Sarah Michelle Crash Course (Women’s Health & Heme/Onc) — Latest Update (Verified Questions & Answers | Nursing Comprehensive Review | Graded A+)

Sarah Michelle Crash Course (Women’s Health & Heme/Onc) — Latest Update (Verified Questions & Answers | Nursing Comprehensive Review | Graded A+) 2026/2027 | GRADED A+ | 100% VERIFIED Question: Which is most common non hormonal contraceptive option? Answer Copper non hormonal IUD Question: Which contraceptive method may increase risk for osteoporosis? Answer Depo Shot encourage Vit D supplementation limit to 2-5 years max Question: While breast feeding which contraception is ideal? Answer Anything progrestin only like mini pill or IUD Question: Which contraceptives are contraindicated in those with migraines with aura? Answer Combined oral contraceptives due to increased clot and stroke risk Question: Which contraceptive has the highest risk for clots? Answer Patch Question: What should somebody do if they miss one pill? Answer Take the next one as soon as they remember even if it means taking 2 in one day Question: What if the patient misses 2 birth control pills? Answer They should take the most recent only and then use back up birth control such as condoms Question: According to ACOG what are cervical cancer screening guidelines and when do they begin? Answer Age 21 every 3 years for those of average risk Question: Age 30-65 what are options? Answer Cytology alone every 3 years Primary HPV testing every 5 years Cotesting every 5 years Question: What are the guidelines if the patient has had a hysterectomy for a benign reason Answer No longer need to screen Question: What if the patient had a hysterectomy d/t cancer or pre-cancer? Answer Continue with regular screening Question: What if ASC-US is the result? Answer 25: reflex HPV 25: nothing repeats in 1 year Question: At what age do you start Gardisil and up until what age can you catch up? Answer Starting at age 11 but as young as 9 You can catch up if delayed between ages 13-26 Question: What is the most common side effect of Gardisil? Answer Post vaccination syncope Question: What is the treatment for genital warts caused by HPV? Answer Trichloracetic Acid or TCA Question: When do we start breast cancer screenings? Answer Age 40 Question: What if patient has a palpable mass but negative mammogram? Answer Refer for US or MRI Question: IDC aka Answer Invasive Ductal Carcinoma 80% of all cases of breast cancer Question: What s/s of invasive ductal carcinoma do we typically see? Answer typically asymptomatic until advanced but: fixed, singular HARD mass commonly in outer breast Question: Fibrocystic Breast Disease Answer s/s: lumpiness, tenderness, and pain typically in the upper outer quadrants of the breasts and fluctuate with the menstrual cycle Question: What is Galactorrhea? Answer The production of breast milk in individuals who are not breastfeeding Question: What are some typical causes of galactorrhea? Answer Hyperprolactinemia often due to a prolactinoma which is a benign pituitary tumor, hypothyroidism, antipsychotic medications like Zyprexa or frequent breast stimulation Question: Is it normal to have vaginal bleeding after menopause? Answer NO definitely not Menopause is 12 complete months without a period Question: Post menopausal bleeding could indicate... Answer Endometrial cancer, MUST refer out Question: What medications can be prescribed to patients who are experiencing vasomotor symptoms post-menopause? Answer Hormone Replacement Therapy Estrogen-only & combo type Question: Who should be prescribed combo estrogen-progesterone hormone therapy? Answer ANYONE WITH A UTERUS -- this is to help prevent endometrial hyperplasia Question: Estrogen only therapy is for who? Answer Those who have had a hysterectomy and this is merely just management of symptoms Question: What are risks of hormone replacement therapy? Answer Blood clots Stroke Breast cancer Cardiovascular disease Question: What if we don't want to use hormone replacement therapy d/t risks? Answer Can use Paxil or peroxetine Question: What if the patient is struggling with vaginal dryness? Answer Can use topical estrogen as it does not carry the same risks Question: What is secondary dysmenorrhea? Answer Painful menstruation from PID, endometriosis, or other underlying conditions Question: How is primary dysmenorrhea managed? Answer NSAIDs or naproxen to help decrease the production of prostaglandins responsible for pain and inflammation Question: What else can we give to manage primary