NR 602 Final Exam –
Question and Answers
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
findings with fibroadenoma - answer- painless, firm or rubbery mass with well defined
borders, freely mobile, changes with size may occur with pregnany or menstrual cycle,
lesions under 5 cm, considered to be giant fibrodenomas no nipple discharge
Dx of fibroadenoma - answer- mammo, us to differentiate fluid filled to solid mass, fine
needle aspiration biopsy, open biopsy
Intraductal papilloma - answer- benign tumor within the ductal system of the breast, one
of the heterogeneous group of lesions encompassed by the term benign breast disease
seen in females 30-50
risk factors for intraductal papilloma - answer- multiple papilloma's which increases the
risk for breast cancer
Question and Answers
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
findings with fibroadenoma - answer- painless, firm or rubbery mass with well defined
borders, freely mobile, changes with size may occur with pregnany or menstrual cycle,
lesions under 5 cm, considered to be giant fibrodenomas no nipple discharge
Dx of fibroadenoma - answer- mammo, us to differentiate fluid filled to solid mass, fine
needle aspiration biopsy, open biopsy
Intraductal papilloma - answer- benign tumor within the ductal system of the breast, one
of the heterogeneous group of lesions encompassed by the term benign breast disease
seen in females 30-50
risk factors for intraductal papilloma - answer- multiple papilloma's which increases the
risk for breast cancer
