OB/Gyn packrat Flashcards
A 25 year-old woman has noted an enlarging painful swelling of the right labia for three days. Which of the following is the most likely diagnosis? A. Condyloma acuminata B. Gartner duct cyst C. Bartholin gland abscess D. Squamous cell carcinoma
(c) C. Bartholin glands, located on the inferior borders of the vagina, are a common location for N. gonorrhoeae or C. trachomatis infection. When the gland becomes full or painful, incision and drainage is appropriate.
A 24 year-old female presents with complaints of dysuria associated with fever, malaise, myalgias and headache for the past 3 days. Today she noticed some lesions on her genitalia. Physical examination reveals the presence of multiple clear vesicles and erythematous ulcers with tender bilateral inguinal adenopathy. Which of the following is the most appropriate treatment for this patient? A. valacyclovir (Valtrex) B. metronidazole (Flagyl) C. ceftriaxone (Rocephin) D. benzathine penicillin G (Bicillin)
(c) A. This patient most likely has herpes genitalis which may be treated with oral antivirals, such as valacyclovir, that will reduce the duration of viral shedding and shorten the duration of symptoms.
A 28 year-old female presents with lower abdominal pain and vaginal discharge. On examination the patient
is toxic appearing and her temperature is 39°C. Pelvic examination reveals cervical motion tenderness. What is the next best step in the evaluation of this patient?
A. Abdominal x-ray
B. Endocervical culture
C. Laparoscopy
D. Hysterosalpingogram
(c) B. Endocervical culture would be helpful in the diagnosis of pelvic infection.
A 24 year-old sexually active woman presents to the clinic complaining of dysmenorrhea, dyspareunia and backache that occurs premenstrually. Pelvic examination shows pain upon uterine motion and uterosacral nodularity in the posterior vaginal fornix. The definitive diagnosis for this patient requires which of the following? A. Pelvic ultrasound B. CT of the abdomen C. Laparoscopy with biopsy D. CA-125 test
(c) C. Diagnosis of endometriosis must be made by direct visualization. Laparoscopy with biopsy is the most appropriate diagnostic study in this patient.
Which of the following is the most common presenting clinical manifestation of breast cancer? A. breast tenderness B. nipple discharge C. nipple retraction D. breast mass
(c) D. A breast mass is the most common presenting clinical manifestation of breast cancer found by the patient or health care provider.
Which of the following is associated with meconium-stained amniotic fluid during labor? A. transition B. prematurity C. fast labor D. fetal distress
(c) D. Passage of meconium is associated with fetal distress usually due to asphyxia.
You are performing a routine gynecological examination on a 49 year-old female. She states that for the last six months her periods have been getting heavier and lasting for seven days duration. She also tells you that she has been experiencing urinary frequency and constipation. Her abdominal exam is unremarkable. On pelvic examination you feel a slightly enlarged uterus and a left adnexal mass that moves with the uterine fundus. Which of the following is the most likely diagnosis? A. Adenomyosis B. Uterine fibroids C. Ovarian neoplasm D. Diverticular disease in the colon
(c) B. Patients with uterine fibroids often have menorrhagia and/ or metrorrhagia. On examination, the uterus will be larger, and irregularly-shaped. If a mass is present and it moves with the uterus, it is suggestive of a fibroid.
What should be the initial evaluation of the etiology of infertility in a 25 year-old female who has been trying to conceive for 1 year? A. Endometrial biopsy B. Hysterosalpingogram C. Serum progesterone levels D. Basal body temperature measurements
(c) D. Basal body temperature measurement is an excellent screening test for ovulation, and will help with the timing of coitus.
A 22 year-old G1P0 female presents at 12 weeks gestation with 24 hours of vaginal bleeding. She complains of continued cramping and bleeding requiring pad change every two hours. Vital signs are normal. Vaginal examination shows bleeding with a dilated cervix. Which of the following is the most likely diagnosis? A. Threatened abortion B. Inevitable abortion C. Incomplete abortion D. Complete abortion
(c) B. Abortion is inevitable when cervical effacement, dilatation and rupture of membranes is noted.
What phase of the female menstrual cycle occurs at the time of elevated estrogen and LH/FSH surge? A. Follicular phase B. Proliferative phase C. Ovulation D. Secretory phase
(c) C. Ovulation occurs within 30-36 hours of the LH surge and at the time of elevated estrogen.
