Screening tests

Screening tests US Medical PG Question 1: Group of 100 medical students took an end of the year exam. The mean score on the exam was 70%, with a standard deviation of 25%. The professor states that a student's score must be within the 95% confidence interval of the mean to pass the exam. Which of the following is the minimum score a student can have to pass the exam?

• A. 45%
• B. 63.75%
• C. 67.5%
• D. 20%
• E. 65% (Correct Answer)

Screening tests Explanation: ***65%*** - To find the **95% confidence interval (CI) of the mean**, we use the formula: Mean ± (Z-score × Standard Error). For a 95% CI, the Z-score is approximately **1.96**. - The **Standard Error (SE)** is calculated as SD/√n, where n is the sample size (100 students). So, SE = 25%/√100 = 25%/10 = **2.5%**. - The 95% CI is 70% ± (1.96 × 2.5%) = 70% ± 4.9%. The lower bound is 70% - 4.9% = **65.1%**, which rounds to **65%** as the minimum passing score. *45%* - This value is significantly lower than the calculated lower bound of the 95% confidence interval (approximately 65.1%). - It would represent a score far outside the defined passing range. *63.75%* - This value falls below the calculated lower bound of the 95% confidence interval (approximately 65.1%). - While close, this score would not meet the professor's criterion for passing. *67.5%* - This value is within the 95% confidence interval (65.1% to 74.9%) but is **not the minimum score**. - Lower scores within the interval would still qualify as passing. *20%* - This score is extremely low and falls significantly outside the 95% confidence interval for a mean of 70%. - It would indicate performance far below the defined passing threshold.

Screening tests US Medical PG Question 2: A 32-year-old woman makes an appointment with her family physician for a new-employment physical examination. She has no complaints and the physical examination is unremarkable. The family history is negative for malignancies and inherited disorders. During the visit, she provides the results of a Pap smear taken last week, which reports the presence of atypical squamous cells of undetermined significance (ASC-US), along with a test for HPV, which was negative. The previous Pap smear was normal (negative for intraepithelial lesions or malignancy). When would you recommend that she have another Pap smear?

• A. 3 years (Correct Answer)
• B. 1 year
• C. Immediately
• D. 6 months
• E. 5 years

Screening tests Explanation: ***3 years*** - For women aged 21-65 with an **ASC-US Pap result AND a negative HPV test**, current guidelines recommend routine **co-testing every 3 years** or cytology alone every 3 years. - A negative HPV test in the setting of ASC-US indicates a very low risk of high-grade disease, allowing for a return to routine screening intervals. *1 year* - A 1-year follow-up would typically be recommended for an **ASC-US Pap result** when the **HPV test is positive**, or if HPV testing was not performed. - This shorter interval is appropriate when there's an increased risk of underlying cervical dysplasia. *Immediately* - Immediate repeat testing is generally reserved for more concerning findings, such as **high-grade squamous intraepithelial lesions (HSIL)**, atypical glandular cells (AGC), or frankly malignant results. - ASC-US with negative HPV does not warrant immediate re-evaluation. *6 months* - A 6-month follow-up is not a standard recommendation for an **ASC-US with a negative HPV test**. - It might be considered in specific circumstances for an ASC-US result with a positive HPV test, but not when HPV is negative. *5 years* - Routine screening with **co-testing (Pap and HPV)** is typically recommended every **5 years** for women aged 30-65 with **normal Pap and negative HPV results**. - This patient has an ASC-US result, which necessitates a slightly shorter follow-up than routine screening.

Screening tests US Medical PG Question 3: You conduct a medical research study to determine the screening efficacy of a novel serum marker for colon cancer. The study is divided into 2 subsets. In the first, there are 500 patients with colon cancer, of which 450 are found positive for the novel serum marker. In the second arm, there are 500 patients who do not have colon cancer, and only 10 are found positive for the novel serum marker. What is the overall sensitivity of this novel test?

