TBL-Women's Health** & Diabetes Flashcards
Procedure used for cervical cancer screening?
When does it start and stop?
pap test
start at 21, stop at 65/ after hysterectomy
How frequently should women be screened for cervical cancer?
How does this differ between age grousps?
21-29: every three years
30-65: Every 3 years OR every 5 years + HPV test
When should average risk women begin mammograms for breast cancer screening?
Discontinue screening?
How often should women be screened?
Begin: 45 yoa
Discontinue: 75 yoa
Screen every 2 years
BRACA1 and BRACA2 code for what type of protein?
tumor suppressor proteins (repair DNA and ^ genetic stability)
BRACA1 risk for breast cancer/ ovarian cancer vs. BRCA 2: which is higher?
BRCA 1 higher risk; both have risk higher than average woman
Family hx factors to consider for genetic screening: (5)
- breast cancer before 50 yoa
- multiple female tumors simultaneously
- 2+ BRCA cancers in 1 relative
- male with breast cancer
- Ashkinazi Jew
How do we manage risk in patients with mutation (3)
- ^ screening: yearly breast exam, mammogram + MRI
- bilateral prophylactic mastectomy
- chemoprevention: tamoxifen, raloxifene, OCPs
What does an ambiguous result mean in regards to BRACA testing:
we do not know if it will lead to developing cancer
Why isnt the HPV vaccine recommended for women over 26 yoa?
When tested in women 25-45there was no benefit
Why did the USPSTF and ACS drop recommendations for self and clinical breast exams?
no evidence to improve outcome; lead to more false +’s and unnecessary biopsies (^ infection risk)
What is the benefit of a 9 valent HPV vaccine for boys and young men?
prevents anorectal cancer and genital warts
**ALSO I THINK PENILE CANCER CAUSE THATS SQUAMOUS CELL/HPV related!!!
21 yo single female, sexually active for 3 years, presents for first pap smear–what is the cervical cancer screening?
check every 3 years; no HPV because probably + and will clear
32 yof married, monogomous, last 3 paps were normal: what is the cervical cancer screening?
check every 3 years or 5 years with HPV cotest
54 yof; 6 mos post radical hysterectomy: what is the cervical cancer screening?
NOTHING
66 yof, hx of CIN2 treated @49 yoa, last 3 paps normal:
what is the cervical cancer screening?
5 years w HPV or every 3 years alone for 20 years after last (-) pap
Why are children not tested for BRACA1 or BRACA2
currently no at risk reduction strategies for children exist
Diagnostic criteria for DM?
- fasting BG over 126
- random glucose/ glucose challenge test over 200
- ++6.5 or more a1c per meadows
Modifiable risk factor for both micro/macrovascular disease in diabetics?
One example of macrovascular disease? micro?
hypertension
macro- gangrene
micro- renal disease, retinal disease
What is the most common cause of diabetic complications? How is this used in terms of measuring disease burden?
- glycosylation of proteins
- Hba1c measures glycosylated Hb, best long term measurement of DM control
Common presentation of autonomic neuropathy in diabetics?
orthostatic hypotension
At what age should all patients be screened for DM?
45+
DM1 or DM2: which has the most significant genetic component?
DM2
In diabetics, how often should you check the following:
- microalbumin
- eyes
- feet
- A1c
- annual microalbumin, eye exams
- ALWAYS check the feet every exam
- A1c every three months
Target BP for diabetics?
130/80 or less; always give them statins as well
