Med-U Cases

Question 1

Risk of Breast Cancer is increased in?

Answer 1

Patients with first degree relatives who have breast cancer. E.g parent or a sibling.

Question 2

Breast exam timings. For women in their 20s and 30s? For women in 40 and over?

Answer 2

ACS recommends the following regarding clinical breast exams (CBE):

1. Women in 20s and 30s= every 3 years.
2. Women 40 and over= every year.

Question 3

Pap Smear equipment choice:

1. To obtain samples from ectocervix?
2. To obtain samples from endocervix?

Answer 3

1. To obtain samples from ectocervix= Ayers spatula.

2. To obtain samples from endocervix= Cytobrush.

Question 4

Pap smear recommendations timeline:

1. At 21 years?
2. 21-29 years?
3. 30-65 years?

Answer 4

1. At 21 years= cervical cancer screening should begin.
2. 21-29 years= every 3 years.
3. 30-65 years= every 5 years if also co-testing for HPV or every 3 years with cytology alone.

Question 5

Recommendations for Breast cancer screening:

ACS v/s USPSTF.

Answer 5

ACS recommends:

1. 45-54 years= mammograms every year.
2. 55 and over= mammograms every 2 years or every year if they prefer.

USPSTF recommends:
50-74= mammography every 2 years.

Question 6

Osteoporosis screening?

Answer 6

> 65 years= screening done with DEXA ( dual energy x-ray absorpitometry).

Question 7

Calcium intake recommendations in pre-menopause v/s post-menopause?

Answer 7

Pre-menopause= 1000mg daily.
Post-menopause= 1200mg daily.

Question 8

Why children have higher risk of dehydration than adults?

Answer 8

Children have:

1. Higher BMR
2. Have higher surface area: body mass ratio—> more evaporation
3. Have more water weight

Question 9

Risk of administering Bicarbonate in DKA?

Answer 9

Cerebral edema—- can lead to cranial nerve palsies.