• A. 450 / (450 + 10)
• B. 490 / (10 + 490)
• C. 490 / (50 + 490)
• D. 450 / (450 + 50) (Correct Answer)
• E. 490 / (450 + 490)

Screening tests Explanation: ***450 / (450 + 50)*** - **Sensitivity** is defined as the proportion of actual positive cases that are correctly identified by the test. - In this study, there are **500 patients with colon cancer** (actual positives), and **450 of them tested positive** for the marker, while **50 tested negative** (500 - 450 = 50). Therefore, sensitivity = 450 / (450 + 50) = 450/500 = 0.9 or 90%. *450 / (450 + 10)* - This formula represents **Positive Predictive Value (PPV)**, which is the probability that a person with a positive test result actually has the disease. - It incorrectly uses the total number of **test positives** in the denominator (450 true positives + 10 false positives) instead of the total number of diseased individuals, which is needed for sensitivity. *490 / (10 + 490)* - This is actually the correct formula for **specificity**, not sensitivity. - Specificity = TN / (FP + TN) = 490 / (10 + 490) = 490/500 = 0.98 or 98%, which measures the proportion of actual negative cases correctly identified. - The question asks for sensitivity, not specificity. *490 / (50 + 490)* - This formula incorrectly mixes **true negatives (490)** with **false negatives (50)** in an attempt to calculate specificity. - The correct specificity formula should use false positives (10), not false negatives (50), in the denominator: 490 / (10 + 490). *490 / (450 + 490)* - This calculation incorrectly combines **true negatives (490)** and **true positives (450)** in the denominator, which does not correspond to any standard epidemiological measure. - Neither sensitivity nor specificity uses both true positives and true negatives in the denominator.

Screening tests US Medical PG Question 4: A group of gastroenterologists is concerned about low colonoscopy screening rates. They decide to implement a free patient navigation program to assist local residents and encourage them to obtain colonoscopies in accordance with U.S. Preventive Services Task Force (USPSTF) guidelines. Local residents were recruited at community centers. Participants attended monthly meetings with patient navigators and were regularly reminded that their adherence to screening guidelines was being evaluated. Colonoscopy screening rates were assessed via chart review, which showed that 90% of participants adhered to screening guidelines. Data collected via chart review for local residents recruited at community centers who did not participate in the free patient navigation system found that 34% of that population adhered to USPSTF guidelines. Which of the following has most likely contributed to the observed disparity in colonoscopy screening rates?

• A. Recall bias
• B. Confirmation bias
• C. Reporting bias
• D. Hawthorne effect (Correct Answer)
• E. Sampling bias

Screening tests Explanation: ***Hawthorne effect*** - The **Hawthorne effect** is a type of reactivity in which individuals modify an aspect of their behavior in response to their awareness of being observed. - In this study, participants were aware that their adherence to screening guidelines was being evaluated, likely leading to increased compliance simply due to this awareness rather than the efficacy of the patient navigation program alone. *Recall bias* - **Recall bias** occurs when participants disproportionately remember or inaccurately recall past events, often due to their current health status or beliefs. - This bias is less likely here as colonoscopy screening rates were assessed via **chart review**, an objective measure, rather than participant self-report. *Confirmation bias* - **Confirmation bias** is the tendency to search for, interpret, favor, and recall information in a way that confirms one's preexisting beliefs or hypotheses. - This bias typically affects the researchers or observers, not the participants' behavior in the observed manner, as the question focuses on the participants' increased screening rates. *Reporting bias* - **Reporting bias** refers to selective revealing or suppression of information during the reporting of research findings, and can occur when study participants selectively report symptoms or behaviors. - While participants might selectively report, the data here was gathered through **chart review**, which is a more objective measure of actual behavior, making reporting bias less likely to explain the disparity in screening rates. *Sampling bias* - **Sampling bias** occurs when a sample is not representative of the population from which it is drawn, leading to skewed results. - While there might be some sampling bias in who chose to participate in the free program, the observed disparity is specifically about behavior change in those *being observed*, pointing more strongly to the Hawthorne effect.

Screening tests US Medical PG Question 5: A 58-year-old woman presents to the physician for a routine gynecological visit. She denies any acute issues and remarks that she has not been sexually active for the past year. Her last Pap test was negative for any abnormal cytology. A pelvic examination and Pap test is performed at the current visit with no remarkable findings. Which of the following approaches to cervical cancer screening is most appropriate for this patient?