dysmenorrhea? Answer Combined oral contraceptives can be really effective as they help decrease and manage menstrual flow Question: How do we treat PCOS? Answer Hormone regulation such as hormonal contraceptives, Metformin, reduce androgen levels Question: How is PCOS diagnosed? Answer Rotterdamn criteria: anovulation or irregular ovulation Increased androgen levels Multiple cysts on the ovaries Question: What is the treatment for PCOS Answer Depends on GOALS Combined oral contracepties: help regulate cycle and androgen levels Metformin: improves insulin resistance Spironolactone: anti-androgen Question: Why does menopause lead to osteoporosis? Answer Because estrogen helps maintain bone density How often should mammograms be completed? Answer Starting at 40 years old and every other year as long as mammogram is normal What is primary amenorrhea? Answer Menstruation that hasn't started by age 15 or 16 What causes primary amenorrhea? Answer genetic disorders such as Turners Syndrome PCOS Anatomical Abnormalities i.e., no sexual development What is secondary amenorrhea? Answer No menstruation for 3 months with a history of regular periods, OR no menstruation for 6 months with a history of irregular periods What causes secondary amenorrhea? Answer PREGNANCY Contraceptives Hormone imbalances Thyroid issues Eating disorders Stress Obesity What is PMDD? Answer PMS on steroids Severe mood swings that can affect daily life What is the 1st line treatment for PMDD? Answer Lifestyle Modifications: Better diet Exercise Stress management What is the medication tx for PMDD? Answer Fluoxetine Prozac Cetirizine + Zoloft Hormonal contraceptives Besides HPV.. what are the biggest risk factors for the development of cervical cancer? Answer Smoking Long term use of Oral contraceptives Multiple full term pregnancies Family history What are the guidelines for patients aged 21-29 regarding Pap smears? Answer Pap smear q3 years What are the guidelines for ages 30+ Answer Pap smear every 5 years with HPV co-testing When can cervical cancer screening stop? Answer Age 65 What happens if you get ASC-US on a pap? Answer If older than 25: HPV test -- if negative repeat pap in 3 years If younger than 25 follow up in 1 year What are some red flag symptoms of cervical cancer? Abnormal vaginal bleeding Pelvic pain Mean Copuscular Volume (MCV) Calculated measure of the size of the average circulating RBC What is the MCHC? Mean corpuscular hemoglobin concentration This is color/concentration of RBCs What does a decreased MCHC suggest? hypochromic anemia with pale red blood cells Normochromic anemia is... anemia with normal color Which are microcytic anemias? LIT Lead Toxicity Iron Deficiency Thalassemia What are macrocyclic anemias? FAB Folate deficiency mActrocytic B12 deficiency What are the most common causes of iron deficiency anemia? lack of iron in diet menstruation or vaginal bleeding GI bleeding S/S of anemia? fatigue pallor generalized weakness Unique clinical findings of iron deficiency anemia? PICA spoon shaped nails Iron deficiency anemia, will MCV be high or low? Low (microcytic anemia) treatment for iron deficiency anemia (if not severe) oral supplements oral iron supplements Take on empty stomach with acid drink (orange juice) to increase absorption Watch for constipation What to limit in kids under 12 months of age? Cows milk bc of inflammation and tiny bleeds in the stomach Tx: Iron replacement therapy What are unique findings in iron deficiency anemia? Pica Kolonichia (Spoon-shaped nails) MVC: low Treatment for Iron Deficiency Anemia? IRON SUPPLEMENTATION What is some education regarding Iron supplementation? Take on empty stomach or with acidic drink to increase absorption Constipation is normal increase water and fiber Lead Toxicity Can lead to microcytic anemia and neurological impairment & cognitive delays more commonly effects children under the age of 6 CDC lab cut-off for lead toxicity: _________ mcg/dL or higher 3.5 or higher Which population does lead toxicity most commonly affect? Those living in homes built prior to 1978 that used a lot of lead based paints & children under 6 CDC lab cut off for lead toxicity 3.5 or higher Thalassemia inherited defect in ability to produce hemoglobin, leading to hypochromia diagnosed in childhood by genetic testing or Hemoglobin Electrophoresis why are patient with Talassemia is at risk for iron overload? transfusions condition increases intestinal absorption of iron MCV low microcytic MCV high macrocytic folate deficiency, MCV