Lecture 4: Well Woman Exam

Question 1

How should a pt’s PSH be recorded?

Answer 1

Chronologically including dates, hospital, surgeon and any complications

Question 2

What are the components of gravidity and parity; in the correct order?

Answer 2

• Gravidity: the # of times a women has been pregnant
• Parity: the # of pregnancies that led to a birth at or beyond 20 wks
• Term: 37-42 wks
• Preterm: 20-36 wks and 6 days (36+6)
• Abortion: includes all losses before 20 wks i.e., therapeutic/elective AB, spontaneous AB and ectopics
• Living

Question 3

2 most common causes of amenorrhea?

Answer 3

Pregnany and menopause

Question 4

Post coital (after sex) bleeding in female is a concern for what?

Answer 4

Cervical cancer

Question 5

Post-menopausal bleeding is a concern for what?

Answer 5

Endometrial/uterine cancer

Question 6

Heavy bleeding, passing clots etc. in a female may indicate what?

Answer 6

Structural abnormality

Question 7

How do you use the LMP and Naegeles Rule to estimate date of delivery in pregnant pt?

Answer 7

• Subtract 3 months and add 7 days
• i.e., LMP 07/20/2016 —> EDC = 04/27/2017

Question 8

What is the recommendation for breast exams in women aged 20-39 and 40+?

Answer 8

• Every 1-3 years for women ages 20-39
• Annually for women 40+

Question 9

Pelvic exams are recommended to begin at what age?

Answer 9

21 y/o

Question 10

ACOG recommends the initital visit to OB/GYN for screening and the provision of preventative health care servives and guidance take place when?

Answer 10

Btw age 13-15

Question 11

Which immunizations should be given/offered to girls btw ages 13-18?

Answer 11

• Tdap vaccine booster: once btw ages 11-18 years
• HBV: one series if they have not yet received
• HPV vaccine: one series btw ages of 9-45 y/o

Question 12

In screening girls 19-39 y/o what important parts of their sexual practices need to be discussed?

Answer 12

Type of intercourse: vaginal, anal, and oral; sexual orientation; number of partners, and contraceptive use

Question 13

A clinical breast exam should occur q 1-3 years beginning at what age?

Answer 13

20 y/o

Question 14

What are recommendations for cervical cytology in pt’s age 21-29 and age 30+?

Answer 14

• 21-29 y/o: screen q 3 years w/ cytology alone
• 30+: screen q 3 years w/ cytology + co-test w/ cytology and HPV testing q 5 years

Question 15

What are 2 components of the psychosocial evaluation in females 19-39 years that should be discussed?

Answer 15

• Intimate partner violence
• Acquaintance Rape prevention

Question 16

How often should woman 50+ y/o receive a colonoscopy?

Answer 16

Every 10 years = preferred method

Question 17

At what age should women get a lipid profile assessment and how often?

Answer 17

q 5 years beginning at 45 y/o

Question 18

What are the criteria that must be met to discontinue cervical cytology in women aged 65+?

Answer 18

• Women with no hx of CIN2 or higher
• 3 consecutive negative prior cytology results
• 2 consecutive negative co-test within previous 10 years

Question 19

If female >65 y/o has hx of CIN2 or 3; what is recommendation for cervical screening?

Answer 19

Need to continue pap x 20 years after even if it extends >65 y/o

Question 20

In absence of new risk factors what is recommendation for bone mineral density screeing in women 65+ y/o?

Answer 20

Do NOT screen more frequently than q 2 years

Question 21

Which vaccine should be offered at 65 y/o+?

Answer 21

Pneumococcal vaccine

Question 22

A female with pigmentation over the bridge of the nose and under eyes may be showing signs of what?

Answer 22

Pregnancy

Question 23

Which specific speculum has wider blades and is more appropriate in multiparous females?

Answer 23

Graves speculum

Question 24

What is the most common vaginal infection?

Answer 24

Bacterial vaginosis