A 65 year-old postmenopausal female presents with complaints of new onset of vaginal bleeding. She relates a history of two episodes of vaginal bleeding during the past month, each lasting about four days. Which of the following diagnostic evaluations is the most reliable to evaluate the suspected diagnosis? A. Pap smear B. endometrial biopsy C. serum prolactin level D. serum FSH and LH levels
(c) B. Postmenopausal bleeding is a primary complaint in patients with endometrial cancer. The only reliable method of diagnosis is by endometrial biopsy.
It is determined that a woman has a nonexistent rubella titer level during her first trimester of pregnancy. When should she receive the rubella vaccine?
A. During the first trimester of pregnancy
B. During the second trimester of pregnancy
C. During the third trimester of pregnancy
D. After delivery of the infant
(c) D. The patient should not receive the rubella vaccine during the course of her pregnancy as the possibility of
transmission of the rubella virus does exist. During the time that the patient is without protective titer she should avoid anyone with active rubella infection. The proper time to receive the vaccine is after delivery of the infant.
What is the initial treatment of choice for hyperthyroidism in a 10-week pregnant patient? A. No treatment is necessary. B. Propylthiouracil (PTU) C. Radioiodine treatment D. Subtotal thyroidectomy
(c) B. This is the initial treatment of choice.
A 24 year-old G2 P1 at 32 weeks of gestation presents to labor and delivery with contractions. Her previous pregnancy resulted in an uncomplicated term delivery at 37 weeks. Which of the following will be most helpful in predicting the likelihood of preterm delivery in this patient? A. Fetal fibronectin B. Screening for candidiasis C. Weekly digital cervical examinations D. Ultrasound of lower uterine segment
(c) A. An increase in the concentration of fetal fibronectin in cervicovaginal secretions is found with preterm labor. A preterm rise in the concentration may be associated with an increase likelihood of birth between 22 and 34 weeks of gestation and birth within 7-14 days of the test.
A 25 year-old female, G2 P1001, presents to your office at 11-weeks gestation with vaginal bleeding, mild lower abdominal cramping, and bilateral lower pelvic discomfort. On examination, blood is noted at the dilated cervical os. No tissue is protruding from the cervical os. The uterus by palpation is 8-9 weeks gestation. No other abnormalities are found. Which of the following is the most likely diagnosis? A. Threatened abortion B. Inevitable abortion C. Incomplete abortion D. Complete abortion
(c) B. Inevitable abortion is the gross rupture of membranes in the presence of cervical dilation.
A 56 year-old female presents to the clinic wanting testing for ovarian cancer. Her best friend was just diagnosed with Stage 4 primary cancer of the ovary. She denies family history of breast or ovarian cancer. According to screening guidelines, which of the following do you recommend?
A. BRCA 1-2 gene testing
B. A pelvic ultrasound yearly
C. Continue her yearly women’s health examinations
D. CA-125testing
(c) C. The patient is advised to have regular pelvic exams. The limited prevalence of ovarian cancer and the lack of sensitivity and specificity of current available tests have so far prevented the implementation of routine ovarian cancer screening of the general population.
In which of the following maternal-fetal blood type pairings should the mother receive Rho-GAM?
A. A positive mother, O negative infant
B. A negative mother, O negative infant
C. AB positive mother, spontaneous abortion
D. AB negative mother, spontaneous abortion
(c) D. Rho-GAM is indicated for an unsensitized Rh-negative patient who has had a spontaneous or induced abortion, ectopic pregnancy, or at the time of amniocentesis. It is also indicated at 28 weeks gestation and within 72 hours of delivery of an Rh-positive infant.
A 34 year-old female G2P1Ab0 at 36 weeks gestation presents to the clinic with a complaint of a sudden gush of fluid from the vagina 18 hours ago. The patient denies any blood in the discharge but describes the fluid as watery. Examination reveals that there is a collection of fluid in the posterior fornix, the Nitrazine test is blue as well as the fluid giving a fern-like crystallization pattern on a slide. Given these findings what is the appropriate clinical intervention? A. Observation B. Induce labor C. Antibiotics D. Corticosteroids
(c) B. Since the patient is 36 weeks gestation and it has been greater than 12 hours since the leakage of fluid, labor should be induced to minimize infection.
Which of the following tocolytic agents works by inhibition of calcium influx? A. Nifedipine (Procardia) B. Terbutaline sulfate (Terbutaline) C. Indomethacin (Indocin) D. Ritodrine (Yutopar)
(c) A. Nifedipine, a calcium channel blocker, prevents calcium entry into muscle cells. It is commonly used for the treatment of preterm labor.
