Well Woman Exam

Question 1

What is Gravidity and Parity

Answer 1

G = # of times a woman has been pregnant P = # of pregnancies that led to a birth ≥ 20 wks or infant > 5 grams

Question 2

What is TPAL in terms of Parity

Answer 2

T = term births (37-42 wks) P = preterm births (20-36+6 wks) A = abortions (< 20 wks) L = living (live births)

Question 3

Def: Gravid

Answer 3

Woman who is or has been pregnant

Question 4

Def: Primigravida

Answer 4

Woman who is in or has experienced her first pregnancy

Question 5

Def: Multigravida

Answer 5

Woman who has been pregnant more than once

Question 6

Def: Nulligravida

Answer 6

Never been pregnant

Question 7

Def: Primipara

Answer 7

Has given birth to one child

Question 8

Def: Multipara

Answer 8

Has given birth to > 1 child

Question 9

Def: Nullipara

Answer 9

Has never given birth or never had a pregnancy > 20 wks

Question 10

What is the avg age of menarche

Answer 10

12-13 yo

Question 11

Def: Primary amenorrhea

Answer 11

No menarche by age 16 yo

Question 12

What is the avg # of days of a cycle

Answer 12

21-35 days

Question 13

If a pt has post-coital bleeding, what should the concern be

Answer 13

Cervical cancer

Question 14

If a pt has post-menopausal bleeding, what should the concern be

Answer 14

Endometiral/Uterine cancer

Question 15

If a pt has heavy bleeding or passes clots, what should the concern be

Answer 15

Structural abnormality

Question 16

Def: Naegeles Rule

Answer 16

Establishes an estimated date of confinement (EDC) (LMP - 3 months) + 7 days = EDC (LMP + 9 months + 7 days = EDC

Question 17

How often should women b/w 20-39 have a clinical breast exam

Answer 17

Every 1-3 years

Question 18

What are the breast exam guidelines for a women > 40 yo

Answer 18

Annual clinical exam and mammogram

Question 19

When should pts begin annual pelvic exams

Answer 19

21 yo

Question 20

What are the risk factors for bone mineral density exam earlier than required

Answer 20

Hx of Fx BW < 127 lbs Medical cause of bone loss

Question 21

What are the risk factors for mammography earlier than required

Answer 21

Hx of BC or FH of premenopausal BC or OC Positive for BRCA1/2 Hx of high risk breast biopsy

Question 22

What are risk factors for lipid profiles earlier than required

Answer 22

Hx of CAD BMI > 30

Question 23

What are risk factors for CRC screening earlier than required

Answer 23

FH of CRC FH of FAP or HNPCC Hx of CRC, adenomatous polyps, IBD, UC, CD

Question 24

What are risk factors for DM screening earlier than requried

Answer 24

BMI > 25 Native America, Latina Hx of GDM

Question 25

What are risk factors for TSH screening earlier than required

Answer 25

FH of thyroid disease

Question 26

What are risk factors for STI screening earlier than required

Answer 26

Hx of multiple sex partners Hx of STIs Sexually active adolescents

Question 27

Wha are the risk factors for meningococcal vaccination

Answer 27

Adults w/ asplenia 1st year college student living in dorm/military recruits Pts traveling to endemic/epidemic areas

Question 28

When/how often should pts be screened for BMD

Answer 28

65 yo q 2 years (if no risk factors)

Question 29

When/how often should pts be screened w/ mammography

Answer 29

40 yo q 1 year

Question 30

When/how often should pts be screened w/ a lipid profile

Answer 30

45 yo q 5 years

Question 31

When/how often should pts be screened for CRC

Answer 31

45 yo for AA q 10 years 50 yo for everyone else q 10 years

Question 32

When/how often should pts be screened for DM

Answer 32

45 yo q 3 years

Question 33

When/how often should pts be screened for TSH levels

Answer 33

50 yo q 5 years

Question 34

When/how often should pts be screened for STI's

Answer 34

≤ 25 yo = if sexually active ≥ 26 yo = if at high risk

Question 35

When should the MMR vaccine be given if the pt is not previously immunized

Answer 35

B/w 40-54 yo

Question 36

When should a pt receive the Varicella Zoster vaccine

Answer 36

\> 60 yo

Question 37

When should a pt receive the Pneumococcal vaccine

Answer 37

≥ 65 yo

Question 38

How often should the Tdap booster be given

Answer 38

q 10 years

Question 39

What are the recommendations for cervical cytology and HPV screening

Answer 39

21-29 yo = cytology alone q 3 years (unless risk factors) \> 30 yo = cytology alone q 3 years OR cytology + HPV q 5 years

Question 40

When should pts be given the HPV vaccine

Answer 40

B/w 9-26 yo

Question 41

Def: Chloasma

Answer 41

Pigmentation over bridge of the nose and under eyes that may be a sign of pregnancy

Question 42

What is a sign on linea nigra that could indicate pregnancy

Answer 42

Pigmentation of the linea nigra

Question 43

What is the difference b/w a spatula and a cytobrush

Answer 43

Spatula = scrapes ectocervic during PAP Cytobrush = obtains specimen that is scrapped off during PAP

Question 44

What pathogen is a "strawberry cervix" associated w/

Answer 44

Trichomonas

Question 45

Which pathogen is the most common cause of vaginal infection

Answer 45

Bacterial Vaginosis

Question 46

How do you test a pt for gonorrhea/chlamydia if there is cervical discharge present

Answer 46

Swab inserted into cervical os for 45 seconds