To Be Trauma Informed
AUB-PALM COEIN
Unplanned Prevention
PAP
100
Using terms like "spread," "feel," "insert," "looks good" are examples of this.
What is trigger language?
100
24 yo G0 with history of heavy periods since menarche. In addition to consideration for hcg, coagulopathy and thyroid testing; you order this screening test.
What is ferritin with cbc?
100
36 yo G2P2002 here for uncontrolled diabetes. You ask about plans for pregnancy - patient not desiring pregnancy and using condoms only, does not want to be on birth control, may want children in future. You offer to prescribe this.
What is emergency contraception? (other acceptable is folic acid, but EC is preferred).
100
23 yo G0 had first pap, and came back as abnormal with LSIL. She had a pap prior to that one year ago that was LSIL. You advise this.
What is repeat Pap smear in 1 year?
200
This is preferred attire for patient when asking reproductive health questions (ex: sexual health, vaginal concerns).
What is dressed?
200
47 yo G2P2002 with 5 month history of very heavy monthly periods. History of fibroids. Currently passing clots and soaking through tampon with pad every 1-2 hours. Thinking her fibroids are causing it. She has a normal pap, TSH testing, an ultrasound the showed multiple fibroids. In addition to hormonal treatment, you advise this.
What is an endometrial biopsy?
200
32 yo G3P3003 who recently diagnosed with DVT postpartum at 4 weeks. She is now 8 weeks postpartum and does not desire a pregnancy at this time. She has a history heavy and painful menses. You advise this.
What is progesterone containing contraception?
200
This is what determines interval follow up following pap result.
What is risk of CIN 3+?
300
This is often not appropriate to ask to discuss in detail just prior to planned gyn exam.
What it trauma history?
300
63 yo G3P3003 in menopause x 12 years, here for follow up in vaginal bleeding x 1 day. She initially had a virtual visit and was advised an ultrasound. Her ultrasound was normal with endometrial stripe of 2mm. You advise this.
What is a gynecological exam?
300
40 yo G3P3003 desiring to take pills for contraception. No past medical history - including neg for migraines or stroke. You counsel preferred method is norethindrone (mini pill) in this setting.
What is current smoking?
300
32 yo patient with recent HPV infection on pap screening. You review her history - she has risk for HPV infection in the future, you perform shared decision making for this.
What is HPV vaccination?
400
This position is a trauma informed approach to gynecological exams and found in research studies to have significant reduction in sense of vulnerability and reduction in physical discomfort.
What is frog legged position? 
400
42 yo G2P2002 with no past medical history. She originally had lab work up - no anemia, normal thyroid - and a progesterone IUD placed which helped initially with bleeding, but now not helping. Her pap and gyn exam was normal with visible strings. You advise this.
What is endometrial biopsy?
400
This is the most efficacious, cost effective, and safe form of contraception.
What is vasectomy?
400
37 year old with history of abnormal pap. 4 years ago had LSIL, followed by CIN 1 on colposcopy, had negative pap/HPV. She was advised 3 year follow up. You perform her pap and it is ASCUS/HPV negative. This is your next best step.
What is download ASCCP app? (acceptable 3 year pap with HPV).