A female patient presents with a vaginal discharge that has a fishy odor. On wet mount examination of the discharge a few white blood cells and many stippled epithelial cells are noted. Which of the following is the treatment of choice for this patient? Answers A. Nonoxynol-9 B. Ceftriaxone C. Metronidazole D. Clotrimazole
(c) C. Metronidazole is the treatment of choice for bacterial vaginosis. Bacterial vaginosis presents with a vaginal discharge with a fishy odor and clue cells on wet mount exam.
In which of the following conditions would human chorionic gonadotropin (hCG) level be lower than expected for gestational age? A. Choriocarcinoma B. Hydatidiform mole C. Ectopic pregnancy D. Twin gestation
(c) C. An ectopic pregnancy will have an abnormally low hCG level because the hCG will not double every 48 hours as a normal pregnancy would.
A 35 year-old G2P1001 female presents to the office at 11 weeks gestation with vaginal bleeding, mid-lower abdominal cramping, and bilateral lower pelvic discomfort. On examination, bright red blood is seen coming from the cervical os. The cervix is closed. The uterus is 9-11 weeks in size by palpation. Her blood pressure is 120/70 mmHg and her pulse rate is 96. What is the patient's most likely diagnosis? A. Inevitable abortion B. Incomplete abortion C. Threatened abortion D. Missed abortion
(c) C. If bleeding occurs in the first 20 weeks of pregnancy and the cervix is closed, threatened abortion is the diagnosis.
A 72 year-old female presents with vulvular pruritus for the last nine months, which has progressively worsened over the last two months. She states that she went through menopause at age 54 and has been on estrogen and progesterone therapy since that time. Physical examination reveals red lesions with white plaques on the vulva. What should the next course of management include?
A. Refer to a gynecologist for biopsy.
B. Refer to a dermatologist for antifungal therapy.
C. Treat with a topical steroid.
D. Treat with estrogen cream.
(c) A. Vulvular squamous cell hyperplasia causes thickening and hyperkeratosis of the vulva. The lesions are red and moist and cause intense pruritus over time the area becomes thickened and a white plaque may develop. Biopsy must be done to evaluate for intraepithelial neoplasm or invasive tumor.
Which of the following clinical manifestations is common in candidal vulvovaginitis? A. Extreme vulvar irritation B. Firm, painless ulcer C. Tender lymphadenopathy D. Purulent discharge
(c) A. Candida infection presents with pruritus, vulvovaginal erythema, and white, cheese-like (curd) discharge that may be malodorous.
A patient with preterm labor may be given corticosteroids to
A. decrease uterine activity.
B. prevent chorioamnionitis.
C. enhance fetal lung maturity.
D. prevent the development of gestational diabetes.
(c) C. Corticosteroids may be given from 24-34 weeks in patients with preterm labor or who have pregnancy complications which may cause premature birth. The corticosteroids enhance pulmonary maturity.
To relieve dependent edema in a pregnant patient, which of the following should be instituted as treatment? A. Limit fluid intake. B. Elevate the legs. C. Prescribe thiazide diuretics. D. Strict avoidance of sodium.
(c) B. Dependent edema is a common and rarely serious complication of pregnancy due to impedance of venous
return. Leg elevation improves circulation.
A 24 year-old sexually active female patient is seen for the first time in the office for a complete history and physical examination. During the history, you find that the patient smokes 2 packs per day and has been sexually active since age 14 with multiple partners without the use of barrier protection. Given this information, what is the patient most at risk for developing? A. Cervical carcinoma B. Ovarian carcinoma C. Uterine carcinoma D. Vulvar carcinoma
(c) A. Human papilloma virus (HPV) is a prime etiologic factor of developing cervical intraepithelial neoplasia (CIN) and cervical cancer. Cigarette smoking and HPV is associated with a two-to-four fold increase in the relative risk for developing cervical cancer.
A 32 year-old female complains of severe irritability and emotional lability accompanied by weight gain, breast tenderness, and headache starting mid-cycle each month and abating with the onset of menses. She has tried relaxation therapy, exercise, dietary changes and over the counter pharmacologic interventions with minimal relief of her symptoms. Which of the following prescription medications is the best choice to relieve her symptoms?
