NMS Q&A Family Medicine

chapter 21Gynecology in Mature AdultsExamination questions: Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST ineach case.1 A 22-year-old single woman complains of a painfullabial ulcer and painful inguinal (lymphadenopathy)4 days after having intercourse with a man she hadjust met. Which of the following organism is thelikely cause of this sexually transmitted disease(STD).(A) Treponema pallidum(B) Calymmatobacterium granulomatis(C) Neisseria gonorrhoeae(D) Chlamydia trachomatis(E) Hemophilus ducreyi2 A 20-year-old woman calls at 2 am after a Saturdaynight the family doctor on call for his group sayingshe unexpectedly found herself having consensualintercourse and is panicked over the fear of anunwanted pregnancy. She agrees to call in a prescriptionfor the “morning after” pill. Which of the followingregimens should accomplish the objective?(A) Norgestimate 0.180 mg/ethinyl estradiol0.035 mg two tablets within 24 hours(B) Levonorgestrel 0.75 mg course of two tabletswithin 72 hours(C) Drospirenone/ethinyl estradiol 3.0 mg/0.030 mgthree tablets over the next 24 hours(D) D. Desogestrel/ethinyl estradiol 0.15 mg/0.02mg two ASAP and one in every 4 hours timefour more doses.(E) Medroxyprogesgterone acetate 10 mg for 10 days3 A 37-year-old woman in a monogamous marriagecomplains of a vaginal discharge with a fishy odor.The vaginal pH is 4.8 and clue cells are present on thesmear. A culture reveals presence of Gardnerella vaginalis. The family doctor diagnoses bacterial vaginosis.Each of the following statements is true except forwhich one.(A) This condition may be a cause of prematurerupture of membranes in labor.(B) Bacterial vaginosis may be the cause ofpremature labor.(C) The transmission of this condition is sexual.(D) The condition is associated with postpartumendometritis.(E) The condition may be a cause of pelvicinflammatory disease (PID).4 You have treated by telephone a woman whose pastexperience made her quite credible in self-diagnosinguncomplicated candida vaginitis. Twice you treated herwith a single 150 mg dose of fluconazole. Both the timesshe complained of recurrent symptoms of pruriticcurdy discharge within a few days of apparent relief ofsymptoms. Which of the following is the least likelyexplanation for the foregoing treatment failures?(A) Presence of diabetes predisposing to candidiasis(B) Presence of HIV disease(C) Infection with candidal species other thanalbicans(D) Incorrect diagnosis of candida vaginitis(E) Presence of immunity compromise due tocancer chemotherapy5 A 45-year-old woman complains of increasinglyirregular menstrual periods, which are becominglighter and less frequent, seldom appearing soonerthan 35 days after the previous one. She complainsalso of gaining weight over the past 5 years. Duringthe same period, hair has grown on her upper lip andshe has developed acne for the first time in her life.She weighs 165 lb (74.8 kg) at a height of 5 ft 4 in.(1.63 m). On examination she manifests central obesityand fading purple striae over the flanks of herabdomen. Which of the following is the best causalexplanation for these findings?(A) Type II diabetes mellitus(B) Hypothyroidism(C) Metabolic syndrome(D) Polycystic ovary syndrome (PCOS)(E) Cushing syndrome6 Regarding the patient in Question 5, besides an elevationof serum testosterone levels, which of the followinglaboratory tests, in conjunction with theclinical picture, gives a distinctive pattern for identificationof the diagnosis?131