Women's health

Question 0

When should screening mammograms commence? How often?

• low risk
• FHx

Answer 0

low risk: 2-yearly from age 50

increased risk: annually from 10 years prior to the Dx of 1st degree relative

Question 1

When should you offer genetic testing for breast cancer?

Answer 1

-3 or more closely affected relatives at younger age of onset
-multifocal or bilateral breast or ovarian cancers
lifetime risk 40-80% (BRCA1 or BRCA2)

Question 2

What are contraindications to ocp due to VTE risk? ie. MEC 3-4

Answer 2

Personal Hx of DVT
1st degree relative with VTE <45 years
Major surgery with prolonged immobilisation
Immobility e.g. wheelchair use
Known thrombogenic mutations e.g. Factor V Leiden deficiency

Question 3

Diagnosis of PCOS

- Rotterdam criteria, 2/3 of:

Answer 3

-Oligo/anovulation
-Clinical or biochemical signs of hyperandrogenism (biochemical = increased FAI or total testosterone; clinical = hirsutism or male pattern balding)
-Polycystic ovaries on u/s
+ exclusion of other causes

Question 4

Tamoxifen

• MOA
• benefits
• risks

Answer 4

Selective estrogen receptor modulator
Benefit: reduced risk of osteoporosis
Risks: endometrial ca, VTE, cataracts, NASH