A. Alprazolam (Xanax)
B. Fluoxetine (Prozac)
C. Oral contraceptive pill (Ortho-novum 1/35)
D. Spironolactone (Aldactone)
(c) B. SSRI’s provide symptom improvement for patients with premenstrual syndrome (PMS).
Which of the following portends the greatest risk for the development of breast cancer?
A. Nulliparity
B. Earlymenarche
C. BRCA 1 positivity
D. Maternal family history of breast cancer
(c) C. BRCA1 positivity is associated with half of the early onset breast cancers and 90% of the hereditary ovarian cancers.
An 18 year-old G1P0 female presents for her 35 week prenatal visit with complaints of headache, blurred vision and right upper quadrant discomfort. Vital signs show BP of 170/100 mmHg and brisk patellar reflexes. Urinalysis shows 3+ proteinuria. Fetal heart tones are 150. What is your next step in the care of this patient?
A. Admit to hospital and prepare for delivery
B. Admit to hospital with antepartum fetal surveillance and close monitoring of maternal conditions
C. Order bed rest at home with daily fetal movement counts and twice weekly antepartum care
D. Order bed rest at home with administration of prophylactic magnesium sulfate
(c) A. Severe preeclampsia mandates hospitalization. Delivery is indicated if gestational age is 34 weeks or greater.
When is the recommendation for the next Pap smear in a 36 year-old patient with a history of 3 consecutive negative annual Pap smears and no history of cervical dysplasia?
A. Yearly Pap smears
B. Pap smear in 4 years
C. Papsmearin3years
D. Patient does not need any further Pap smears
(c) C. Women who have had 3 consecutive negative annual Pap smears results may be screened every 2 or 3 years if they are 30 or older with no history of CIN 2 or 3, immunosuppression, HIV infection, or diethystilbestrol (DES) exposure in utero.
What is the treatment of magnesium sulfate toxicity? A. Nifedipine B. Terbutaline C. Potassium carbonate D. Calcium gluconate
(c) D. 10% calcium gluconate is used to treat magnesium sulfate toxicity.
Which of the following laboratory markers are helpful in establishing the diagnosis of ovarian cancer in a 55 year-old post-menopausal women? A. Ca-125 B. CEA C. LDH D. AFP
(c) A. Ca-125 is one of the best tumor markers in epithelial ovarian cancer.
A 26 year-old woman requests screening after her boyfriend was treated for a sexually transmitted infection recently. On examination you find a painless vulvar ulcer. Which of the following is the most likely diagnosis? A. Herpes B. Syphilis C. Chancroid D. Granuloma inguinale
(c) B. The primary lesion of syphilis presents as a painless ulcer or chancre. Secondary syphilis presents with a skin rash lymphadenopathy and mucocutaneous lesions.
A 52 year-old obese patient with persistent heavy menses undergoes an endometrial biopsy and is diagnosed with atypical adenomatous hyperplasia. What is the next step in the management of this patient?
A. Total abdominal hysterectomy
B. Observation and endometrial biopsy in 3 months
C. Endometrial curettage followed by progesterone daily
D. Oral progesterone days 16-25 of the month for 6 months and repeat biopsy
(c) A. Atypical adenomatous hyperplasia contains cellular atypia and mitotic figures in addition to glandular crowding and complexity. This has a 20-30% risk of progression to endometrial cancer and the recommendation is hysterectomy.
A 29 year-old female G4P2Ab1 at 20 weeks gestation complains of nausea and vomiting with tenderness in the RUQ. Vital signs reveal the patient to be febrile. On physical examination, the abdominal examination reveals positive bowel sounds in all quadrants with a positive Murphy's sign. Fundus can be palpated at the level of the umbilicus. The skin is warm and dry with slight tenting. Oral mucosa is dry as well. What is the most likely diagnosis? A. Peptic ulcer disease B. Hyperemesis gravidarum C. Cholecystitis D. Viral gastroenteritis
(c) C. Gallbladder disease represents one of the most common medical and surgical conditions seen during pregnancy. This is thought to be due to a decrease in gallbladder contractility and lithogenicity of the bile. There is an increased risk in multiparous women.
An 18 year-old female presents with dysmenorrhea associated with nausea and diarrhea for the last 3 years. She is not taking any medications at this time. Examination reveals a midline, mobile, and non-tender uterus of normal size. She has no cervical motion tenderness. Which of the following is the most likely pathophysiology for this patient’s symptoms?
