Colorectal and endometrial cancer, traced through a composite family's three generations and drawn to McGoldrick conventions, seem to satisfy Amsterdam II in this NU568 genogram analysis, reshaping four relatives' screening. Searches like "nu 568 unit 6 assignment example", "nu568 unit 6 sample" and "nu568 unit 6 example" land here.
A Pattern the Family Had Never Seen in One Place: A Three-Generation Genogram Pointing to Lynch Syndrome
[Student Name]
Purdue University Global
NU568: FNP I - Primary Care Across the Lifespan
Unit 6 Genogram Analysis
[Instructor Name]
[Date]
The family is a composite; ages and intervals in brackets are illustrative, and no real family is described.
The Genogram
The figure uses standard conventions: a square for each male and a circle for each female, a diagonal stroke across anyone who has died, the index person, Ms. [R.], 44, marked with a double outline, and a dotted line around her current household (McGoldrick et al., 2020). Pedigree symbols follow the standardized nomenclature used by genetic counselors (Bennett et al., 2008). Ages at diagnosis are written beside each affected symbol; solid shading marks colorectal cancer, and diagonal hatching marks endometrial cancer. A legend explains both.
1. Generation I: paternal grandfather, deceased (stroke through symbol), bowel tumor in his [60s], died [67]; paternal grandmother, died [81] of stroke; maternal grandparents, both died in their [80s], no cancers known.
2. Generation II: father, deceased (stroke through symbol), colorectal cancer at 46, died 49; paternal aunt, endometrial cancer at 49, alive at [68]; paternal uncle, alive at [70], no cancer, colonoscopy history unknown; mother, alive at [72], breast cancer at [70].
3. Generation III: Ms. [R.], 44, double outline, no cancer, one colonoscopy at [40], normal; her brother, [47], no screening yet; her cousin, the aunt's daughter, [30].
4. Generation IV, inside the dotted household line: Ms. [R.]'s son, 15, and daughter, 12.
The Pattern
Colorectal cancer in a father and grandfather, endometrial cancer in an aunt, and two diagnoses before age 50, across two generations on one side of the family, form a history consistent with Lynch syndrome. Lynch syndrome is an inherited condition caused by a pathogenic variant in a DNA mismatch repair gene, and it raises the lifetime risk of colorectal and endometrial cancer substantially, along with several other cancers (Giardiello et al., 2014).
A genogram can show a pattern; it cannot make a diagnosis. The cancers must be confirmed by pathology, since "bowel tumor" in a grandfather's history could mean a colorectal cancer, a stomach cancer or something else. Polyposis syndromes, which also cause early colorectal cancer, must be excluded. And only genetic testing can establish Lynch syndrome.
The Amsterdam II Criteria, Checked
1. At least three relatives with a Lynch-associated cancer, such as colorectal or endometrial cancer: grandfather, father, aunt. Met, if the grandfather's tumor is confirmed as colorectal.
2. One affected person closely related, parent, child or sibling, to both others: the father is the son of the grandfather and the brother of the aunt. Met.
3. At least two successive generations affected: generations I and II. Met.
4. At least one diagnosed before age 50: father at 46, aunt at 49. Met.
5. Familial adenomatous polyposis excluded: unverified; the father's pathology report is needed.
6. Tumors verified by pathological examination: unverified.
(Vasen et al., 1999)
Four criteria are met and two are unverified. The family history is highly suggestive, and even if a criterion fails, the family would still warrant genetic evaluation.
Recommendation
Referral to genetic counseling for Ms. [R.]. The most informative first step is testing an affected relative: her aunt is alive, and the aunt's endometrial tumor tissue, or the father's stored colon tumor tissue, can be tested for mismatch repair protein loss or microsatellite instability. If tumor testing is abnormal, germline testing of the aunt would identify the family's variant, and relatives could then be tested for that specific variant (Syngal et al., 2015). If no tissue is available, germline multigene panel testing of Ms. [R.] is an option, though a negative result is less informative without a known family variant.
Four Screening Plans
Ms. [R.], 44. Relationship: daughter of an affected man, niece of an affected woman. Screening now: colonoscopy every [1 to 2] years, starting now, as recommended for relatives in families that meet Amsterdam criteria while testing is pending (Giardiello et al., 2014). Gynecologic: discuss endometrial cancer risk, symptoms to report and options. What would change it: a negative test for a known family variant would return her to average-risk screening; a positive test would continue Lynch surveillance and add discussion of risk-reducing surgery after childbearing.
Her brother, 47. Relationship: son of an affected man. Screening now: colonoscopy promptly, since he has had none, then every [1 to 2] years pending testing. What would change it: the same testing results.
Her cousin, 30. Relationship: daughter of the affected aunt. Screening now: genetic counseling; colonoscopy every [1 to 2] years from [25] if the family is confirmed as Lynch, which at 30 would start now. Gynecologic: counseling on endometrial and ovarian risk. What would change it: testing for the family variant. Ms. [R.] cannot share this plan directly; she is encouraged to tell her cousin and her aunt, and a family letter from the genetics service can help.
