nr 602 final exam 100% Correct!!
ASCCP recommended management for an ASCUS pap result with high risk hpv 16 cotest in 26 year
old no abnormal paps - ANSWERcolposcopy
What is included in the well women of an adolescent? - ANSWERhealth history
menses
gynecologic and pregnancy issues
psychosocial
abuse drugs alcohol use
physical exam
screening tests
immunizations
When does ACOG pap smear start - ANSWER21 years old done every three years
ACOG pap for over 30 yrs old - ANSWERevery five years with HPV test completed
ACOG when can you stop pap smear - ANSWERcan stop at 65 if negative history for 10 years or if
they had a hysterectomy with no history of cervical cancer
Bethesda pap smear report reads LSIL is what classification? - ANSWERCIN 1
A single Pap smear reading of ASCUS in a patient negative for HPV infection should have what as
follow-up? - ANSWERroutine screening
a female patient is 35 years old. she has never had an abnormal PAP smear has regular screening
since age 18. If she has a normal PAP smear with HPV testing today, when should she have the next
cervical cancer screening? - ANSWER5 years
A young sexually active is having her first pap smear what would you explain? - ANSWERpap smear
detects cervical cancer
26 year old pap smear shows negative and positive HPV what do you do? - ANSWERrepeat HPV and
pap
what is not part of criteria for older women to cease pap smears? - ANSWERover 55 year old
no menarche in a 15 year old with no medical problems and Tanner stage 1 with a uterus -
ANSWERprimary amenorrhea
No menses for at least 6 months - ANSWERsecondary amenorrhea
female athlete triad - ANSWERdisordered eating, amenorrhea, osteoporosis
labs for female athlete triad - ANSWERHCG
serum prolactin
,serum TSH,FSH, LH
if amenorhea lasts longer than 6 months do what? - ANSWERbone density test
treatment plan for female athlete triad - ANSWERincrease caloric intake, decrease exercise
prescribe ca and vit d 1200/1500 daily and vitamin e 400 iu daily
complications of female athlete triad - ANSWERosteopenia/osteoporosis (stress fracture)
myocardial atrophy, arrhythmia, hypotension, brady
hypoglycemia, dehydration, electrolytes
lanugo, telogen effluvium hair loss zerosis dry skin, infertility, low body mass, cachexia, respiratory
failure
purpose of progesterone challenge - ANSWERendogenous estrogen
primary and secondary amenorrhea originates in hypothalamus - ANSWERsheehans syndrome
symptoms of breast cancer ( early) - ANSWERNone
Non-painful mass (occasionally pain)
Eczematous nipple (Paget's)
Serosanguinous (bloody) nipple discharge
late symptoms of breast cancer - ANSWERskin or nipple retraction
axilary lymhadenpathy
breast enlargement
redness, edema, brawny induration
peau d' orange
pain
fixation of the mass to the skin or chest wall
very late findings of breast cancer - ANSWERulceration
supraclavicular lymphadenopathy
edema of the arm, bone, lung, liver, brain or other distant metstases
Follow up for breast cancer patients - ANSWER1. Bilateral mammogram 6 months after complete
radiation post-lumpectomy; Mammogram yearly after
2. Contralateral mammogram annually post-mastectomy (entire breast + pectoralis major fascia)
PE every 3-6 months for 3 years then annually
fibrocystic breast disease - ANSWERthe presence of single or multiple benign cysts in the breasts
, signs and symptoms of fibrocystic breast disease - ANSWERoccurs 2 weeks before the onset of
mensus and worst right before the menstrual cycle. resolves after menses starts often in women in
their 30's. breast lumps are rubbery and mobile to touch
Tx for fibrocystic breast disease - ANSWEROnce a benign diagnosis or normal findings have been
established by biopsy or on clinical or imaging findings, simple reassurance will provide many
patients with adequate relief.
For those patients who still seek treatment, symptomatic relief by avoiding trauma and by wearing a
bra with adequate support can be very helpful. The role of caffeine consumption in the development
and treatment of fibrocystic change has never been proven; however, many patients report relief of
symptoms after abstinence from coffee, tea, and chocolate. Similarly, observational studies have
suggested that low-fat diets can provide some relief. The data regarding the utility of vitamin E
supplementation and evening primrose oil are controversial. Mild analgesics such as acetaminophen
and nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to relieve breast pain. For more
symptomatic women, danazol and tamoxifen have been found to be effective, although their
significant side effects have limited their acceptability and utility.
Fibroadenoma - ANSWERbenign breast lesion 15-40 yrs old
risk factors for fibroadenoma - ANSWERmultiple fibroadenomas associated with rate cancer
syndromes like mafficci syndrome, Cowden syndrome, carney complex early ETOH consumption
findings with fibroadenoma - ANSWERpainless, firm or rubbery mass with well defined borders,
freely mobile, changes with size may occur with pregnany or menstrual cycle, lesions under 5 cm,
considered to be giant fibrodenomas no nipple discharge
Dx of fibroadenoma - ANSWERmammo, us to differentiate fluid filled to solid mass, fine needle
aspiration biopsy, open biopsy
Intraductal papilloma - ANSWERbenign tumor within the ductal system of the breast, one of the
heterogeneous group of lesions encompassed by the term benign breast disease seen in females 30-
50
risk factors for intraductal papilloma - ANSWERmultiple papilloma's which increases the risk for
breast cancer
dx studies for intraductal papilloma - ANSWERmammo, us mri, galactography, fine needle or core
biopsy
a pap smear result of atypical squamous cells of undetermined significance rule out high grade
squamous intraepithelial lesions will require which procedure next? - ANSWERcolposcopy
pap smear is ASCUS what is next? - ANSWERfollow up pap smear
Bartholin's glands obstruction symptoms - ANSWERpain, tenderness, dyspareunia, walking with
adducted thighs
assessment findings of Bartholin's glands obstruction - ANSWERfirm labia mass or cyst, erythema,
induration, edema of
treatment for bartholins gland obstruction - ANSWERwarm baths
