symptoms after abstinence from coffee, tea, and chocolate. Similarly, observational studies have
suggested that low-fat diets can provide some relief. The data regarding the utility of vitamin E
supplementation and evening primrose oil are controversial. Mild analgesics such as acetaminophen and
nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to relieve breast pain. For more
symptomatic women, danazol and tamoxifen have been found to be effective, although their significant
side effects have limited their acceptability and utility.
Fibroadenoma - Answer-benign breast lesion 15-40 yrs old
risk factors for fibroadenoma - Answer-multiple fibroadenomas associated with rate cancer syndromes
like mafficci syndrome, Cowden syndrome, carney complex early ETOH consumption
ASCCP recommended management for an ASCUS pap result with high risk hpv 16 cotest in 26 year old
no abnormal paps - Answer-colposcopy
What is included in the well women of an adolescent? - Answer-health history
menses
gynecologic and pregnancy issues
psychosocial
abuse drugs alcohol use
physical exam
screening tests
immunizations
When does ACOG pap smear start - Answer-21 years old done every three years
ACOG pap for over 30 yrs old - Answer-every five years with HPV test completed
ACOG when can you stop pap smear - Answer-can stop at 65 if negative history for 10 years or if they
had a hysterectomy with no history of cervical cancer
Bethesda pap smear report reads LSIL is what classification? - Answer-CIN 1
A single Pap smear reading of ASCUS in a patient negative for HPV infection should have what as follow-
up? - Answer-routine screening
,a female patient is 35 years old. she has never had an abnormal PAP smear has regular screening since
age 18. If she has a normal PAP smear with HPV testing today, when should she have the next cervical
cancer screening? - Answer-5 years
A young sexually active is having her first pap smear what would you explain? - Answer-pap smear
detects cervical cancer
26 year old pap smear shows negative and positive HPV what do you do? - Answer-repeat HPV and pap
what is not part of criteria for older women to cease pap smears? - Answer-over 55 year old
no menarche in a 15 year old with no medical problems and Tanner stage 1 with a uterus - Answer-
primary amenorrhea
No menses for at least 6 months - Answer-secondary amenorrhea
female athlete triad - Answer-disordered eating, amenorrhea, osteoporosis
labs for female athlete triad - Answer-HCG
serum prolactin
serum TSH,FSH, LH
if amenorhea lasts longer than 6 months do what? - Answer-bone density test
treatment plan for female athlete triad - Answer-increase caloric intake, decrease exercise
prescribe ca and vit d 1200/1500 daily and vitamin e 400 iu daily
,complications of female athlete triad - Answer-osteopenia/osteoporosis (stress fracture)
myocardial atrophy, arrhythmia, hypotension, brady
hypoglycemia, dehydration, electrolytes
lanugo, telogen effluvium hair loss zerosis dry skin, infertility, low body mass, cachexia, respiratory
failure
purpose of progesterone challenge - Answer-endogenous estrogen
primary and secondary amenorrhea originates in hypothalamus - Answer-sheehans syndrome
symptoms of breast cancer ( early) - Answer-None
Non-painful mass (occasionally pain)
Eczematous nipple (Paget's)
Serosanguinous (bloody) nipple discharge
late symptoms of breast cancer - Answer-skin or nipple retraction
axilary lymhadenpathy
breast enlargement
redness, edema, brawny induration
peau d' orange
pain
fixation of the mass to the skin or chest wall
very late findings of breast cancer - Answer-ulceration
supraclavicular lymphadenopathy
edema of the arm, bone, lung, liver, brain or other distant metstases
, Follow up for breast cancer patients - Answer-1. Bilateral mammogram 6 months after complete
radiation post-lumpectomy; Mammogram yearly after
2. Contralateral mammogram annually post-mastectomy (entire breast + pectoralis major fascia)
PE every 3-6 months for 3 years then annually
fibrocystic breast disease - Answer-the presence of single or multiple benign cysts in the breasts
signs and symptoms of fibrocystic breast disease - Answer-occurs 2 weeks before the onset of mensus
and worst right before the menstrual cycle. resolves after menses starts often in women in their 30's.
breast lumps are rubbery and mobile to touch
Tx for fibrocystic breast disease - Answer-Once a benign diagnosis or normal findings have been
established by biopsy or on clinical or imaging findings, simple reassurance will provide many patients
with adequate relief.
For those patients who still seek treatment, symptomatic relief by avoiding trauma and by wearing a bra
with adequate support can be very helpful. The role of caffeine consumption in the development and
treatment of fibrocystic change has never been proven; however, many patients report relief of
symptoms after abstinence from coffee, tea, and chocolate. Similarly, observational studies have
suggested that low-fat diets can provide some relief. The data regarding the utility of vitamin E
supplementation and evening primrose oil are controversial. Mild analgesics such as acetaminophen and
nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to relieve breast pain. For more
symptomatic women, danazol and tamoxifen have been found to be effective, although their significant
side effects have limited their acceptability and utility.
Fibroadenoma - Answer-benign breast lesion 15-40 yrs old
risk factors for fibroadenoma - Answer-multiple fibroadenomas associated with rate cancer syndromes
like mafficci syndrome, Cowden syndrome, carney complex early ETOH consumption
