Comprehensive GYN Exam

Cancer Screenings

100

These guidelines were updated in 2019 and are currently being used to emphasize current and future risk of pre-cancer (CIN3+) to determine management and next steps

What are the ASCCP guidelines?

200

These models are used to determine high risk for invasive breast cancer over the next 5yrs and up to 90yrs old (aka lifetime risk)

What is the Gail Model or Tyrer-Cuzick score?

300

These are cervical cancer screening recommendations

What is cervical cytology 21 to 29yrs old q3yrs, Primary HPV testing 25 and older q5yrs, Cervical cytology and HPV co-test 30 to 65 q5 yrs?

400

These are all options for colon cancer screening

What is: Colonoscopy q10yrs, Fecal occult blood or FIT q1yr, Flexible sigmoidoscopy q5yrs, Double contrast barium enema q5yrs, CT colongraphy q5yrs, Cologuard (Stool DNA) q3yrs?

500

These are breast cancer screening recommendations

What is Clinical breast exam [starting at 25yrs old q1 to 3yrs], Mammo [starting at 40yrs q1 to 2yrs until 75 (share decision making)], Self breast awareness for all patient's?

Lifestyle Counseling

100

These are options for treatment including patch/gum or lozenge's. Others include bupropion or varenicline

What are smoking cessation options?

200

1. Intense fear of weight gain, distorted perception of body weight and shape. Low BMI <18.5

2. Purging type: vomiting, laxatives or Non purging type: fasting, excessive exercise

What is anorexia nervosa? What is bulimia nervosa?

300

These are the screening tools used for alcohol abuse at well woman visit and also in pregnancy

What is TACE and TWEAK?

400

These are some preconception counseling recommendations and considerations

What are smoking risks, teratogenic medications, substance use/food exposures, radiation exposures, caffeine use, dental concerns, supplementation, diet/exercise/weight loss, immunizations, co-morbid conditions, genetic concerns? 

500

These are screening/test recommendations for obese patient's that differ from the general population

What is

OSA screening: STOP-BANG

Lab tests: Fasting glucose or DM screen, TSH, Lipid profile. 1st tri: 1hr GCT, TSH

Screening for metabolic syndrome 

Primary Care

100

These are the stages of hypertension

What is 

Normal: <120/80

Elevated: 120-129/<80 

Stage 1: 130-139/80-89

Stage 2: >140/>90

Hypertensive urgency/emergency: >180/>120

200

These 4 lab results can be used to diagnose diabetes

What is Fasting glucose >126 (x2), 2hr GTT >200, HbA1c >6.5, Random glucose >200 and symptoms present?

300

This calculator allows us to evaluate a patient's 10yr and lifetime risk for atherosclerotic cardiovascular disease (Defined by coronary death, nonfatal myocardial infarction, fatal or nonfatal stroke). Done in women 40 to 75yrs of age.

What is the ASCVD risk calculator?

400

These are treatment options for acute back pain

What are NSAIDs, muscle relaxers, PT. Should be 4 to 6 weeks for improvement. If none by 12 weeks, then X-ray AP/lateral LS spine is done, referral recommended. MRI is done after above if persistant concerns. Imaging done immediately: Neuro finding/Hx trauma/Hx malignancy/Age >50, immunocompromised/infection/IV drug use ?

500

This is how asthma is categorized

What is 

Intermittent: <2/week, <2/nights per month. FeV1= normal

Mild persistant: >2/week <daily, 3-4/nights per month. FeV1= normal

Moderate persistant: Daily, >1 night per week. FeV1= 60-80% of predicted

Severe persistant: Throughout day and night. FeV1= <60% of predicted

Immuninzations

100

Given to all >6 months of age, annually. Oct through May. CI: those who develop Guillain-Barre Syndrome within 6 weeks after previous administration

What is the influenza vaccination?

200

Side effects most commonly include HA, fever, swelling at injection site, rarely syncope. Observe adolescents for POTS for at least 15mins. Approved 9 to 45yrs of age.

What is the HPV vaccination?

300

These are pregnancy recommended vaccinations

What are the TDAP, Influenza, Hepatitis B, RSV and C19 vaccinations?

400

Conception is delayed 3 months for 2 doses of either vaccination or Conception is delayed for 1 month for single dose booster

What is MMR and the Varicella vaccination?

500

Allergy to yeast is a contraindication for administration

What are the contraindications for HPV and Hepatitis B vaccinations?

Random

100

Age 13 to 15 is when __

Age 21 is when __

What is the first age they should be seen at the GYN? What is the first age they should be getting a pelvic exam

200

Patient is here for her annual exam. These things are important regarding her family history

What is history of DVT, CV disease, GYN conditions: PCOS, endometriosis, leiomyoma, Breast/colon/endometrial/ovarian Ca, bleeding do like von willebrand or G6PD, Genetic do (like CF, Huntington's disease)?

300

This is a step by step example of how to approach an annual GYN appointment

Discussion

400

These are osteoporosis screening recommendations

What is Age >65 done q15yrs if normal, q5yrs for osteopenia or q2yrs if risk factors develop or on medication?

500

These are the thyroid testing result changes expected in pregnancy and if needed, this is how you start the patient on treatment

What is 

TSH level decrease in first trimester, no change in free T4 but increased total T4 levels

LevoT 1.7mcg/kg/day or 1.0mcg (elderly). Rpt TSH 4 to 6 weeks