Self-assessment Questions

1). A 31 year old female presents for her health care exam. She is married. At what frequency should her PAP smears be done?

1. Yearly until three consecutive yearly PAPs are normal, then every three years US Preventive Services Task Force, 1996
2. Yearly until three consecutive yearly PAPs are normal, then every two years
3. Yearly, not dependent on status of prior PAP tests
4. Can be skipped since she is married and her risk of cervical cancer is extremely low

2). A 50 year old female presents for her health care exam. She had a total abdominal hysterectomy for uterine fibroids. At what frequency should her PAP smears be done?

1. Yearly until three consecutive yearly PAPs are normal, then every three years
2. Yearly until three consecutive yearly PAPs are normal, then every two years
3. Yearly, not dependent on status of prior PAP tests
4. Can be skipped since she had a total hysterectomy for a non-cancerous condition US Preventive Services Task Force, 1996

3). A 66 year old female presents for her health care exam. She has never had an abnormal PAP smear, has had PAP smears done every three years, and has been with the same male partner for 35 years. At what frequency should her PAP smears be done?

1. Every three years
2. Every two years
3. Yearly
4. Can be skipped due to her age US Preventive Services Task Force, 1996

4).An 18 year old male presents for his health care maintenance exam. He has a friend recently diagnosed with testicular cancer and would like to know how often he should perform a testicular self-exam. Your recommendation is:

1. Never, there is no data that this counseling and exam is efficacious or effective US Preventive Services Task Force, 1996
2. Monthly
3. Yearly
4. Never, but a yearly exam by a physician is important

5). Asymptomatic bacteriuria should be screened in the following:

1. Pregnant females US Preventive Services Task Force, 1996
2. Women over 65 years
3. Men over 65 years
4. b and c
5. all of the above

6). The following physician-counseling areas have been shown to be effective by the US Preventive Services Task Force:

1. To prevent tobacco use
2. To promote physical activity
3. To prevent HIV and STDs
4. To prevent low back pain
5. a-b
6. a-c US Preventive Services Task Force, 1996

7). Your 35 year old female patient has asked about starting colon cancer screening. She has no family history but would like to be screened for disease as aggressively as possible. Your recommendation:

1. Start at age 65, then repeat every five years
2. Start at age 50, then repeat every five years US Preventive Services Task Force, 1996
3. Start at age 45, then repeat every five years
4. Start at age 40, then repeat every five years

8).The best test to screen for colon cancer is:

1. flexible sigmoidoscopy
2. stool Hemoccult Cards
3. colonoscopy
4. a and b, studies have shown benefit from either US Preventive Services Task Force, 1996
5. none of the above, there is no insufficient data to recommend screening for colon cancer at this time

9). A 48 year old female presents for her yearly exam. She is asymptomatic for thyroid disease and has no family history. Should screening be applied?

1. Yes, a TSH is indicated because treatment of occult hypothyroidism has been shown to decrease mortality or significant morbidity..
2. Yes, a TSH is indicated because treatment of occult hyperthyroidism has been shown to decrease risk of atrial fibrillation.
3. No, a TSH is not indicated because treatment of occult hypothyroidism has not been shown to decrease mortality or significant morbidity.
4. No, a TSH is not indicated because treatment of occult hyperthyroidism has not been shown to decrease mortality or significant morbidity.
5. a and b
6. c and d Ann Intern Med 1998:129:147-148

10). Your group has decided that men undergoing prostate cancer screening should sign an informed consent form. Important issues to include which are discussed in the literature include:

1. Inform patient that some patients worry, even after normal tests
2. Inform patient that prostate cancer can be asymptomatic, conversely, that symptomatic prostate cancer may be un-treatable.
3. Inform patient that the test will differentiate aggressive from non-aggressive forms of cancer
4. Inform patient that all patients with prostate cancer benefit from treatment
5. a-b Am J Med 1998 Oct;105(4):266-74
6. c-d
7. a-d

11). Among women aged 40-69, the percentage who will experience a false-positive mammogram and/or breast exam when screened for 10 years is:

1. 1/3 N Engl J Med 1998:338:1089-1096
2. 1/4
3. 1/6
4. 1/10
5. 1/100

12). 9/100 women who have a normal mammogram will report that they have worried about the testing when questioned at three months. How many women out of 100 will report worry at three months after a false positive mammogram?

1. 52
2. 26 N Engl J Med 1998;338:1100-1102
3. 13
4. less than 9, they have been reassured because of the intensive testing performed for the false-positive mammogram

13). Among women 50-59 at the time of screening, the probability of cancer following a single abnormal mammogram is:

1. 100%
2. 72%
3. 38%
4. 18%
5. 9% JAMA 1995;273:149-154

14). Among women screened over a 10 year period between the age 40-59 at age of study entry, the potential life years lost ranking for lung cancer, breast cancer, and heart disease deaths is:

1. heart disease>breast cancer>lung cancer N Engl J Med 1998:338:1089-1096
2. heart disease>lung cancer>breast cancer
3. breast cancer>heart disease>lung cancer
4. breast cancer>lung cancer>heart disease
5. lung cancer>breast cancer>heart disease
6. lung cancer>heart disease>breast cancer

15). Which of the following cancers have an efficacious and effective screening procedure using US Preventive Services Task Force criteria? (Choose all that apply)

16). Which of the following health behavior counseling areas have been demonstrated to be efficacious and effective using US Preventive Task Force criteria? (Choose all that apply)

17). The age at which the pneumococcal vaccine should be administered is:

18). The accepted interval for tetanus administration after an initial series and booster at age 15 years is:

19). The group in which screening for iron deficiency is asymptomatic persons has been demonstrated by the US Preventive Task Force review is:

20). Which of the following screening or preventive treatment procedure has been shown to be effective in decreasing disease burden in a 60 year old man with no risk factors or symptoms: (Choose all that applies)