Deck 14: Womens Health Problems

Question 1

A 26-year-old woman tells the clinician that she has endometriosis, because she has frequent pelvic pain.The clinician also should consider which of these differential diagnoses?

A)Diverticulitis
B)Cholelithiasis
C)Kidney stones
D)Ovarian cysts

Answer 1

Ovarian cysts

Question 2

A 32-year-old woman is seen in the clinic because she has been unable to get pregnant after 12 months of unprotected sex.In order to determine the cause of the infertility, the clinician should question her about which of these possible causes?

A)Pelvic inflammatory disease
B)Oral contraceptive use for 15 years
C)Early menarche
D)Diet high in soy protein

Answer 2

Pelvic inflammatory disease

Question 3

A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge.On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae.Which of the following treatments would be appropriate?

A)Fluconazole
B)Estrogen vaginal cream
C)Metronidazole
D)Doxycycline

Answer 3

Fluconazole

Question 4

A 22-year-old woman is diagnosed with premenstrual syndrome.Which of the following lifestyle changes should the clinician suggest to help minimize the patient's symptoms?

A)At least 4 cups of green tea daily
B)Regular exercise
C)Take vitamin A supplements
D)Eat a diet high in iron

Question 5

A 26-year-old woman is seen with complaints of irregular vaginal bleeding.Which of the following tests should be the first priority?

A)Pregnancy test
B)Pelvic ultrasound
C)Endometrial biopsy
D)Platelet count

Question 6

A 58-year-old woman presents with a breast mass.Which of the following responses by the clinician would be most appropriate?

A)"It is probably just a cyst because that is the most common breast mass."
B)"We will order a mammogram and ultrasound to help establish a diagnosis."
C)"We will go ahead and schedule you for a biopsy because that is the only way to know for sure."
D)"Because your lump is painful, it is most likely not cancer."

Question 7

Which of the following medications is the treatment of choice for trichomonas?

A)Metronidazole
B)Ceftriaxone
C)Diflucan
D)Doxycycline

Question 8

A 44-year-old patient with breast cancer is prescribed tamoxifen by her surgeon.She is complaining about hot flashes.Which of the following responses by the clinician would be most appropriate?

A)"You must be having menopause."
B)"The hot flashes are a result of the antiestrogenic effects of tamoxifen."
C)"Tamoxifen will impact your temperature regulation center."
D)"The drug destroys your ovaries."

Question 9

A 15-year-old girl is seen in the clinic because she has not yet had her first period.Which of the following questions would help the clinician determine the cause?

A)"Are you sexually active?"
B)"How long have you been underweight?"
C)"Did your mother take diethylstilbestrol during her pregnancy?"
D)"Have you noticed any changes in your moods lately?"

Question 10

When assessing a woman for infertility, which of the following tests should be done first?

A)Analysis of partner's sperm
B)Magnetic resonance imaging (MRI)
C)Hysterosalpingogram
D)Estrogen level

Question 11

A 21-year-old woman is seen in the clinic requesting birth control pills.Which of the following tests is essential before prescribing any oral contraceptive?

A)Pregnancy test
B)Complete blood cell count
C)Thyroid-stimulating hormone
D)Urine dip for protein

Question 12

A 23-year-old sexually active woman presents for her first Pap smear.Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners.Which of the following conditions should the clinician be particularly alert for during her examination?

A)Human papillomavirus (HPV)
B)Endometrial hyperplasia
C)Vagismus
D)Polycystic ovarian syndrome

Question 13

A 25-year-old woman is seen in the clinic complaining of painful menstruation.Which of the following pelvic pathologies is the most common cause of dysmenorrhea?

A)Pelvic inflammatory disease
B)Endometriosis
C)Sexually transmitted infections
D)Ovarian cyst

Question 14

A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea.Which of the following is the treatment of choice for gonorrhea?

A)Ceftriaxone
B)Doxycycline
C)Acyclovir
D)Metronidazole

Question 15

A 40-year-old woman is seen for her yearly examination.She is single and not in a monogamous relationship.Her social history includes smoking cigarettes "occasionally" and drinking about two beers a day.Her body mass index (BMI) is 25.She is requesting birth control.Which of the following methods would be best for this patient?

A)Intrauterine device
B)Oral contraceptive
C)Condom
D)Vaginal contraceptive sponge

Question 16

A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge.Her boyfriend was recently treated for nongonococcal urethritis.What sexually transmitted disease has she most probably been exposed to?

A)Gonorrhea
B)HPV
C)Chlamydia
D)Trichomonas

Question 17

Which of the following would be appropriate treatment for a woman with mild endometriosis?

A)Oral contraceptives
B)Leuprolide acetate injections
C)Nafarelin nasal spray
D)Hysterectomy

Question 18

A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge.The clinician identifies clue cells on the vaginal smear.Which of the following diagnoses is associated with this finding?

A)Trichomonas
B)Bacterial vaginosis
C)HPV
D)Herpes simplex virus

Question 19

A 42-year-old woman presents to the clinic with complaints of painful intercourse for the last month.Which of the following should be explored as the likely cause of her dyspareunia?

A)Menopause
B)Dehydration
C)Excess progesterone
D)Sexual trauma as a child

Question 20

What is the most common cause of secondary amenorrhea?

A)Pregnancy
B)Pituitary dysfunction
C)Inadequate estrogen levels
D)Genetic disorders

Question 21

A 45-year-old woman is seen because of irregular menstrual periods.Her follicle-stimulating hormone (FSH) level is 48 mIU/mL, and her luteinizing hormone (LH) level is elevated.She asks the clinician what this means.Which would be the best response?

A)"You are approaching menopause."
B)"You have a hormonal imbalance."
C)"Your FSH is normal, but your pituitary is making too much LH."
D)"There is an imbalance between your ovaries and pituitary."

Question 22

A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods.She is pale and states she can no longer exercise.Pelvic exam reveals a single, very large mass.Which of the following diagnostic tests should the clinician order first?

A)Transvaginal ultrasound
B)Endometrial biopsy
C)MRI
D)Abdominal computed tomography scan

Question 23

Which of the following tests is essential for a 46-year-old woman who the clinician suspects is perimenopausal?

A)Pregnancy
B)Estrogen level
C)Progesterone level
D)LH level

Question 24

Oral contraceptive pills can cause endometrial cancer.

Question 25

A 58-year-old woman, who had a total abdominal hysterectomy at the age of 45, is diagnosed with atrophic vaginitis.Which of the following is the most appropriate treatment?

A)Conjugated estrogen, 0.625 mg/day oral
B)Estradiol, 7.5 mcg/24 hr vaginal ring
C)Medroxyprogesterone, 10 mg/day oral
D)Conjugated estrogen, 0.3 mg + medroxyprogesterone 1.5 mg/day oral

Question 26

A 60-year-old woman is seen for an annual checkup.Her obstetric history reveals para 6, gravida 6.She reports that she went through menopause at age 45.Her grandmother died at age 80 of colon cancer, and her father died of lung cancer.What in her history would be a risk factor for ovarian cancer?

A)Her numerous pregnancies
B)Her age at menopause
C)Her father's history of lung cancer
D)Her grandmother's history of colon cancer

Question 27

Most breast cancer cases are in women with a family history of breast cancer.

Question 28

A woman taking estradiol is at risk for developing endometrial cancer.

Question 29

A 45-year-old woman is seen in the clinic with abnormal uterine bleeding and pain during intercourse.The clinician should consider which of the following diagnoses?

A)Leiomyoma
B)Pregnancy
C)Ovarian cancer
D)All of the above