Health maintenance trigger Flashcards
menorrhagia
heavy/prolonged menstrual flow
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.
G - 7
T - 2
P - 2
A - 2
L - 4
G - 7
P - 4
A - 2
if a woman is G4P2A1 what does that mean?
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
no idea whats going on here
Describe the newer pap smear test
- Insert broom so that short bristles touch ectocervix and long bristles in the center in the endocervical canal.
- Smash broom and swirl inside container once samples are obtained.
how often would the following ages need a pap?
1. 29
2. 34
3. 22
4. 58
5. 67
- Q 3 yrs
- Q 3yrs or HPV +/- pap every 5
- Q 3 yrs
- Q 3 yrs or HPV +/- pap every 5
- 65+: can stop if no hx of dysplasia/cx + 3 negative paps or 2 negative paps/HPVs in past 10y
who do pap smear frequency guidelines NOT apply to
- cervical cancer
- HIV +
- immunocomp
- DES exposure
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.
- being african american - yes
- newly married - no
- new partner in the past 6 months - No
- living in a low socioeconomic area - yes
- unemployment - no
- a hx of prior STI - yes
- being LGBTQIA+ - no
- Meeting partners on dating apps. - yes
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
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)
what is the bethesda system used for?
pap smear grading
what does ASC-H mean on a pap smear?
atypical squamous cells that cannot exclude a high grade lesion
CIN 1 is what kind of lesion?
low-grade squamous intraepithelial lesion
CIN 2 and 3 are what kinds of lesions
high-grade squamous intraepithelial lesion (HGLSIL/HSIL)
what type of cells are found in Adenocarcinoma of the endocervix or endometrium
atypical glandular cells (ACG)
do CIN 1 and 2 refer to the upper or lower cervix?
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
what demographic is treated differently when high grade squamous intraepithelial lesions are found?
pregnant
CIN 2 adolescents
(CIN 2 and 3 = HGSIL)
true or false: most cervical cancer is HPV, but most HPV will not become cervical cancer.
True!
If a patient is found to have ASC-US, what is the protocol
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.
A patient has ASC-US and you decide to test for high risk HPV. HPV comes back positive, what is your next step?
refer for immediate colposcopy
A patient has ASC-US and you decide to repeat serial cytology. What findings on cytology would suggest that you immediatly refer for colposcopy
any abnormalities including:
* LSIL
* HSIL
* ASC-H
*AGC
this is ordered to:
assess fx risk or precocious/delayed puberty.
estrone
also:
to monitor antiestrogen therapy and to assess disorders of sex steroid metabolism
this is ordered to assess fetal demise, preterm labor risk, fetal pathologies, and quad screens
estriol
this is ordered to evaluate ovarian function, monitor HRT therapy, and evaluate hepatic cirrhosis or hyperthyroidism.
estradiol
also:
to monitor antiestrogen therapy and to assess disorders of sex steroid metabolism
these are ordered to monitor antiestrogen therapy and to assess disorders of sex steroid metabolism
estrone and estradiol
can be secreted by corpus luteum, adrenal glands, or placenta
progesterone
a biotin level of >5mg/day can interfere with what lab reading.
progesterone.
adrenal tumors would also cause
if low grade squamous intraepithelial lesions are found on colposcopy, what is the management
- 2 pap Q 6 mo or pap + HPV @ 6 mo
- cytology abnormal or HPY + then repeat colposcopy
- if neg then normal screening continues
pregnancy and OCP’s can cause LOW FSH/LH. what else could cause this
pituitary failure
hypothalamic failure
anorexia/malnutrition
on colposcopy high grade squamous intraepithelial lesions are found. what is the next step for this patient?
refer for surgery (CIN2/3)
Menopause can cause elevated FSH/LH, what else can cause this?
castration
precocious puberty
what is inhibited by dopamine?
prolactin
decreased muscle mass, osteoporosis, impotence and oligo/amenorrhea are all signs of what
hyperprolactinemia