high or low? high (macrocytic) B12 deficiencies, MCV high or low? high (macrocytic) Lead Toxicity, MCV high or low? low (microcytic) Iron Deficiency, MCV high or low? low (microcytic) Thalassemia, MCV high or low? low (microcytic) Which populations is Thalassemia most common in? Southeast Asians or those of Mediterranean descent How is thalessemia diagnosed? By Hemoglobin Electrophoresis Ferritin will be low What are thalassemia patients at an increased risk of? Iron overload from lifelong transfusions What are some MAJOR s/s of thalassemia? Pallor Fatigue Splenomegaly Why does lead toxicity lead to anemia? It interferes with heme synthesis and diminishes rbc survival Macrocytic Anemias Level MVC level: 100 What are the types of macrocytic anemias? Folate deficiency anemia B12 deficiency anemia Pernicious anemia For folate and B12 deficiency anemias what are the main causes? diet (strict vegan diets for example) and excessive alcohol use Causes of B12 deficiency anemia? Pernicious anemia gastric/bariatric surgery What do patients lack in pernicious anemia? Intrinsic factor needed for b12 absorption What is intrinsic factor? A protein in the gut needed to absorb B12 Long term use of which medications can lead to a deficiency in B12? PPIs Metformin Which medications cause a folate deficiency? Methyltrexate How can we differentiate between folate and B12 deficiency anemias? There are more neuro symptoms with B12 deficiency such as abnormal gait and paresthesias what is more common in b12 deficiency vs folate? neuro symptoms abnormal gait and paresthesias glossitis a red, smooth, beefy tongue common in b12 anemia What is the solution when patients have B12 deficiency anemia d/t lack of intrinsic factor? IM B12 for life (oral will not work) Sickle Cell Anemia Usually diagnosed in infancy during genetic newborn screening Autosomal recessive genetic disorder that leads to sickling of the RBCs How do you confirm sickle cell anemia? Hemoglobin electrophoresis PERIPHERAL SMEAR What are the typical causes of a sickle cell crisis? Dehydration hypoxia illness Education for sickle cell anemia in pediatrics Should avoid high altitudes - because hypoxia Children should receive ALL vaccines - because of illnesses What do we do in a sickle cell crisis? Refer to ER for fluids and pain management Hemochromatosis a genetic disorder that leads to increased intestinal absorption of iron leading to iron overload & subsequent organ damage may have a BRONZE skin color Tx for hemochromatosis? therapeutic phlebotomy or regularly drawing the patients blood to reduce those levels CDC screening recommendations for Hep B? Once in lifetime at minimum during each pregnancy Polycythemia Vera Overproductive of RBCs which causes blood to appear thick and viscous S/S of polycythemia vera? Paresthesias RLS increased clotting risk**** Tx for polycythemia vera? regular phlebotomy will remove excess RBCs What is secondary polycythemia vera? Living in high altitudes COPD What populations does the CDC recommend screening for Hep B? All adults at normal risk should be screened atleast once in their lifetime Pregnant patients in each pregnancy Infants born to Hep B mothers HBsAg Active Hep B Infection AG = Always Growing Total anti-HBc Core antigen antibody testing (IgM and IgG) means that they have a previous or current infection IgM = positive now (acute). M for miserable IgG = previous positive. G for gone What if a patient has a positive IgG accompanied by a positive HBsAG? chronic infection Positive Anti-HBs (Hep B antibody) indicates? Antibodies are present and pt is immune from past infection or vaccine. Negative Anti-HBs (Hep B antibody) indicates? Not immune from Hep B and they are susceptible to infection What if a patient has a positive IgG accompanied by a negative HBsAG? past infection IgM M = miserable/ this MINUTE ACTIVE INFECTION IgG G = gone Postivite HBsAg: CHRONIC Negative HBsAg: past infection What is HBsAg is positive & so is IgG? Chronic Hep B What is TNM staging? T - tumor N - nodes M - Metastisis Leukemia is a cancer of... The blood cells Acute -- grow quickly Chronic -- take years to grow Lymphoma Cancer of the lymph system Hodgkin & Non-Hodgkin Hodgkin is more common in young adults Non-Hodgkin is more common in older adults Which lymphoma is more common in young adults? Hodgkin Which lymphoma is more common in older adults? Non-Hodgkins What type of cells are diagnostic of Hodgkins Lymphoma? Reed-Sternberg Cells These are ABNORMAL & LARGE WBCs Myaloma effects plasma cells