SUBJECTIVE: A 35-year-old white female here for well-woman exam. She is (1)________, P2. None in the past year secondary to Depo-Provera use and a history of (2)________. Patient is sexually active with one partner. She is married. Last (3)________ 1 year ago, within normal limits. The patient has not had a baseline (4)________ done. She does self-breast exams sporadically. No history of uterine, (5)________, or breast cancer of herself or her family. Patient is currently, as noted, on Depo-Provera. A negative uterine pregnancy test was done today, and a prescription was filled. The patient has her Depo-Provera injection with her.
OBJECTIVE: Neck: Thyroid nonpalpable. Breasts: Symmetrical, mild (6)________ changes bilaterally, nontender without masses, no skin changes, no nipple discharge. Genitalia: (7)________ within normal limits, vagina normal, cervix normal in appearance and nontender. Pap done without incident. Bimanual: (8)________ nontender without fullness, (9)________ midline, anteverted, and nontender without mass. Rectal exam was not done.
LABORATORY DATA: (10)________ within normal limits.
ASSESSMENT AND PLAN: Health maintenance. Pap done. Recommend annual Pap. Patient referred for baseline mammogram. Self-breast exam every month recommended. Depo-Provera shot given. Recommend negative pregnancy test prior to every Depo-Provera injection. Follow up as needed.
Question 2
BILATERAL MAMMOGRAMS
DATE OF EVALUATION: (Current Date)
NAME OF TEST: Bilateral (1) ________, 4 views.
FINDINGS: Comparison is made with (2)________ obtained 2 and 4 years ago.
The breasts demonstrate a (3)________ pattern without evidence of a (4)________ mass or (5)_______ calcifications. Focal glandularity within the upper right breast, seen only in the mediolateral (6)________ view, appears slightly more (7)________ than it did on the most recent earlier exam. This probably represents a focus of normal glandular tissue; however, further evaluation is suggested. There are no clustered (8)________.
IMPRESSION: (9)________, upper right breast, for which a coned mediolateral oblique (10)________ is suggested.
This finding was discussed with the referring physician.
Female (doe)
Siberian Yupik woman holding walrus tusks
Desert cottontail as seen from behind such that the white tail is easily visible
Muscle male/female
A spark plug from an engine that had a blown head gasket. The white deposits could be from the ...