An obese 62-year-old with diabetes has light spotting four years after menopause. Another woman has had months of bloating and gets full fast. A 45-year-old hasn't had a Pap smear in 15 years and bleeds after sex. An older woman has treated years of itching with antifungal creams, and now she has a raised lesion.

Four women, four gynecologic cancers, and each one has a reassuring answer that's wrong.

In Episode 178, we cover endometrial, ovarian, cervical, and vulvar cancer, including:

• Who gets each one, and the risk factor that matters most
• Why any bleeding after menopause needs a workup, and the ultrasound number that decides the biopsy
• Why ovarian cancer is the one most likely to be fatal, and where CA-125 fits
• Why a suspected ovarian cancer never gets a needle biopsy
• Cervical cancer screening by age: Pap, HPV test, or both, and how often
• Reading an abnormal Pap: ASC-US, LSIL, HSIL, and which results go to colposcopy
• What happens at a colposcopy, and what CIN on the biopsy means for treatment
• Why years of vulvar itching gets a biopsy, not another round of cream

The study strategy for this episode: close out a system with a blank page. List the diagnoses, then write the test and the treatment for each one from memory. Then open your notes and check. The blanks are your review list.

Visit physicianassistantexamreview.com/178 for the episode notes.

Free Master Class: 8 new ways to get more out of the question bank you already have, Tuesday Nov 10 and Thursday Nov 12, 8 PM Eastern. Register at physicianassistantexamreview.com/masterclass.

Think different. Work different. Score different.

A pregnant woman at 28 weeks says she fell. She has bruises of different ages on her abdomen, and her partner answers every question for her. Four days after delivery, a new mom cries easily but is still caring for her baby. A week after delivery, another mother says her baby is evil.

Each of these is a classic PANCE setup, and each one has a wrong answer that sounds reasonable.

In Episode 177, we cover trauma in pregnancy and postpartum psychiatric disorders, including:

• Why a minor fall still matters, and how long you watch the baby afterward
• Getting the imaging the mother needs, and how much radiation actually worries you
• What to do when a pregnant patient is hypotensive lying flat on her back
• The red flags for abuse, and how to ask about it
• Postpartum blues vs postpartum depression: the timeline that separates them
• Which SSRI to pick for a breastfeeding mother
• Postpartum psychosis: the strongest risk factor, and why an SSRI alone is the wrong move

The study strategy for this episode: get into the sun. About 10 minutes of bright light early in the morning, and more later in the day, sets your body clock. Better sleep is one of the biggest things you can do for your studying.

Visit physicianassistantexamreview.com/177 for the episode notes.

Coming in November: a free Master Class on getting the most out of the question bank you already have, Nov 10 and 12. Register at physicianassistantexamreview.com/masterclass.

Think different. Work different. Score different.

A new mom is bleeding heavily minutes after delivery, and her uterus feels soft and boggy above the umbilicus. Six weeks later, another mother still can't breastfeed and her period hasn't come back. Two days after a C-section, a third has a fever, a tender uterus, and foul-smelling lochia.

Each of these is a classic PANCE setup, and each one has a wrong answer that sounds reasonable.

In Episode 176, we cover postpartum complications, including:

• What counts as postpartum hemorrhage, and why blood pressure is a late sign
• The 4 T's: tone, trauma, tissue, and thrombin
• Placenta accreta vs placenta previa, and why they get mixed up
• The first steps for hemorrhage, and how to pick a second-line uterotonic by what the patient can't take
• Where tranexamic acid fits, and its time window
• Sheehan syndrome: the hormones that drop and the order you replace them
• Postpartum endometritis: the risk factors, the antibiotic of choice, and what to do when the fever won't break

The study strategy for this episode: go back to material you've already covered. Pull a few cards from an old pile, or reread one section from a month ago. A little, often, is how you interrupt the forgetting curve.

Visit physicianassistantexamreview.com/176 for the episode notes.

The December 33 Days cohort is coming soon. Join the waitlist at physicianassistantexamreview.com/33.

Think different. Work different. Score different.