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  #1  
Old 04-09-2010
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Question Routine Gynecologic Visit

A 55-year-old woman presents to her gynecology clinic for a routine checkup. She says she has been too busy for the past 3–4 years to come to the clinic. She is G2P2, and both children were delivered by spontaneous vaginal delivery without complications. She is currently sexually active with her husband, and has no other partners. She says she has an occasional glass of wine with dinner, and has smoked about half a pack per day for the past 25 years. To her knowledge, there is no family history of cancer, heart disease, or diabetes. Her blood pressure is 115/75 mm Hg and heart rate is 80/min. She is 170 cm (5 ft 7 in) tall and weighs 65.8 kg (145 lb). Skin examination reveals no suspicious moles. Breast examination reveals no masses. Pelvic and bimanual examinations are likewise within normal limits. A sample is taken for a Pap smear without significant cervical bleeding. Mammography from 3 years ago shows no suspicious masses. A Pap smear from 3 years prior showed no atypical cells. Relevant laboratory findings are:
WBC count 7500/mm3
Hemoglobin 12.4 g/dL
Platelet count 220,000/mm3
Total cholesterol 195 mg/dL
LDL 125 mg/dL
HDL 45 mg/dL
What is the next appropriate step in the management of this patient?
(A) Cancer antigen-125
(B) Endometrial biopsy
(C) Mammogram
(D) Transvaginal ultrasound
(E) X-ray of the chest
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aungawa (04-10-2010), dr-ahmed (04-10-2010)



  #2  
Old 04-09-2010
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I think mammogram .... After 40 years with no risk factor should do annually ..
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Old 04-09-2010
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I vote for mammo, although pap smear is more important but not mentioned in the choices.
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Old 04-10-2010
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You guys are right.
This question is about which of the following screening tools is recommended and definitely only mammography is currently recommended.
Important note. even though she's a smoker there's no use of CXR in preventing cancer
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