• A. Colposcopy in 3 years
• B. Pap test and HPV test in 5 years (Correct Answer)
• C. Pap test only in 5 years
• D. Discontinue screening until the patient becomes sexually active
• E. Colposcopy at the current visit to verify Pap test results

Screening tests Explanation: ***Pap test and HPV test in 5 years*** - For women aged 30-65, **co-testing with both a Pap test and HPV test every 5 years** is the preferred screening interval if both results are normal. - This patient, at 58 years old, falls within this age range, and her prior normal Pap tests along with a normal current one, support a 5-year interval for co-testing. *Colposcopy in 3 years* - **Colposcopy** is a diagnostic procedure performed to further evaluate abnormal Pap test results, not a routine screening method. - Doing a colposcopy in 3 years would be an overly aggressive approach given her history of normal screenings. *Pap test only in 5 years* - While a Pap test alone every 3 years is an acceptable screening option, **co-testing with HPV every 5 years** is generally preferred due to its higher sensitivity for detecting precancerous lesions. - Omitting the HPV test would reduce the effectiveness of the screening strategy in detecting cervical cancer early. *Discontinue screening until the patient becomes sexually active* - **Sexual activity** is a risk factor for HPV infection, but cervical cancer screening guidelines do not link its discontinuation to a lack of sexual activity. - Women over 65 years old with a history of adequate negative screenings may discontinue screening, but this patient is 58 and does not meet that criterion yet. *Colposcopy at the current visit to verify Pap test results* - A **colposcopy** is indicated for **abnormal Pap test results**, which this patient does not have. - Performing a colposcopy in the absence of abnormal findings is unnecessary and not part of routine screening.

Screening tests US Medical PG Question 6: A 32-year-old woman presented for her annual physical examination. She mentioned that her family history had changed since her last visit: her mother was recently diagnosed with breast cancer and her sister tested positive for the BRCA2 mutation. The patient, therefore, requested testing as well. If the patient tests positive for the BRCA1 or BRCA2 mutation, which of the following is the best screening approach?

• A. Order magnetic resonance imaging of the breast
• B. Annual ultrasound, annual mammography, and monthly self-breast exams
• C. Twice-yearly clinical breast exams, annual mammography, annual breast MRI, and breast self-exams (Correct Answer)
• D. Annual clinical breast exams, annual mammography, and monthly self-breast exams
• E. Refer to radiation therapy

Screening tests Explanation: ***Twice-yearly clinical breast exams, annual mammography, annual breast MRI, and breast self-exams*** - For patients with **BRCA1 or BRCA2 mutations**, an intensive breast cancer screening protocol is recommended due to their highly increased lifetime risk of breast cancer. - This typically includes **semiannual clinical breast exams**, **annual mammography**, and **annual breast MRI**, often starting at a young age. *Order magnetic resonance imaging of the breast* - While MRI is a crucial part of screening for high-risk individuals, it is **not sufficient as a standalone screening modality**. - A comprehensive approach combining multiple screening methods is needed to maximize detection rates. *Annual ultrasound, annual mammography, and monthly self-breast exams* - **Breast ultrasound** is generally used as an adjunct to mammography when specific abnormalities are found or in women with dense breasts, not as a routine primary screening tool for BRCA carriers. - While **mammography** and **self-breast exams** are included, this option lacks the crucial **annual MRI** and **twice-yearly clinical breast exams** recommended for BRCA carriers. *Annual clinical breast exams, annual mammography, and monthly self-breast exams* - This protocol is **less intensive** than what is recommended for women with BRCA mutations. - It omits the essential **annual breast MRI** and the **twice-yearly clinical breast exams** that are critical for early detection in this high-risk population. *Refer to radiation therapy* - **Radiation therapy** is a treatment modality for existing cancer, not a screening approach for cancer prevention or early detection. - Referring for radiation therapy would be appropriate only after a diagnosis of breast cancer, not as a primary screening strategy.

Screening tests US Medical PG Question 7: A student health coordinator plans on leading a campus-wide HIV screening program that will be free for the entire undergraduate student body. The goal is to capture as many correct HIV diagnoses as possible with the fewest false positives. The coordinator consults with the hospital to see which tests are available to use for this program. Test A has a sensitivity of 0.92 and a specificity of 0.99. Test B has a sensitivity of 0.95 and a specificity of 0.96. Test C has a sensitivity of 0.98 and a specificity of 0.93. Which of the following testing schemes should the coordinator pursue?

