01 45 yo woman PE

Question 1

breast exams guidelines

Answer 1

USPSTF against self exams
insufficient for clinical in 40 and older
ACS says q3y for 20-30s and then yearly over 40

Question 2

cervical cancer screening

Answer 2

at age 21 - q 3
30-65 q3 OR q5 with HPV 
high risk require more frequent
65+ with adequate screening in last 10 years may stop (3 consecutive normal paps OR two normal with negative HPV)
if benign hyst, no need

Question 3

lung cancer screening

Answer 3

low dose CT in ages 55-80 with 30+ pack years - currently smoking or quit wihtin last 15 years

Question 4

mammograms ACS

Answer 4

40-44 up to pt
45-54 yearly
55+ yearly or every 2 years

Question 5

mammograms USPSTF

Answer 5

every 2 years 50-74

individual decision under 50

Question 6

breast lump eval

Answer 6

location, how noticed, how long, discharge?, change in size?

Question 7

dx tests breast lump

Answer 7

cystic - aspiration
solid - mammogram
US can help distinguish between the two

Question 8

risk factors breast cancer

Answer 8

fam hx (first degree)
menarche < 12, menopause > 45
genetic 
age
female
increased breast density

age at first pregnancy (older)
DES
hormone therapy

therapeutic radiation, obesity, alcohol intake

Question 9

decreased risk bc

Answer 9

pregnancy at early age
late menarche
early menopause
high parity
use of some medications such as SERMS, NSAIDs

Question 10

Menopause

Answer 10

avg at 51
12 mo without menstruation
perimenopause 2-8 years

Question 11

osteoporosis prevention

Answer 11

premeno 1000 mg ca
postmeno 1200 mg ca
3-4 servings daily

Question 12

osteoporosis screening

Answer 12

> 65 DEXA
< 65 yo if risk equal or greater than 65 yo white woman due to risk factors (early menopause, prolonged amenorrhea, low BMI, lack of physical activity, poor calcium intake, fam hx, smoking, hx fx)

Question 13

exercise recs

Answer 13

150 minutes moderate-intensity exercise
75 min vigorous
or combo
at least 2 days week strengthening

Question 14

bethesda cervical cytology

Answer 14

specimen adequacy
general categorization
interpretation

ASC: some abnormal cells seen
LSIL: low grade squamous
HSIL
SCC

Question 15

vaccine HPV

Answer 15

Gardasil - 6, 11, 16, 18: ages 9-26
Cervarix - 16, 18, 31, 45, females only 9-25
Gardasil 9 - 6, 11, 16, 18 , 31, 33, 45, 52, 58, all 9-26