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FM Cases > 01 - 45 yo F annual exam > Flashcards

01 - 45 yo F annual exam Flashcards

1
Q

at what age and how often should a clinical breast exam be performed?

A

part of a periodic health exam

  • every 3 years for women in their 20s-30s
  • every year for women 40 and over
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2
Q

what non-sexual factors are related to cervical cancer risk?

A
  • diethylstilbesterol (DES) in utero
  • cigarette smoking (strong correlation, 4x risk)
  • immunosuppression
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3
Q

when should cervical cancer screening begin?

A

21

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4
Q

how often should cervical cancer screening be performed between age 21-29?

A

every 3 years

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5
Q

how often should cervical cancer screening be performed between age 30-65?

A

every 5 years if co-tested for HPV (preferred) or every 3 years with cytology alone (acceptable)

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6
Q

what are the cervical cancer screening guidelines for women over 65?

A

adequate screening is 3 consecutive normal pap tests with cytology alone or two normal pap tests if combined with HPV testing

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7
Q

what are the characteristics of a good screening test?

A
  • accuracy
  • able to detect disease in an asymptomatic phase
  • minimal associated risk
  • reasonable cost
  • acceptable to patient
  • have an available treatment
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8
Q

what are the USPSTF recommendations for lung cancer screening?

A
  • annual screening with low dose CT in patients 55-80 who have smoked for 30 pack years
  • must be currently smoking or have quit in the last 15 years
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9
Q

what are the ACS recommendations for breast cancer screening?

A
  • women 40-44 have the choice for annual mammography if they wish
  • women 45-54: annual mammogram
  • women 55 and older: switch to mammogram every 2 years or choice to continue annual
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10
Q

what is the USPSTF recommendation for breast cancer screening?

A

biennial mammography 50-74 (grade B)

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11
Q

what are the breast cancer screening guidelines for women younger than 40?

A

not recommended unless high risk (eg BRCA)

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12
Q

what are the diagnostic tests for a breast lump?

A
  • if it feels cystic: aspirate and cytology, FNA
  • if it feels solid: mammography
  • US to distinguish cystic vs solid
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13
Q

what are the menarche- and menopause-related risk factors for breast cancer?

A

menarche before age 12 or menopause after age 45

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14
Q

what are the hormonal risk factors for breast cancer?

A
  • advanced age at first pregnancy
  • exposure to DES
  • hormone therapy
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15
Q

what are the Tdap recmomendations for adults?

A

Tdap should replace a single dose of Td for adults age 19-64 who have not received a dose of Tdap previously

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16
Q

when can menopause be confirmed?

A

only after a woman has not menstruated for 12 straight months

17
Q

what is the hallmark of perimenopause?

A

menstrual irregularity

18
Q

how much calcium do pre-menopausal women need? post-menopausal?

A
  • pre-menopausal: 1000 mg daily

- post-menopausal: 1200 mg daily

19
Q

what are the USPSTF recommendations for calcium and vitamin D supplementation in healthy pre- and post-menopausal women?

A

recommends AGAINST

20
Q

what are the recommendations for osteoporosis screening in women younger and older than 65?

A
  • under 65: use WHO risk assessment tool - screen with DEXA if risk of fracture is greater than or equal to that of a 65 year old white woman without additional risk factors (9.3% over 10 years)
  • over 65: DEXA
21
Q

what are the Bethesda system criteria for reporting cervical cytology?

A
  1. specimen adequacy: pap smear must contain over 5000 squamous cells and have sufficient endocervical cells
  2. general categorization of results: evidence of intraepithelial lesion or malignancy?
  3. interpretation: a) atypical squamous cell, b) low grade intraepithelial lesion (LSIL), c) high grade squamous intraepithelial lesion (HSIL), d) squamous cell carcinoma
22
Q

what type of vaccine is Gardasil? what strains does it prevent against?

A
  • quadrivalent recombinant DNA vaccine (HPV4)

- 6, 11, 16, 18

23
Q

what type of vaccine is Cervarix? what strains does it prevent against?

A
  • bivalent vaccine (HPV2)

- 16 and 18, 31, 45

24
Q

what strains does Gardasil 9 prevent against?

A

6, 11, 16, 18, 31, 33, 45, 52, 58

25
Q

what is the role of MRI in breast cancer screening?

A
  • surveillance of women with more than 20% lifetime risk
  • diagnostic tool to identify more completely the extent of disease in patients with a recent breast cancer diagnosis
  • contrast enhanced MRI may be indicated in the evaluation of patients with breast augmentation
26
Q

what is the role of US in breast cancer screening?

A
  • not recommended for screening purposes

- used for evaluation of suspected abnormalities

FM Cases (40 decks)

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