A. Myometrial irritation from ectopic endometrial glands
B. Excessive prostaglandin-induced myometrial contraction
C. Pelvic congestion from dilated spiral arterioles
D. Excessive endometrial proliferation from unopposed estrogen
(c) B. Primary dysmenorrhea is caused by an excess of prostaglandin F2 alpha produced in the endometrium. Prostaglandin production in the uterus normally increases under the influence of progesterone, reaching a peak at the start of menses.
A postmenopausal patient is diagnosed with rade I breast cancer. The tumor is 0.7 cm in size, estrogen- receptor positive, and axillary nodes are negative. After undergoing a lumpectomy, which of the following adjuvant therapy is indicated for this patient? A. Chemotherapy B. Tamoxifen (Nolvadex) C. Ovarian ablation D. Bisphosphonate therapy
(c) B. Tamoxifen is the adjuvant therapy of choice in post menopausal estrogen receptor positive axillary node negative breast cancer.
Which of the following physical examination findings is present in a 12 week singleton pregnancy?
A. Chadwick’s sign
B. Uterus palpable at the level of the umbilicus
C. Blood pressure lower than non-pregnant state
D. Hyperreflexia
(c) A. Chadwick’s sign is a bluish discoloration of the vagina early in pregnancy; it usually appears by 12 weeks of gestation.
A 29 year-old female has been diagnosed with infertility due to anovulation. Her provider suggests using a medication that will block the feedback inhibition of estradiol on the hypothalamus and pituitary leading to an increase in FSH. Which of the following medications is the most appropriate for this patient? A. Leuprolide (Lupron) B. Clomiphene citrate (Clomid) C. Medroxyprogesterone acetate (Provera) D. Metformin (Glucophage)
(c) B. Clomiphene citrate is the agent of choice for women younger than 36 years of age who need induction of ovulation
A 30-week pregnant patient presents with sudden onset of profuse, painless vaginal bleeding. Which of the following is the most likely diagnosis?
Answers
A. Abruptio placentae
B. Uterine rupture
C. Placenta previa
D. Disseminated intravascular coagulation
(c) C. Placenta previa presents with sudden, painless, profuse bleeding in the third trimester.
What is the drug of choice for reversing magnesium sulfate toxicity in the management of premature labor? A. Calcium gluconate B. Potassium chloride C. Naloxone (Narcan) D. Oxytocin (Pitocin)
(c) A. Calcium gluconate is the drug used to reverse magnesium sulfate toxicity.
A 36-week pregnant patient presents to the ED with hypertension. Physical examination reveals 2+/4+ edema in the lower extremities with hyperreflexia and clonus bilaterally. A urinalysis reveals 3+ protein. Which of the following is the best treatment option for this patient? Answers A. Magnesium sulfate B. Nifedipine (Procardia) C. Diazepam (Valium) D. Captopril (Capoten)
(c) A. Magnesium sulfate is indicated in this patient with preeclampsia to reduce the risk of seizures.
A 28 year-old G0 P0 female presents with a 2 week history of pelvic pain and scant vaginal bleeding. She reports a history of regular menses every 28 days, however, her LMP was 37 days ago. On examination, her uterus is normal in size. There is a small amount of blood in the vagina. Her left adnexa is somewhat tender. Which of the following is the most likely diagnosis? A. Ruptured corpus luteum cyst B. Pelvic inflammatory disease C. Ectopic pregancy D. Threatened abortion
(c) C. An ectopic pregancy is one in which the blastocyst implants anywhere other than the endometrial lining of the uterine cavity. The classic symptoms of an ectopic pregnancy are amenorrhea, followed by vaginal bleeding, and abdominal pain on the affected side.
Which of the following lab findings is suggestive of menopause?
A. Decrease in FSH, increase in LH
B. Decrease in FSH, decrease in LH
C. Increase in FSH, increase in estradiol
D. Increase in FSH, decrease in estradiol
(c) D. FSH greater than 30 mIU/mL is diagnostic of menopause. LH is also elevated in menopause. Estradiol starts to decrease around menopause to levels of 10-15 pg/mL.
You are following a patient in labor at term. You evaluate the fetal monitoring tracing and note the presence of variable, repetitive decelerations in the heart rates. The contractions have a sharp deceleration slope. What is the recommended treatment for these decelerations? A. Change maternal position B. Administer tocolytic therapy C. Apply vibroacustic stimulation D. Perform cesarean section
(c) A. Variable decelerations occur from umbilical cord compression and oligohydramnios. They are treated by changing maternal positioning to relieve pressure on the umbilical cord. Additionally, amnioinfusion may be used to relieve umbilical cord compression in cases of oligohydramnios.