• A. Test A on the entire student body followed by Test B on those who are positive
• B. Test A on the entire student body followed by Test C on those who are positive
• C. Test C on the entire student body followed by Test B on those who are positive
• D. Test C on the entire student body followed by Test A on those who are positive (Correct Answer)
• E. Test B on the entire student body followed by Test A on those who are positive

Screening tests Explanation: ***Test C on the entire student body followed by Test A on those who are positive*** - To "capture as many correct HIV diagnoses as possible" (maximize true positives), the initial screening test should have the **highest sensitivity**. Test C has the highest sensitivity (0.98). - To "capture as few false positives as possible" (maximize true negatives and confirm diagnoses), the confirmatory test should have the **highest specificity**. Test A has the highest specificity (0.99). *Test A on the entire student body followed by Test B on those who are positive* - Starting with Test A (sensitivity 0.92) would miss more true positive cases than starting with Test C (sensitivity 0.98), failing the goal of **capturing as many cases as possible**. - Following with Test B (specificity 0.96) would result in more false positives than following with Test A (specificity 0.99). *Test A on the entire student body followed by Test C on those who are positive* - This scheme would miss many true positive cases initially due to Test A's lower sensitivity compared to Test C. - Following with Test C would introduce more false positives than necessary, as it has a lower specificity (0.93) than Test A (0.99). *Test C on the entire student body followed by Test B on those who are positive* - While Test C is a good initial screen for its high sensitivity, following it with Test B (specificity 0.96) is less optimal than Test A (specificity 0.99) for minimizing false positives in the confirmation step. - This combination would therefore yield more false positives in the confirmatory stage than using Test A. *Test B on the entire student body followed by Test A on those who are positive* - Test B has a sensitivity of 0.95, which is lower than Test C's sensitivity of 0.98, meaning it would miss more true positive cases at the initial screening stage. - While Test A provides excellent specificity for confirmation, the initial screening step is suboptimal for the goal of capturing as many diagnoses as possible.

Screening tests US Medical PG Question 8: A 50-year-old male presents to his primary care physician for a routine check-up. He reports that he is doing well overall without any bothersome symptoms. His past medical history is significant only for hypertension, which has been well controlled with losartan. Vital signs are as follows: T 37.0 C, HR 80, BP 128/76, RR 14, SpO2 99%. Physical examination does not reveal any concerning abnormalities. The physician recommends a fecal occult blood test at this visit to screen for the presence of any blood in the patient's stool that might be suggestive of an underlying colorectal cancer. Which of the following best describes this method of disease prevention?

• A. Primary prevention
• B. Primordial prevention
• C. Secondary prevention (Correct Answer)
• D. Tertiary prevention
• E. Quaternary prevention

Screening tests Explanation: ***Secondary prevention*** - **Secondary prevention** involves **early detection** of a disease or health problem in apparently healthy individuals. Screening tests, such as the fecal occult blood test used to detect colorectal cancer before symptoms arise, are prime examples of secondary prevention. - The goal is to identify and address the disease in its early stages, allowing for timely intervention and potentially improving outcomes. *Primary prevention* - **Primary prevention** aims to **prevent a disease from occurring** in the first place by reducing risk factors or increasing protective factors. Examples include vaccinations, promoting healthy diets, and regular exercise. - In this scenario, the individual is already being screened for a potential disease, not taking measures to prevent its initial development. *Primordial prevention* - **Primordial prevention** focuses on **preventing the development of risk factors** themselves at a societal level. This often involves public policy and environmental changes to promote healthier lifestyles. - It targets broad determinants of health before specific risk factors emerge in individuals, which is distinct from an individual screening test. *Tertiary prevention* - **Tertiary prevention** occurs **after a disease has been diagnosed** and aims to prevent progression, reduce complications, improve quality of life, and restore function. Examples include rehabilitation after a stroke or chemotherapy for cancer. - The patient in the scenario is asymptomatic and undergoing screening, not managing an existing, diagnosed condition. *Quaternary prevention* - **Quaternary prevention** aims to **protect patients from medical interventions** that are likely to cause more harm than good, or to mitigate the consequences of unnecessary or excessive medical care. It focuses on identifying and avoiding overmedicalization. - The fecal occult blood test is a standard screening tool in this context, not an intervention designed to counter the negative effects of over-treatment.

Screening tests US Medical PG Question 9: A 5-year-old patient presents to the pediatrician's office with fatigue and swollen lymph nodes. Extensive work-up reveals a diagnosis of acute lymphoblastic leukemia. In an effort to better tailor the patient's treatments, thousands of genes are arranged on a chip and a probe is made from the patient's mRNA (converted to cDNA). This probe is then hybridized to the chip in order to measure the gene expression of thousands of genes. The technology used to investigate this patient's gene expression profile is best for detecting which of the following types of genetic abnormalities?

