Well Woman Exam

Question 1

What do you include on surgical history?

Answer 1

procedures chronologically, dates, hospital, surgeon, and any complications

Question 2

What is gravidity and parity?

Answer 2

Gravidity: # of times a woman has been pregnant

Parity: Term, Preterm, Abortion, Living

Question 3

What are the most common causes of abnormal bleeding?

Answer 3

pregnancy and menopause

Question 4

How old should a woman be at her first OB/GYN visit?

Answer 4

13-15

generally no pelvic exam

chlamydia and gonorrhea testing if sexually active (urine sample); HIV

Question 5

What vaccines are give under 18?

Answer 5

Tdap vaccine booster (once b/t 11-18)

Hep B

HPV

Influenza

MMR (if not previously immunized)

Varicella

Question 6

What PE is added in the 19-39 age group?

Answer 6

breast exam q 1-3 years starting at 20

pelvic exam (19-21 when indicated by hx, 21+)

pap smear

chlamydia and gonorrhea testing (if sexually active)

Question 7

How often do 40-64 y/os get breast exams?

Answer 7

yearly clinical exams

*colorectal cancer screening begins 45-50 y/o

Question 8

What lab tests are done for 40-64 y/os?

Answer 8

HIV

Lipid profile assessment (q5 after 45)

Mammography (yearly after 40)

TSH (q5 after 5)

Diabetes testing (q 3 years after 45)

Question 9

What vaccine is added for 60+?

Answer 9

varicella zoster

Question 10

When do we discontinue pap smears?

Answer 10

no history of CIN 2 or higher, and 3 consecutive negative prior cytology results

*if hx of CIN 2 or 3, need to continue pap for 20 ys (even after 65)

Question 11

What lab tests are done for 65+?

Answer 11

bone mineral density screening (q2 yrs)

Lipid profile assessment

Mammography

TSH

Diabetes

Urinalysis

Question 12

What vaccine is added 65+?

Answer 12

pneumococcal vaccine

Question 13

Who gets meningococcal vaccination?

Answer 13

adults with anatomic or functional asplenia

freshman college students in dorms

military recruits

pts traveling to hyperendemic or epidemic areas

Question 14

If you notice darkening of linea nigra in the midline of the abd can be a sign of?

Answer 14

pregnancy

Question 15

What are the various types of speculums?

Answer 15

grave’s is also good for obese pts

Question 16

At what angle do you insert the tip of the speculum?

Answer 16

45^o

may need to adjust angle depending on prolopase (cystocele, rectocele…)

Question 17

If the cervix is not in view, you should…

Answer 17

NOT pull speculum out intially

If you cannot find the cervic after readjustment, remove speculum and perform bimanual exam + review surgical hx

Question 18

What is Chadwicks sign?

Answer 18

blueish coloring seen in a pregnant cervix

Question 19

What are the benefits of liquid based prep over conventional slide?

Answer 19

both can do cytology

liquid: cytology + HPV, evaluate ASCUS cytology, gonorrhea/chlamydia testing

Question 20

What is the cervical consistency of a pregnant pt? non pregnant?

Answer 20

pregnant: softer
non: firm (like tip of the nose)

Question 21

What are the positions of the uterus?

Answer 21

Question 22

How big should ovaries feel?

Answer 22

3 x 2 x 1 cm