Latrina

Question 1

Mass one side feels hard, irregular, immobile, located tail of spence, skin color peud orange (resembles orange peel), dimpling retraction, painless, bloody nipple discharge,
Dx - order mammogram, refer to breast surgeon

Answer 1

Dominant breast/breast cancer

Question 2

Chronic red scaly rash resembling eczema starts on nipple and spreads to areola, itching, pain, burning sensation, skin lesion enlarges includes crusting, ulceration and bleeding at the nipple.

Answer 2

Paget’s disease of the breast

Question 3

Recent or acute onset red swollen warm area in breast of younger woman, mimics mastitis, no lump, may pit, turn orange, appear bruised, rare but aggressive breast cancer

Answer 3

Inflammatory breast cancer

Question 4

Engorged and painful breasts symptoms 2 weeks before menses and at worst before cycle, resolves after menses Dx - multiple, mobile rubbery cystic masses on both breasts, Tx - stop caffeine, take vitamin E, IS IT “NORMAL IN AGING/ELDERLY”

Answer 4

Fibrocystic breast

Question 5

Family history is high risk, Men are higher risk,
Tx - patient positive referred to breast specialist, MRI and mammogram, high risk in Jews, refer to counseling and mutation testing

Answer 5

BRCA1/2 associated hereditary breast/ovarian Cancer

Question 6

Palpate ovary in 1-year post-menopausal woman

Answer 6

Ovarian cancer

Question 7

Include family history, Jewish descent, BRCA1/2 mutation, lynch syndrome, breast cancer, >55 age, endometriosis, first child at age 30, nulliparity(never completed pregnancy past 20 weeks)

Answer 7

Ovarian cancer risk factors

Question 8

Pelvic exam, transvaginal US, biopsy, intravaginal US, CA124

Answer 8

Ovarian cancer Dx

Question 9

chemotherapy, referral surgical oncology eval and treatment

Answer 9

Ovarian cancer Tx

Question 10

Begins at 21 and every three years till 30 then every 5 years

Answer 10

Pap testing

Question 11

• Recommends at age 30 with HPV testing to every 5 years, - - HIV positive women
  can screen before 21 years of age, stop PAP screening at 65

Answer 11

UPSTF

Question 12

Is a device used like a scalpel cut thru cervix to treat cervical cancer.

Answer 12

Loop electrosurgical excision procedure (LEEP)

Question 13

KOH aids in diagnosing fungal infections hair, nails and skin, KOH works by causing lysis of the squamous cell which makes it easier to see the hyphae and spores, vaginal specimens do not require KOH.

Answer 13

Potassium hydroxide slide

Question 14

Test for BV, fish odor is released after dropping KOH on slide

Answer 14

Whiff test

Question 15

hormone abnormality marked by anovulation, infertility

excessive androgen production and insulin resistance

Answer 15

Polycystic ovarian syndrome

Question 16

High risk for type 2 diabetes, dyslipidemia, metabolic syndrome, endometrial hyperplasia, obesity and cancer, infertility, sleep apnea, hirsutism, acne, amenorrhea
(HIA)

Answer 16

Polycystic ovarian syndrome

High Risk

Question 17

High risk for endometrial cancer
Dx - transvaginal US, testosterone, FSH, fasting glucose.
Tx - low dose contraceptives, spiraladactone for hirsutism, metformin

Answer 17

Post menopause with bleed/PCOS

Question 18

DEXA >-2.5

Answer 18

Osteoporosis

Question 19

-1.5 to -2.4

Answer 19

Osteopenia

Question 20

Vaginal and urinary tract infections screened for diabetes

Answer 20

Persistent infection

Question 21

Responsible for dysmenorrhea

Answer 21

Prostaglandins