• A. Trisomies
• B. Large scale chromosomal deletions
• C. Frame-shift mutations
• D. Chromosomal translocations (Correct Answer)
• E. Single nucleotide polymorphisms

Screening tests Explanation: ***Chromosomal translocations*** - The described process, involving gene expression analysis using a **DNA chip** (microarray), is effective at identifying translocations indirectly by detecting abnormal **fusion transcripts** or altered **gene expression patterns** resulting from the translocation. - Many leukemias, especially **acute lymphoblastic leukemia (ALL)**, are characterized by specific chromosomal translocations that lead to the creation of **oncogenic fusion genes**, thereby altering gene expression. *Trisomies* - Trisomies are **numerical chromosomal abnormalities** involving an extra copy of an entire chromosome, which are typically detected by **karyotyping** or **fluorescence in situ hybridization (FISH)**, not by gene expression arrays directly unless they cause a widespread, quantifiable change in dosage. - While gene expression might be altered, a microarray designed for gene expression profiling is not the primary or most sensitive tool for identifying the presence of an entire extra chromosome. *Large scale chromosomal deletions* - Large-scale deletions would lead to a **reduced expression** of a large number of genes in the affected region, but direct detection of the deletion itself is usually done with **comparative genomic hybridization (CGH)** or **karyotyping**, which are designed to identify copy number variations. - While gene chips can show altered expression, they are less precise for delineating the exact boundaries of a deletion compared to genetic-level analyses. *Frame-shift mutations* - **Frame-shift mutations** are small insertions or deletions within a gene that alter the reading frame, leading to a truncated or non-functional protein. - These are typically detected by **DNA sequencing**, not broadly by gene expression microarrays, which measure the abundance of mRNA transcripts rather than sequence changes. *Single nucleotide polymorphisms* - **Single nucleotide polymorphisms (SNPs)** are variations in a single nucleotide at a specific position in the genome. - While specialized SNP arrays exist, general gene expression microarrays are designed to quantify mRNA levels and are not the primary method for identifying individual SNPs, which require **genotyping** techniques.

Screening tests US Medical PG Question 10: A 38-year-old G2P2 presents to her gynecologist to discuss the results of her diagnostic tests. She has no current complaints or concurrent diseases. She underwent a tubal ligation after her last pregnancy. Her last Pap smear showed a high-grade squamous intraepithelial lesion and a reflex HPV test was positive. Colposcopic examination reveals areas of thin acetowhite epithelium with diffuse borders and fine punctation. The biopsy obtained from the suspicious areas shows CIN 1. Note the discordancy between the cytology (HSIL) and histology (CIN 1) results. Which of the following is an appropriate next step in the management of this patient?

• A. Test for type 16 and 18 HPV
• B. Cryoablation
• C. Cold-knife conization
• D. Loop electrosurgical excision procedure
• E. Repeat cytology and HPV co-testing in 6 months (Correct Answer)

Screening tests Explanation: ***Repeat cytology and HPV co-testing in 6 months*** - In cases of **discordant results** where cytology shows **HSIL** but histology only shows **CIN 1**, repeat co-testing in 6 months is an appropriate management strategy, especially if the **colposcopy was satisfactory** (entire squamocolumnar junction visualized). This approach allows for monitoring while avoiding overtreatment, as many low-grade lesions spontaneously regress. - Given the patient's history (G2P2, tubal ligation), future fertility is not a concern, making conservative management suitable when there's uncertainty about the severity of the lesion. *Test for type 16 and 18 HPV* - The patient already has a **positive reflex HPV test**, indicating the presence of high-risk HPV. Knowing the specific types (16 or 18) would assist in risk stratification, but it would not change the immediate management given the existing discordance between HSIL cytology and CIN 1 histology. - While **HPV 16 and 18** are associated with a higher risk of progression to cancer, current guidelines for discordant HSIL/CIN 1 emphasize observation or excisional procedures based on other factors, not just specific HPV typing if HPV is already confirmed as positive. *Cryoablation* - **Cryoablation** is an ablative treatment that destroys abnormal cervical tissue. It is typically reserved for confirmed **CIN 2 or CIN 3** with a satisfactory colposcopy, when there is no suspicion of invasive cancer. - Applying an ablative treatment like cryoablation based on discordant results (HSIL with CIN 1) without further clarification could lead to overtreatment, and it may not fully address the possibility of a missed higher-grade lesion elsewhere. *Cold-knife conization* - **Cold-knife conization** is an excisional procedure used to remove a cone-shaped piece of cervical tissue, typically for confirmed **CIN 2 or CIN 3**, or when **colposcopy is unsatisfactory**, or there's a suspicion of invasive disease, or glandular lesions. - Performing a conization based on HSIL cytology but only CIN 1 histology, without further investigation or follow-up, is premature and unnecessarily aggressive given the potential for an overestimation of disease severity by cytology alone. *Loop electrosurgical excision procedure* - **LEEP** is an excisional procedure commonly used for the management of **high-grade cervical intraepithelial neoplasia (CIN 2 or CIN 3)** or when there is a significant discrepancy between cytology and histology that suggests a higher-grade lesion. - While LEEP is an excisional procedure, it is typically performed when there is a confirmed CIN 2/3, not when histology shows CIN 1, especially given the potential for spontaneous regression and the less invasive options for managing discordant results.

