NMS Q&A Family Medicine

SECTION VIIIProblems Unique toFemales in Primary Carechapter 20Problems of the Older WomanExamination questions: Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST ineach case.1 A 68-year-old Caucasian woman who is gravida 3,para 3, 18 years postmenopause, complains of sensationof full bladder in inconvenient situations andconsequent frequent inability to make it to bathroomswithout losing significant amounts of urine.She has no cardiac conditions. Which of the followingmeasures is the most appropriate therapeuticapproach to the problem?(A) Prescription for oxybutynin (Ditropan) orally(B) Recommendation for pseudoephedrine orally(C) Prescription for estrogen replacement therapy(D) Placement of a pessary(E) Evaluate for bladder neck obstruction2 Each of the following may be likely causes of amenorrheain a 45-year-old woman except which of thefollowing condition?(A) Hyperthyroidism(B) Hypothyroidism(C) Polycystic ovary syndrome (PCOS)(D) Prolactinoma(E) Estrogen deficiency3 Afamily doctor is treating a 60-year-old woman forosteoporosis with alendronate (Fosamax). As a bisphosphonate,this medication may be associated with eachof the following side effects except for which one?(A) Esophagitis(B) Bone and joint pains(C) Osteonecrosis(D) Uveitis(E) Clinical hypoparathyroidism4 A 48-year-old white woman for whom you have caredfor 5 years complains of bouts of depression for thefirst time in her life. This is the first occasion for herto visit you in the past 6 months. These bouts comeon rapidly over periods of less than an hour, last foras long as 12 to 24 hours, and rapidly disappear. Shedenies headaches and difficulty thinking and calculating,although she notes that during the depressiveepisodes, she finds it difficult to concentrate on problemsthat require focused attention. She denies anyrelationship between these episodes and the menstrual125