AQUIFER FAMILY MEDICINE END OF CASE EXAM
QUESTIONS 2024-2025 ACTUAL EXAM 70
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES
Terms in this set (58)
,A 34-year-old woman who The correct answer is B.
has no past medical
problems nor is currently With a BMI of 32, obesity is the one risk factor for this
taking any medications patient based on the information given. Other risk
comes into your office factors for breast cancer include family history of breast
because she noticed a cancer in a first degree relative (mother or sister - not
tender lump in her left aunt), prolonged estrogen exposure (menarche before
breast starting age 12, menopause after 45, advanced age at first
approximately one month pregnancy), genetic predisposition (BRCA 1 or 2
ago. She is worried mutation), advanced age (breast cancer risk increases
because she has an aunt with age, and this patient is relatively young), female sex,
who had breast cancer that increased breast density and certain exposures
was BRCA positive, though (diethylstilbestrol, hormone or radiation therapy, heavy
her mother is BRCA smoking).
negative. Her periods have
been regular since they
started at the age of 13 and
occur every 32 days. She is
currently menstruating. She
has three children aged 12,
9, and 4. On exam, her BMI
is 32, up from 28 three years
ago and her other vital
signs are stable. On breast
exam, you note a mobile
rubbery mass of
approximately 1 x 1cm and
with regular borders that is
tender to palpation. You
appreciate no axillary
adenopathy. The rest of her
physical exam is
unremarkable. Of the
information provided, which
of the following places this
patient at increased risk for
breast cancer?
,A. Age
B. Weight
C. Parity
, A 64-year-old woman who The correct answer is E.
is overweight with well-
controlled hypertension The patient experienced menopause at the age of 44,
comes to your office which shortens her time of estrogen exposure, a known
complaining of a lump in risk factor for the development of breast cancer. Factors
her breast that she noticed associated with decreased breast cancer risk include
while showering. She denies pregnancy at an early age, late menarche, early
any pain, tenderness, or skin menopause, high parity and medications such as
changes. A pertinent review selective estrogen receptor modulators along with
of systems is negative. NSAIDs and aspirin. Risk factors for breast cancer
Menarche began at the age include family history of breast cancer in a first degree
of 10. Her first child was relative (mother or sister), prolonged estrogen exposure
born when she was 31 and (menarche before age 12, menopause after 55, advanced
she had her second and last age at pregnancy, obesity after menopause), female sex,
child at the age of 33. She genetic predisposition (BRCA 1 or 2 mutation), advanced
experienced menopause at age (breast cancer risk increases with age), increased
the age of 44. Her mother breast density and exposures (diethylstilbestrol,
died of colon cancer when hormone or radiation therapy, smoking).
she was 65 and her father
passed away from
metastatic prostate cancer
at the age of 70. She has no
history of tobacco use ever
and occasionally drinks a
glass of wine with dinner.
Her BMI is 34. Which of the
information provided thus
far puts the patient at
decreased risk for breast
cancer?
A. Age
B. Weight
C. Age at first birth
D. Age at menarche
E. Age at menopause
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