Screening tests Flashcard 1 of 10

Question: What is the key risk factor for Cervical Carcinoma?_____

Answer: High-risk HPV (16, 18, 31, 33)

Screening tests Flashcard 2 of 10

Question: What is the gold standard procedure for screening for Cervical Carcinoma?_____

Answer: Pap Smear

Screening tests Flashcard 3 of 10

Question: cervical dysplasia/squamous cell carcinoma

Answer: HPV 16, 18

Extra Information: koilocytes (enlarged, hyperchromatic epithelial cells) on Pap smear. (normal left, abnormal right) multiple sexual partners, smoking, early age of firts intercourse, HIV infectionmay progress to invasive carcinoma

Screening tests Flashcard 4 of 10

Question: Worldwide, _____ cancer is the most common gynecologic tumor.

Answer: cervical

Screening tests Flashcard 5 of 10

Question: secondary prevention (epidemiology)

Answer: early detection (e.g. Pap smear)

Screening tests Flashcard 6 of 10

Question: Ovarian surface epithelial tumors typically present _____ and therefore have _____ prognosis

Answer: late

Extra Information:   Watch Ovarian Cysts & Epithelial Ovarian Cancer [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-reproductive-gu/videos/medical-pathophysiology-reproductive-and-gu-reproductive-hormones-and-ovarian-disorders-ovarian-cysts-and-epithelial-ovarian-cancer?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical] https://onlinemeded.org?ref=anki 

Screening tests Flashcard 7 of 10

Question: What is the key risk factor for Cervical Carcinoma? _____

Answer: High-risk HPV (16, 18, 31, 33)

Extra Information:    https://onlinemeded.org/spa/gynecology/cervical-cancer/acquire?ref=anki Other: - smoking - starting sexual intercourse at a young age - immunodeficiency (e.g. HIV infection) 

Screening tests Flashcard 8 of 10

Question: Spontaneous, unilateral serosanguinous nipple discharge is followed up with _____ and _____

Answer: mammography → ultrasound

Extra Information:  * vascular connection to the tumor that is not present normally; connects papilloma to duct wall Watch Benign Breast Disorders [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-reproductive-gu/videos/medical-pathophysiology-reproductive-and-gu-breast-benign-breast-disorders?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical] Watch Benign Breast Disorders [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-reproductive-gu/videos/medical-pathophysiology-reproductive-and-gu-breast-benign-breast-disorders?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical] https://onlinemeded.org?ref=anki 

Screening tests Flashcard 9 of 10

Question: Fibrocystic change presents as a '_____' breast that may be painful

Answer: lumpy

Extra Information:   * Often co-occurs with breast cysts Watch Benign Breast Disorders [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-reproductive-gu/videos/medical-pathophysiology-reproductive-and-gu-breast-benign-breast-disorders?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical] https://onlinemeded.org/spa/obgyn?ref=anki  

Screening tests Flashcard 10 of 10

Question: A pap smear is performed by scraping cells at the _____ of the cervix

Answer: transformation zone

Extra Information:   Watch Cervical Neoplasia [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-reproductive-gu/videos/medical-pathophysiology-reproductive-and-gu-uterine-and-vulvovaginal-disorders-cervical-neoplasia?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical]Watch associated Bootcamp video [https://app.bootcamp.com/med-school/histology/videos/female-reproductive-system?index=13] https://onlinemeded.org/spa/gynecology/cervical-cancer/acquire?ref=anki