Q9/3:
Meg, 66 is now a widow. She asks you when she can stop having pap smears as she finds them quite uncomfortable. When can older women cease having pap smears?
a) When they have had two normal smears after the age of 70
b) At age 70 if there have been two normal smears in the preceding 5 years
c) At menopause if they have no vaginal discharge or bleeding after this time
d) Once they are no longer sexually active if their last smear was normal
Q9/4:
Cyril J, aged 64, presents complaining that he can't hold a cup of tea steadily. You would suspect a benign essential tremor if the tremor is:
a) Increased with voluntary movement towards a target
b) Most significant at rest
c) Maximal when the limb is maintained against gravity
d) Repetitive and flapping in nature
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5 comments:
Q9/3 According to the latest guideline it is B.
q9/4
A CEREBELLAR LESION
B RESTING TREMORS
D IS PARKINSON'S SO I'LL OPT FOR C
Q9/3: B
Q9/4: B
Q9/3 My answer is B (guess)
Q9/4 My answer is C
a is cerebellar, b and d are Parkinson disease
Q9/3 - B
Q9/4 - C (acentuated by voluntary contraction)
Q9/3
The correct answer is (b).
The national policy on cervical screening provides consensus guidelines on which women need screening and how often Pap smears should be taken. It states:
“Pap smears may cease at the age of 70 years for women who have had two normal Pap smears within the last five years.” Women over 70 years who have never had a Pap smear should have 2 consecutive pap smears performed. Women who request a Pap smear should be screened.
If older women are finding pap smears uncomfortable, the use of topical oestrogen for 2 weeks prior to taking a pap smear can reduce the discomfort due to atrophy/dryness.
Q9/4
The correct answer is (c).
A benign essential tremor is present constantly, but becomes more pronounced when the limb is maintained against gravity. It is lessened by rest and not markedly enhanced during voluntary movement towards a target. An intention tremor is typical of cerebellar disease and a rest tremor is more likely to be caused by Parkinson’s disease or be an exaggerated physiological tremor.
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