Pance Questions 14 Flashcards
Q–31 Women’s Health
Which of the following is/are (a) potential factor(s) in development of cervical neoplasia?
a. Early intercourse
b. Multiple sex partners
c. Oral contraceptive use
d. All of the above
(D) (A), (B), and (C) have been shown to increase the chance of developing cervical carcinoma. Recent research is showing that use of oral contraceptives in the absence of other risk factors may not contribute to the development of carcinoma; however, the research is not yet complete. Q–32
Q–32 Women’s Health
The most common reproductive tract malignancy in women is
a. cervical cancer
b. ovarian cancer
c. endometrial cancer
d. vulvar cancer
(C) Endometrial carcinoma is the most common genital tract malignancy and the fourth most common cancer in women. In 2008, 40,100 new cases were diagnosed in the United States. New cases of ovarian cancer in 2008 were 21,650; cervical cancer, 11,070; and vulvar cancer 3,460.
Q–33 Women’s Health
The most common malignancy in women in developed countries is
a. breast
b. cervical
c. lung
d. uterine
(A) Breast cancer is the most common cancer in women in developed countries. Cervical cancer ranks as the second most common gynecological cancer, but lung cancer is rated second most common overall. Uterine cancer ranks fourth in occurrence for all women.
Q–34 Women’s Health
Women with molar pregnancy may present with findings consistent with pregnancy. Which one of the following symptoms is the most characteristic of a molar pregnancy?
a. Uterine size/dates discrepancy
b. Painless bleeding
c. Passage of tissue
d. Exaggerated “morning sickness”
A–34 (B) All answer choices are characteristic symptoms of molar pregnancy, but painless bleeding is the most characteristic and occurs in most patients early in the second trimester of the pregnancy.
Q–35 Women’s Health
Because of controversy surrounding hormone replacement therapy, many women are seeking alternative therapy for symptoms of menopause. Which of the following have proven to be successful treatment for the majority of women?
a. Soy products
b. SSRI antidepressants
c. Antiseizure medications, e.g., gabapentin
d. None of the above
A–35 (D) All answer choices can be suggested for possible management of hot flushes, but none have been proven successful for all women or for other symptom management.
Q–36 Women’s Health
Which of the following is/are (a) typical symptom(s) of molimina?
a. Fluid retention
b. Fluctuations in mood
c. Food cravings
d. All of the above
A–36 (D) Many women experience peri-menstrual symptoms. In addition to the answer choices, some report anxiety, nervousness, variations in sexual feelings, and difficulty sleeping.
Q–37 Women’s Health/Reproductive Infertility is generally defined as failure
a. to conceive after one year of unprotected sexual intercourse
b. to conceive after 18 months of unprotected sexual intercourse
c. to conceive within 6 months of oral contraceptive use
d. to carry repeated pregnancies to 8 weeks gestation
A–37 (A) Failure to conceive following one year of unprotected sexual intercourse is defined as infertility.
Q–38 Women’s Health/Reproductive
A woman’s last menstrual period is dated from the
a. first day of the last bleeding episode
b. first day of the last “normal” period
c. last day of the last “normal” period
d. last day of the last bleeding episode
A–38 (B) The first day of the last “normal” period is the date from which a woman’s last menstrual period is measured. This is important in assessing gestational age in order to estimate the date of delivery. This information helps in managing possible preterm labor or postdates pregnancy as well as timing of specific evaluations throughout the pregnancy.
Q–39 Women’s Health/Reproductive
The abbreviation of an obstetric history is often depicted as G(a), P(b,c,d,e). In such a recording, the c stands for the number of
a. pregnancies
b. living children
c. abortions
d. preterm pregnancies
A–39 (D) The number of preterm pregnancies (20 through 36 weeks) is designated by the letter “c.” The letter “a” refers to the number of pregnancies; “b” to the number of term pregnancies (beyond 36 weeks); “d” to the number of abortions and ectopic pregnancies; and “e” to the number of living children.
