Well women exam

Question 1

Gardasil

Answer 1

months 0,2,6

Question 2

1st GYN visit

Answer 2

13-15

only pelvic if sexually active or symptomatic

Question 3

HIV testing

Answer 3

routine from 19-63

Question 4

mammogram

Answer 4

every 1-2 years at 40 and every year at 50

Question 5

colon cancer

Answer 5

colonoscopy
flex sig every 5
Fecal immunochemical testing every year
barium enema every 5

Question 6

TSH screening

Answer 6

TSH screening every 5 years at age 50

Question 7

Lipid screening

Answer 7

every 5 years at age 45

Question 8

Fasting Glucose

Answer 8

every 3 years at age 45

Question 9

Bone Density

Answer 9

at 65 or risk factors

Question 10

Routine Screening at 
20-
up to 25- 
40- 
45-
50-
65-

Answer 10

20- cholesterol with increased risk for CHD (obese, smoker, Family Hx, Diabetes)
up to 25- gc/chlam
40-mammogram q1-2
45- Lipids q5 /Glucose q3/Colon cancer for AA
50- TSH q 5/colon cancer screening.
65- Bone density (not more than q 2)

Question 11

HIV and pap smears

Answer 11

q 6 months in 1st year

HPV cotesting is not recommended

Question 12

Adult Immunization

Answer 12

Td q 10 years and 1 dose of Tdap
MMR 1-2 doses between 19-49, 1 dose after 50
Herpes Zoster 1 dose>60 years old
Pneumonia- at 65

Question 13

Weight Loss Drugs

Answer 13

Orlistat: inhibits fat absorption
Phentermine: appetite suppressant
Sobutramine: appetite suppressant
Diethylpropion : appetite suppressant
Loracaserin HCl (Belviq) : appetite
suppressant
Qsymia (Phenteramine + Topiramate [antiseizure])
\: appetite suppressant

Question 14

When to consider bariatric Surgery

Answer 14

BMI > 40 or BMI > 35 with significant comorbidities

Question 15

When to use statins

Answer 15

Four groups most likely to benefit from statin therapy are identified:

1. Patients with any form of clinical ASCVD
2. Patients with primary LDL-C levels of 190 mg per dL or greater
3. Patients with diabetes mellitus, 40 to 75 years of age, with LDL-C levels of 70 to 189 mg per dL
4. Patients without diabetes, 40 to 75 years of age, with an estimated 10-year ASCVD risk ≥ 7.5%

Question 16

Rouex-en-Y nutritional deficiencies

Answer 16

Fat soluble vitamins (A,D,E,K)
Vitamin B12
Iron

Question 17

Outpatient treatment of pneumonia

Answer 17

Doxycycline

Question 18

Who takes baby Aspirin

Answer 18

81 mg between 50 and 70 with a 10% risk of CVD in 10 years

Question 19

Metabolic Syndrome

Answer 19

In women, defined as 3 out of the following 5:
– Abdominal circumference ≥ 88 cm (35 in)
– Triglycerides ≥ 150 mg/dl
– HDL cholesterol < 50 mg/ dl
– Elevated BP ≥ 130/85
– Fasting glucose ≥ 110 mg/dl

Question 20

When to start interventions for BP in diabetes or renal disease

Answer 20

130/80

Question 21

What is cholesterol screening

Answer 21

Screening should include:
‐Total cholesterol
‐High density lipoprotein cholesterol
If total cholesterol is ≥200 mg/dl or HDL is <40mg/dl ,
fasting lipoprotein profile should be checked.

Question 22

Diabetes Screening

Answer 22

Prediabetes
- FBG>100
2 hr >140
HbA1c >5.7

Diabetes
FBG >126
2 hr>200
HbA1c >6.5

Question 23

When asked about well women make sure you remember..

Answer 23

Depression screening
Domestic Violence screening
Smoking screening
Standard cancer, heart disease and bone screening
Vaccines

Question 24

Migraine definition

Answer 24

A migraine is a headache lasting 4 to 72 hours and must have nausea, vomiting, or photophobia, as well as at least two of the following: unilateral location, pulsating quality, moderate to severe pain, and aggravation by routine physical activity.

Question 25

When do migranes occur in the “cycle”

Answer 25

While on CHCs, migraines typically occur during the hormone-free interval, and are termed estrogen withdrawal-associated headaches. Using continuous dosing with a shortened or absent hormone free interval typically alleviates these headaches.