If a woman has a normal 28-day menstrual cycle what tissue and hormonal phase occurs during the last 14 days?
A. Proliferative follicular phase under the influence of estrogen.
B. Secretory luteal phase under the influence of estrogen and progesterone.
C. Proliferative follicular phase under the influence of estrogen and progesterone.
D. Secretory luteal phase under the influence of estrogen.
(c) B. The endometrial changes seen in the latter half of the cycle are under the influence of both estrogen and
progesterone from the corpus luteum. During this phase, the endometrium becomes more vascularized and
slightly edematous.
A 22 year-old G0P0 asymptomatic female is seen for her yearly gynecologic examination. She denies performing self-breast exams and any family history of breast or gynecologic cancers. On palpation of her left breast, a solitary 1 cm rubbery, firm, well-circumscribed, non-tender breast mass is noted. In review of her records, similar findings were noted on last year's examination. Which of the following is the most likely diagnosis? A. fibroadenoma B. breast fat necrosis C. fibrocystic changes D. intraductal papilloma
(c) A. Fibroadenoma of the breast most commonly is seen in young females. Typical characteristics include a solitary 1-3 cm firm, painless, freely movable mass that does not change with the menstrual cycle and are slow growing. Most are found as an incidental finding on physical examination or during self-breast examination.
Which of the following best describes the purpose of intravenous magnesium sulfate in patients with preeclampsia? A. Prevention of convulsions B. Prevention of HELLP syndrome C. Lowering of blood pressure D. Reversal of proteinuria
(c) A. Magnesium sulfate is used to prevent and treat eclamptic seizures. Magnesium sulfate is not sufficient to treat hypertension, therefore antihypertensives must be added. Magnesium sulfate is excreted solely from the kidneys and urine output must be preserved to prevent accumulation of the drug. Magnesium sulfate does nothing to prevent HELLP syndrome.
Which of the following is a major risk factor for an ectopic pregnancy? A. alcohol intake B. young maternal age C. history of salpingitis D. low dose oral contraceptive use
(c) C. A previous history of salpingitis is a major risk factor for ectopic pregnancy since damage to the fallopian tube prevents the fertilized ovum from reaching the uterus prior to implantation.
Which of the following is the most significant factor in the production of menopausal symptoms? A. decrease in estrogen B. decrease in testosterone C. increase in progesterone D. increase in androstenedione
(c) A. A decrease in estrogen is responsible for the majority of menopausal symptoms including, but not limited to, hot flashes, sleep disturbances, genital tract atrophy and mood changes.
Which of the following is required for the initiation and maintenance of the menstrual cycle?
A. Prolactin release by the anterior pituitary
B. Pulsatile secretion of gonadotropin-releasing hormone (GnRH)
C. Follicular phase of variable length
D. Estrogen secretion by the ovary
(c) B. Gonadotropin-releasing hormone is secreted in a pulsatile fashion from the arcuate nucleus of the hypothalamus. The pulsatile secretion of GnRh stimulates and modulates pituitary gonadotropin secretion.
Which of the following tests is the most specific for the diagnosis of syphilis?
A. Rapid plasma reagin (RPR)
B. Weil-Felix agglutination test
C. Venereal Disease Research Laboratory (VDRL)
D. Fluorescent treponemal antibody absorption (FTA-ABS)
(c) D. The FTA-ABS and the MTA-TP are specific treponemal tests used for the confirmation of syphilis.
A 33 year-old female presents for follow-up of her Pap smear that showed cervical dysplasia. Which of the following is the most appropriate diagnostic procedure? A. Cone biopsy B. Aspiration needle biopsy C. Dilation and curettage D. Colposcopy-directed biopsy
(c) D. A colposcopy-directed biopsy is the first diagnostic evaluation indicated for cervical dysplasia.
In the treatment of endometriosis, which of the following medications has a side effect profile that includes loss of bone mineral density, vasomotor symptoms, vaginal dryness and mood changes? A. Oral contraceptives B. Dantrolene (Danazol) C. Leuprolide (Lupron) D. Progestational agents
(c) C. Leuprolide is a gonadotropin releasing hormone analogue that results in suppression of gonadotropic secretion. This suppression leads to a hypoestrogenic state which contributes to these side effects.