Her children, 15 and 12. Relationship: grandchildren of an affected man. Screening now: nothing. Counseling as they approach adulthood; testing for a known family variant is usually offered at 18 or later, and colonoscopy, if they carry the variant, would begin at [20 to 25].
Conversations the Genogram Opens
Drawing the genogram took twenty minutes and raised questions Ms. [R.] had never asked. She did not know where her father's surgery had been done, whether his tumor tissue was stored, or whether her uncle had ever had a colonoscopy. She did not know her aunt's exact diagnosis beyond "cancer of the womb." Each gap became a task: requesting her father's pathology report from the hospital where he was treated, asking her aunt whether she would consent to tumor testing, and asking her uncle about his screening. Her mother's breast cancer at 70 was recorded but is not part of the Lynch pattern, which is on the paternal side; it matters for her own breast screening and was noted separately so that it would not be lost.
The conversation also touched on what testing might mean for her. A positive result would bring more frequent colonoscopy and decisions about gynecologic surgery, and it would raise the question of when and how to tell her children. A negative result for a known family variant would bring relief and a return to ordinary screening. Genetic counseling exists to help her weigh those outcomes before, not after, the test.
What the Family Had Never Seen
Ms. [R.] knew each of these cancers as a separate family story. Seeing them drawn together was the first time she recognized them as a possible pattern. That is the genogram's work: it gathers what a family knows in pieces and puts it in one place where it can be read.
References
Bennett, R. L., French, K. S., Resta, R. G., & Doyle, D. L. (2008). Standardized human pedigree nomenclature: Update and assessment of the recommendations of the National Society of Genetic Counselors. Journal of Genetic Counseling, 17(5), 424-433. https://doi.org/10.1007/s10897-008-9169-9
Giardiello, F. M., Allen, J. I., Axilbund, J. E., Boland, C. R., Burke, C. A., Burt, R. W., Church, J. M., Dominitz, J. A., Johnson, D. A., Kaltenbach, T., Levin, T. R., Lieberman, D. A., Robertson, D. J., Syngal, S., & Rex, D. K. (2014). Guidelines on genetic evaluation and management of Lynch syndrome: A consensus statement by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology, 147(2), 502-526. https://doi.org/10.1053/j.gastro.2014.04.001
McGoldrick, M., Gerson, R., & Petry, S. (2020). Genograms: Assessment and treatment (4th ed.). W. W. Norton.
Syngal, S., Brand, R. E., Church, J. M., Giardiello, F. M., Hampel, H. L., & Burt, R. W. (2015). ACG clinical guideline: Genetic testing and management of hereditary gastrointestinal cancer syndromes. American Journal of Gastroenterology, 110(2), 223-262. https://doi.org/10.1038/ajg.2014.435
Vasen, H. F. A., Watson, P., Mecklin, J.-P., & Lynch, H. T. (1999). New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome) proposed by the International Collaborative Group on HNPCC. Gastroenterology, 116(6), 1453-1456. https://doi.org/10.1016/S0016-5085(99)70510-X
How this NU568 Unit 6 example is structured
The analysis moves from figure to pattern to plans, and every claim in it can be checked against the drawing. The pattern section is careful about what a genogram can and cannot establish: it identifies a family history consistent with Lynch syndrome, notes that pathology must confirm the diagnoses and exclude polyposis, and leaves diagnosis to genetic testing. The criteria are checked in a small table, one row per criterion, marked met, not met or unverified. The plans section is organized by person, and each plan states the relative's relationship to the affected members, their age, the screening that applies now and the event that would change it. Screening intervals are bracketed and attributed to the US Multi-Society Task Force document cited by year. The children's plan is deliberately short: nothing now, counseling as they approach adulthood.
Get an NU568 Unit 6 example written to your instructions
Genogram prompts vary: some supply a family, others leave its invention to whoever writes. Send what your NU568 Unit 6 case provides, the risk it centers on and the rubric. Back in 24-48h, the sample sets a figure drawn to McGoldrick conventions beside an analysis and per-relative plans. Your first request is free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU568 Unit 6 questions, answered
Can the genogram use my own family?
Some sections allow it and a few require it. A sample cannot, since it would expose real people's health histories; an invented family carries the same conventions and analysis instead. If you use your own family, consider whether relatives would consent to their diagnoses appearing in coursework, and follow any privacy guidance your instructor gives.
Which genogram software do courses accept?
Most accept any tool that produces clear standard symbols, including dedicated genogram programs, general drawing software or a careful hand drawing scanned at good resolution. What rubrics grade is correctness and legibility, not the program. Put the legend inside the image itself, because a grader may view the figure separately from the written analysis.
How many generations are required?
Three is the usual minimum and the McGoldrick convention for a basic genogram. Add a fourth when the risk under discussion passes to children or grandchildren who need their own plans, as it does in this sample. More generations help only when they carry information; a figure crowded with unaffected distant relatives can obscure the pattern the analysis depends on.