Q–40 Infectious Disease/Pulmonary
Uncomplicated acute sinusitis is often successfully treated without the use of antibiotics. Of the drugs types listed, which one is contraindicated in acute sinusitis?
a. Decongestants
b. Antihistamines
c. Intranasal steroids
d. Analgesics
A–40 (B) Antihistamines can thicken secretions, dry mucous membranes, and impair drainage. Decongestants decrease swelling in the mucous membranes of the nasal passage and improve breathing. Intranasal steroids are not necessary in most patients but may accelerate symptomatic improvement in some. Analgesics are helpful in relieving sinusitis associated pain.
Q–41 Infectious Disease/Pulmonary
You see a patient who gives a history of self-diagnosed acute sinusitis for three weeks. The patient has a temperature of 104°F and appears toxic. He has lid edema, proptosis, chemosis, and 3rd, 4th, and 6th cranial nerve palsies. He also has papilledema. The most likely diagnosis at this time is
a. ethmoidal sinusitis
b. orbital cellulitis
c. septic cavernous sinus thrombophlebitis
d. subdural empyema
A–41 (C) Septic cavernous sinus thrombophlebitis is the most likely diagnosis, due to elevated temperature and clinical manifestations. Orbital cellulitis would not typically cause cranial nerve palsies. Ethmoidal sinusitis implies containment of the infection within the ethmoid sinus. A subdural empyema may result from direct spread of the infection through bone or through venous channels. Clinical findings vary but may include personality changes, headaches, and alterations of consciousness.
Q–42 Infectious Disease/EENT
The primary diagnostic method to distinguish acute otitis media from otitis media with effusion is
a. needle aspiration of the middle
b. ear tympanoplasty
c. pneumatic otoscopy
d. visual otoscopic examination
A–42 (C) Pneumatic otoscopy is performed to evaluate how well the eardrum responds to changes in pressure. Poor eardrum response to pressure changes indicates fluid in the middle ear, which prevents the eardrum and middle ear bones from moving properly and causes a corresponding impairment of hearing. Needle aspiration is used to confirm a diagnosis of purulent otitis media and to identify the causative organism. Tympanoplasty is reconstructive surgery of the tympanic membrane. A simple visual otoscopic examination may not be sufficient to differentiate the conditions.
Q–43 EENT
You see a patient who complains of ear pain and pruritis. Inspection of the affected ear reveals inflammation and crusting in the canal. The patient experiences pain when you manipulate the external ear. The most likely diagnosis is
a. otitis media
b. otitis externa
c. mastoiditis
d. cerumen impaction
A–43 (B) The signs and symptoms described are typical for otitis externa. Otitis media is not painful with manipulation of the external ear. Mastoiditis is infection of the part of the temporal bone located behind the ear. It is painful if pressure is applied to the mastoid process. Cerumen impaction
Q–44 ENT
Which of the following clinical criteria have been proposed as suggestive of group A streptococcal pharyngitis?
a. Tonsillar exudates
b. Tender anterior adenopathy
c. History of fever
d. All of the above
A–44 (D) All the choices are suggestive of group A streptococcal pharyngitis, but there is considerable overlap between streptococcal and viral pharyngitis. A throat culture can be obtained to identify group A streptococcus.
Q–45 EENT
Also known as “quinsy throat,” this disorder is a complication of streptococcal tonsillitis most often seen in adolescents and young adults. The disorder is
a. retropharyngeal infection
b. peritonsillar abscess
c. epiglottitis
d. Ludwig’s angina
A–45 (B) Peritonsillar abscess is primarily due to group A streptococcal infection and presents as dysphagia, drooling, and a “hot potato voice.” Retropharyngeal infections are most common in childhood, and epiglottitis is most seen in children between the ages of two and eight years. Ludwig’s angina is cellulitis of the submandibular, submental, and sublingual areas and is due to a dental infection.
