D120 2026 EXAM SCRIPT COMPLETE
QUESTIONS AND SOLUTIONS
● Symptoms of pregnancy . Answer: missed menses,
urinary frequency,
breast engorgement,
nausea,
tiredness, and
easy fatigability
● Presumptive signs of pregnancy . Answer: 1. skin and mucous
membrane changes (Chadwich sign: dark discoloration of the vulva and
vaginal walls)
● Probable signs of pregnancy . Answer: detectible physical changes of
the uterus. Enlargement (Pickacek sign: one cornu of the uterus may
enlarge slightly), softens (Hegar sign: possible to palpate or compress
the connection between the cervix and the fundus).
● Positive signs of pregnancy . Answer: Fetal heartbeat and fetal
movement
,Endovaginal us can detect cardiac activity as early as 6 weeks and fetal
movement around 7-8 weeks.
Modern Doppler can detect heartbeat as early as 9 weeks and definitly
by 12 weeks.
Stethescope can detect heartbeat between 16-20 weeks
A multiparous woman can feel movement between 15-17 weeks; a
primigravida usually does not recognize fetal movement until 18-20
weeks.
● Breast exam screening (what age to start? How many years between?)
. Answer: Annual breast exam ages >39 and every 1-3 years age 20-39;
high-risk women should consider an annual exam;
screening mammography annually starting at age 40; USPSTF
recommends starting at age 50;
breast self-exam not universally recommended
● pap smear guidelines . Answer: Pap smear from age 21 irrespective of
sexual activity:
age 21-29, every 3 years;
30-65, every 3 years with cytology only every 5 years with HPV testing
added;
age>65, only with a history of significant CIN (cervical intraepithelial
neoplasia)
After total hysterectomy (corpus and cervix) cytology not needed.
, ● ASC-US . Answer: (atypical squamous cells of undetermined
significance)
younger than 25:
preferred- Repeat in 12 months.
acceptable- reflex HPV test
25-29:
Preferred- Reflex HPV test
Acceptable- Repeat pap test in 12 months
>30:
HPV neg: repeat co-testing in 3 years
HPV pos: colposcopy
● LSIL . Answer: (Low grade Squamous Intraepithelial Lesion)
21-24: repeat pap test in 12 months
25-29: colposcopy
>30:
HPV neg-
Preferred-repeat pap test in 12 months
Acceptable- colposcopy
HPV pos- colposcopy
QUESTIONS AND SOLUTIONS
● Symptoms of pregnancy . Answer: missed menses,
urinary frequency,
breast engorgement,
nausea,
tiredness, and
easy fatigability
● Presumptive signs of pregnancy . Answer: 1. skin and mucous
membrane changes (Chadwich sign: dark discoloration of the vulva and
vaginal walls)
● Probable signs of pregnancy . Answer: detectible physical changes of
the uterus. Enlargement (Pickacek sign: one cornu of the uterus may
enlarge slightly), softens (Hegar sign: possible to palpate or compress
the connection between the cervix and the fundus).
● Positive signs of pregnancy . Answer: Fetal heartbeat and fetal
movement
,Endovaginal us can detect cardiac activity as early as 6 weeks and fetal
movement around 7-8 weeks.
Modern Doppler can detect heartbeat as early as 9 weeks and definitly
by 12 weeks.
Stethescope can detect heartbeat between 16-20 weeks
A multiparous woman can feel movement between 15-17 weeks; a
primigravida usually does not recognize fetal movement until 18-20
weeks.
● Breast exam screening (what age to start? How many years between?)
. Answer: Annual breast exam ages >39 and every 1-3 years age 20-39;
high-risk women should consider an annual exam;
screening mammography annually starting at age 40; USPSTF
recommends starting at age 50;
breast self-exam not universally recommended
● pap smear guidelines . Answer: Pap smear from age 21 irrespective of
sexual activity:
age 21-29, every 3 years;
30-65, every 3 years with cytology only every 5 years with HPV testing
added;
age>65, only with a history of significant CIN (cervical intraepithelial
neoplasia)
After total hysterectomy (corpus and cervix) cytology not needed.
, ● ASC-US . Answer: (atypical squamous cells of undetermined
significance)
younger than 25:
preferred- Repeat in 12 months.
acceptable- reflex HPV test
25-29:
Preferred- Reflex HPV test
Acceptable- Repeat pap test in 12 months
>30:
HPV neg: repeat co-testing in 3 years
HPV pos: colposcopy
● LSIL . Answer: (Low grade Squamous Intraepithelial Lesion)
21-24: repeat pap test in 12 months
25-29: colposcopy
>30:
HPV neg-
Preferred-repeat pap test in 12 months
Acceptable- colposcopy
HPV pos- colposcopy
