Health maintenance trigger

Question 1

menorrhagia

Answer 1

heavy/prolonged menstrual flow

Question 2

What is the GTPAL and GPA for a woman who has 4 children, 2 of which were premature, and has been pregnant six times in the past and is currently pregnant again.

Answer 2

G - 7
T - 2
P - 2
A - 2
L - 4

G - 7
P - 4
A - 2

Question 3

if a woman is G4P2A1 what does that mean?

Answer 3

she has been pregnant 4 times, given birth twice and had one abortion. therefore she is currently pregnant.

if this is wrong plz lemme know cuz i struggle

Question 4

no idea whats going on here

Question 5

Describe the newer pap smear test

Answer 5

1. Insert broom so that short bristles touch ectocervix and long bristles in the center in the endocervical canal.
2. Smash broom and swirl inside container once samples are obtained.

Question 6

how often would the following ages need a pap?
1. 29
2. 34
3. 22
4. 58
5. 67

Answer 6

1. Q 3 yrs
2. Q 3yrs or HPV +/- pap every 5
3. Q 3 yrs
4. Q 3 yrs or HPV +/- pap every 5
5. 65+: can stop if no hx of dysplasia/cx + 3 negative paps or 2 negative paps/HPVs in past 10y

Question 7

who do pap smear frequency guidelines NOT apply to

Answer 7

1. cervical cancer
2. HIV +
3. immunocomp
4. DES exposure

Question 8

pick out which of the following ARE considered high risky sexual behaviors:
1. being african american
2. newly married
3. new partner in the past 6 months
4. living in a low socioeconomic area
5. unemployment
6. a hx of prior STI
7. being LGBTQIA+
8. Meeting partners on dating apps.

Answer 8

1. being african american - yes
2. newly married - no
3. new partner in the past 6 months - No
4. living in a low socioeconomic area - yes
5. unemployment - no
6. a hx of prior STI - yes
7. being LGBTQIA+ - no
8. Meeting partners on dating apps. - yes

Question 9

match the age start recommendation to the screening:

screenings:
Mammogram
pap smear
skin exam
colonoscopy
bone Density (DEXA)

ages:
40-45
45
21
65
20

Answer 9

Mammogram - 40-45 (some recommend not till 50)
pap smear - 21
skin exam - 20
colonoscopy - 45
bone Density (DEXA) - 65 (or younger if bone density assumed to be similar to 65+ white woman)

Question 10

what is the bethesda system used for?

Answer 10

pap smear grading

Question 11

what does ASC-H mean on a pap smear?

Answer 11

atypical squamous cells that cannot exclude a high grade lesion

Question 12

CIN 1 is what kind of lesion?

Answer 12

low-grade squamous intraepithelial lesion

Question 13

CIN 2 and 3 are what kinds of lesions

Answer 13

high-grade squamous intraepithelial lesion (HGLSIL/HSIL)

Question 14

what type of cells are found in Adenocarcinoma of the endocervix or endometrium

Answer 14

atypical glandular cells (ACG)

Question 15

do CIN 1 and 2 refer to the upper or lower cervix?

Answer 15

lower!

CIN-I = disordered growth of lower 1/3
CIN-II = disordered growth of lower 2/3
CIN-III = disordered growth of over 2/3; considered full thickness

Question 16

what demographic is treated differently when high grade squamous intraepithelial lesions are found?

Answer 16

pregnant
CIN 2 adolescents

(CIN 2 and 3 = HGSIL)

Question 17

true or false: most cervical cancer is HPV, but most HPV will not become cervical cancer.

Answer 17

True!

Question 18

If a patient is found to have ASC-US, what is the protocol

Answer 18

3 options:
1. repeat cytology Q6m until 2 normal
2. test for high risk HPV
3. immediate colposcopy

if you choose option one, be sure to treat atrophic vaginitis or infections if present.

Question 19

A patient has ASC-US and you decide to test for high risk HPV. HPV comes back positive, what is your next step?

Answer 19

refer for immediate colposcopy

Question 20

A patient has ASC-US and you decide to repeat serial cytology. What findings on cytology would suggest that you immediatly refer for colposcopy

Answer 20

any abnormalities including:
* LSIL
* HSIL
* ASC-H
*AGC

Question 21

this is ordered to:
assess fx risk or precocious/delayed puberty.

Answer 21

estrone

also:
to monitor antiestrogen therapy and to assess disorders of sex steroid metabolism

Question 22

this is ordered to assess fetal demise, preterm labor risk, fetal pathologies, and quad screens

Answer 22

estriol

Question 23

this is ordered to evaluate ovarian function, monitor HRT therapy, and evaluate hepatic cirrhosis or hyperthyroidism.

Answer 23

estradiol

also:
to monitor antiestrogen therapy and to assess disorders of sex steroid metabolism

Question 24

these are ordered to monitor antiestrogen therapy and to assess disorders of sex steroid metabolism

Answer 24

estrone and estradiol

Question 25

can be secreted by corpus luteum, adrenal glands, or placenta

Answer 25

progesterone

Question 26

a biotin level of >5mg/day can interfere with what lab reading.

Answer 26

progesterone.

adrenal tumors would also cause

Question 27

if low grade squamous intraepithelial lesions are found on colposcopy, what is the management

Answer 27

1. 2 pap Q 6 mo or pap + HPV @ 6 mo
2. cytology abnormal or HPY + then repeat colposcopy
3. if neg then normal screening continues

Question 28

pregnancy and OCP’s can cause LOW FSH/LH. what else could cause this

Answer 28

pituitary failure
hypothalamic failure
anorexia/malnutrition

Question 29

on colposcopy high grade squamous intraepithelial lesions are found. what is the next step for this patient?

Answer 29

refer for surgery (CIN2/3)

Question 30

Menopause can cause elevated FSH/LH, what else can cause this?

Answer 30

castration
precocious puberty

Question 31

what is inhibited by dopamine?

Answer 31

prolactin

Question 32

decreased muscle mass, osteoporosis, impotence and oligo/amenorrhea are all signs of what

Answer 32

hyperprolactinemia