Preventive Care

Question 1

Breast cancer occurs in

Dec over time possibly due to dec use of

RF for breast cancer
E
M
N
First birth after 
M
Breastfeeding > than
M
Genes such as \_\_ or \_\_\_ w breast cancer

Answer 1

men and women

HRT

early menarche
Menopause after 51
Nulliparity
35
Menopausal HRT
1 yr
Menopause before 40
BRCA1/2, 1st degree relative

Question 2

2 most concerning mutations to the gyne

BRCA 1 found on

90% risk for

55% risk for developing

BRCA 2 found on

80% risk for

25% risk for

Assc w

Answer 2

BRCA1/BRCA2

Chromosome 17

breast cancer

ovarian cancer

Chromosome 13

breast cancer

ovarian cancer

male breast cancer

Question 3

Annual clinical breast exam w __ every 1-2 yrs from age

Annual clinical breast exam w mammogram yearly after

Yearly __

Answer 3

mammogram, 40-49

50

breast exam

Question 4

Rf for cervical cancer

Start screening at age

21-24yrs screen every ___ yrs

If pap abnormal ASCUS or higher, perform

25-29yrs screen every __ yrs

Pap test w reflex HPV if

30 and above, screen every __ yrs

Pap test plus __

HIV Positive, screen every __mnths in 1st yr, then __

HIV pts are ___ so they need more surveillance

Answer 4

Smoking, HPV exposure

21

3yrs

pap test w reflex HPV

3yrs

pap abnormal (ASCUS or higher)

5 yrs

HPV cotesting

6mnths, yearly

immunocompromised

Question 5

Stop screening for cervical cancer at age ___

if pap ___

no abnormal paps in __

not ___ and no RF for

Answer 5

65

neg 3x in a row

10 yrs

immunocompromised, STDs

Question 6

Cervical cancer can be negativ for

or have ASCUS

Squamous - LSIL
or HSIL

Glandular- AGC
AIS

Answer 6

intraepithelial lesions/malignancy

atypical squamous cells of unknown significance

Low grade squamous intraepithelial lesion
High grade squamous intraepithelial lesion

Atypical glandular cells
Adenocarcinoma in situ

Question 7

Neg Pap and No HPV perform

Negative Pap and +HPV perform

ASCUS/No HPV perform

ASCUS + HPV perform

LSIL/No HPV perform

LSIL + HPV

HSIL perform

AGC perform

AIS perform

Answer 7

routine screening

Repeat pap in 1 yr

Routine screening

Colposcopy

Repeat cotesting in 1 yr

Colposcopy

Colposcopy (or excisional procedure)

Colposcopy +endometrial/endocervical biopsy

hysterectomy

Question 8

Colposcopy- exam of __/__ w magnifying device

___ or ___ used to identify abnormality

Abnormal areas are

CIN I indicates

CIN II/III indicates

Excisional procedures include

Answer 8

cervix/vagina

Acetic Acid/Lugals

biopsied

repeat cotesting in 12m

excisional procedure

Loop Electrosurgical Excision Procedure/ Cold Knife Cane

Question 9

Prevalent STIs include

Screen sexually active, nonpregnant women at inc risk of

Screen preg women for ___

also those at inc risk for

Screen sexually active men at inc risk of

Do not routinely screen women/men who are not

Answer 9

Chlamydia, gonorrhea, hepB/C, HIV, HPV, syphillis

chlamydia, gonorrhea, HIV, syphillis

Hep B, HIV, syphillis

chlamydia, gonorrhea

HIV/syphillis

at inc risk of STI

Question 10

RF for osteoporosis
A
S
H and W
F
P
P
T
Use of
R
More than

Answer 10

age
sex
ht.wt
Femoral neck BMD
Prior fragility fx
Parental hx of hip fracture
Tobacco use
GC
RA
 3 drinks daily

Question 11

Screen for osteoporosis in all women >

also post menopasual women w

Post menopausal women > 50 w RF including F, B, w, H, S, R, EtOH >

Answer 11

65

medical causes of bone loss

Fracture after menopause, BMI<21, w <127
Hip fx, smoker, RA, 2x day

Question 12

RF for colon ca
A
Ethnicity such as
O
Genetics including
Diet
S
S/A

Answer 12

Age >50
AA, Ashkenazi jews
Obesity
FAP, HNPCC, FH
processed meats
Sedentary life
Smoking/Alcohol

Question 13

HNPCC aka
inheritance
high risk of __ and others such as ____, ___
Caused by defect in genes for

Screen for colon ca at age 
Colonoscopy every \_\_ yrs
Yearly \_\_\_
Flex sig every 
FOBT/Flex sig every
Double contrast barium enema every

Answer 13

Lynch Syndrome
AD
Colon Ca, Endometrial/Ovarian
DNA mismatch repair enzymes

50 yrs
10
FOBT
5 yrs
5 yrs
5 yrs

Question 14

RF for skin cancer
O
F
F
E
T
High risk
M

Yearly

Answer 14

Older people
Fair skin/hair/eyes
FH of skin cancer
Excess sun exposure
Tanning beds
moles
Multiple sunburns

body exam

Question 15

Intimate partner violence seen in women of ____ and contributes to

IPV is a pattern of __ or ___ that includes __ injury, __ abuse, __ assault, __ isolation, s____, d___, I___, ___ coertion

Screen for IPV in setting w

Use ___ not assc w patient

offer ___ to indicate screening is done universally

Best to incorporate screening qs into ___ by using intake forms

Answer 15

repro age, many other disorders

assaultive/coercive, physical, psych, sexual, progressive, stalking, deprivation, intimidation, repro

woman alone

professional language interpreters

framing statement

routine medical history

Question 16

Keep resources

Ensure staff receives ___ and that it is __

RF for STIs
M
P
S
P
Use/Partner use of

Answer 16

handy/accesible

training about IPV, regularly offered

Multiple sex partners
Partner has had multiple partners
Sex w someone w STI
Personal hx of STI
IV drugs

Question 17

Common STIs
C/G
H/H
T/S
H
H

Prevent STDs by
K
Use 
Avoid 
Get

Answer 17

Chlamydia, gonorrhea
HIV/HPV
Trich/Syphillis
Hep B
HSV

Know partner
latex condoms
risky sex
immunized (HPV/HepB)

Question 18

HPV vaccines include

prevent against HPV type ___ which causes ___

Gardasil/Gardasil 9 also prevent against type __ which causes

For healthy adults, moderation means __ for women of all ages/men >65

___ drinks a day for men <65

Answer 18

Gardasil, Gardasil 9. cervarix

16/18, cervical cancer

6/11, genital warts

1 drink/day

2