You are reviewing the laboratory results of an 18 y/o female…

You are reviewing the laboratory results of an 18 y/o female patient seen recently in your clinic for a pap smear. Lab results reveal Classification – high grade squamous intraepithelial lesion; endocervical cells seen; adequate smear. You phone the patient and give her which of the following reports?

A couple present for a preconception health counseling sessi…

A couple present for a preconception health counseling session.  He is a 34 y/o and she is 33. They have a 5 y/o son who is the product of an uncomplicated pregnancy and delivery. At birth he was noted to have an open neural tube defect and now has spina bifida with a loss of function in his lower extremities. They want another child and ask if there is anything they can do to prevent the recurrence of a neural tube defect in future pregnancies. What is your best response to the couple?