Screening
Screening of women (VIA/VILI, Pap smear or HPV DNA testing) from age 25, or from 30 years where resources are limited, and from diagnosis in HIV-positive women.
What our notes say
- Screening of women (VIA/VILI, Pap smear or HPV DNA testing) from age 25, or from 30 years where resources are limited, and from diagnosis in HIV-positive women. (Year 4 Gynaecology CAT 2 (MBOG 4212): 8 October 2021)
- HPV DNA screening is of value to detect high-risk individuals (Year 4 Gynaecology CAT (MBOG 4212): 15 March 2019, 39 of 40 MCQs)
- Rating scales: Young Mania Rating Scale (YMRS), Mood Disorder Questionnaire (MDQ) (screening), PHQ-9 for depression. (Bipolar and Related Disorders)
- Echocardiography for pulmonary hypertension; HIV and TB screening in Kenya. (Interstitial Lung Diseases)
- Investigations: chest X-ray (use ILO classification for pneumoconioses), HRCT, spirometry and DLCO, serial peak flow (occupational asthma), TB screening in silica-exposed workers, specific IgE or challenge tests, biopsy if needed, mineral analysis. (Occupational Lung Disease)
- Low-dose CT screening in some countries for high-risk smokers (aged 50–80 with 20 or more pack-years): limited availability in Kenya. (Lung Cancer)
Study material on Screening
- Molecular Basis of Cancer: Cell Cycle, Apoptosis & Angiogenesis
- Growth and Development in Children
- Chemical Pathology Practice Examination
- Epidemiology And Biostatistics
- Female & Male Genital Pathology: Ulcers, HPV, Endometriosis, Pre-eclampsia
- Oncopathology MCQs: Test Your Knowledge on Cancer Pathology
- Skin & Breast Pathology MCQs: Dermatological Lesions & Diseases
- EXAM: Bacteriophages, Laboratory Diagnosis, HPV & Parvovirus B19
- CLINICAL BIOCHEMISTRY LAQs & SAQs
- Obstetrics II CAT: miscarriage, pregnancy physiology and antenatal care, 26 MCQs and 4 short answers
- Chemical Pathology MCQS
- Chemical Path Mcqs
- Chemical Pathology
- Embryology — Past Paper Questions & Answers
Practice questions on Screening
A 22-year-old woman has noted no fetal movement at 17 weeks gestation. A screening fetal ultrasound shows a midline abdominal wall defect, with bowel contents contained within a membranous sac. Her serum alpha-fetoprotein is increased. Which of the following abnormalities is most likely present in her fetus?
- Exstrophy
- Gastroschisis
- Omphalocele
- Patent urachus
- Persistent vitelline duct
Answer: C. A midline defect involving the umbilicus and covered by a sac is called an omphalocele. Abdominal contents such as bowel can herniate into the sac. Some omphaloceles are associated with chromosomal anomalies such as trisomy 18 (Edwards syndrome). ---
A 24-year-old primigravida has felt no fetal movement at 16 weeks gestation. A screening fetal ultrasound shows anhydramnios, poorly formed pelvic bones, and no recognizable lower extremities. An abnormality involving which of the following structures was most likely present with these findings?
- Dermis
- Lumbosacral spine
- Neural crest
- Splanchnic mesoderm
- Zone of proliferating activity
Answer: B. The condition described is caudal regression syndrome. Limb buds did form, but compete development was restricted. Pelvic structures such as the lower urinary tract may also be affected. ---
A 61-year-old man has a screening colonoscopy performed. A 2.7 cm polypoid mass in the rectum is biopsied and diagnosed as grade I on a scale of I to III, and assessed as stage I disease. Which of the following is the best interpretation of these findings in this man?
- Unlikely to be malignant
- Arising from epithelium
- May spread via lymphatics and bloodstream
- Has an in situ component
- Well-differentiated and localized
Answer: E. A well-differentiated (low grade) and localized (lower stage) malignant neoplasm often has both a low grade and low stage. In such cases surgery to excise the lesion is more likely to be curative. ---
Screening test for the extrinsic pathway?
- APTT
- Bleeding time
- PT
- Thrombin time
Answer: C. PT measures the extrinsic (Factor VII + tissue factor) and common pathways. ---
The newborn screening test for PKU measures
- Urine homocysteine
- Serum phenylalanine
- Urine phenylpyruvate
- Serum tyrosine
Answer: B. Elevated serum phenylalanine on the Guthrie test or tandem mass spectrometry is the basis of newborn PKU screening. ---
The best screening test for acromegaly is
- Random GH level
- IGF-1
- GH after glucose load
- MRI pituitary
Answer: B. IGF-1 is stable throughout the day (unlike pulsatile GH) and reflects integrated GH secretion, making it the best screening test. ---