NMS Q&A Family Medicine

132 NMS Q&A Family Medicine(A) White blood cell count(B) Blood sugar(C) Serum luteinizing hormone (LH)(D) Serum electrolytes(E) Serum creatinine7 Regarding the patient in Questions 5 and 6, assumingweight loss was effected without success, which of thefollowing should be the first treatment option?(A) Menstrual regulation with cyclic contraceptivehormonal treatment(B) Increased physical activity and decreased calorieingestion(C) Prescription of metformin(D) Prescription of clomiphene(E) Epilation and electrolysis8 Each of the following is a relative contraindicationfor intrauterine device (IUD) insertion except forwhich one?(A) Nulliparity(B) Active STD(C) History of PID(D) Presence of an intrauterine pregnancy(E) Multiparity9 A 14-year-old nulliparous girl complains of primarydysmenorrhea. She is overweight and attempting tolose weight. Her parents have recently separated, andshe has been sporadically involved in drinking fairlyheavily and smoking at parties of young people buthas not become sexually active. Each of the followingaspects of her life situation is a risk factor for dysmenorrheaexcept for which one?(A) Drinking alcohol(B) Smoking(C) Losing weight(D) Experiencing family stress(E) Being nulliparous10 Which of the following is the only medication approvedspecifically by the Food and Drug Administration forthe treatment of nausea and vomiting of pregnancy?(A) Prochlorperizine (Compazine)(B) Promethazine (Phenergan)(C) Trimethobenzamide (Tigan)(D) Pyridoxine/doxylamine (Bendectin)(E) Ondansetron (Zofran)11 Each of the following conditions occurs at a greaterrate than expected in people exposed to diethylstilbestrol(DES) in utero except for which one?(A) Squamous cell carcinoma of the cervix(B) T-shaped uterus(C) Clear cell adenocarcinoma of the vagina(D) Undescended testicle(E) Hypoplastic uterus12 A 21-year-old sexually active woman complains ofintense pain in the left vulvar area building over aperiod of 2 to 3 days. She has not had similar symptomsin the past, and she has not been with her sexpartner for several weeks. The pain is of such severitythat she has been afraid to attempt intercourse oreven to sit down normally. Which of the following isthe most likely diagnosis?(A) Herpes simplex type 2(B) Craurosis vulvae(C) Candida vaginitis(D) Trichomonas vaginitis(E) Bartholin gland abscess13 A 65-year-old woman visits you for the first time tocomplain of vaginal bleeding for the first time sinceher natural menopause 15 years ago. The bleedingbegan 2 weeks ago and is mild in flow. Which of thefollowing is the most critical question to be asked incompleting the history?(A) Are there cramps associated with the bleeding?(B) How many pads per days are needed to keepabreast of the bleeding?(C) Are you taking hormone therapy of any type?(D) Have you developed light-headedness uponstanding after sitting for prolonged periods oftime?(E) Is there bleeding with intercourse?14 You have diagnosed chlamydia on “routine” Papsmear with an enzyme-linked test for STDs. Thewoman confessed that she was concerned about thepossible infidelity of her husband. Which of the followingmay be among the aspects of this infectionyou must explain to this woman?(A) The course for the infected female is virtuallyalways benign.(B) Unless successfully treated she will havesignificantly increased risk of spontaneousabortion and infertility.(C) The infection responds to amoxicillin.(D) Macrosomia may occur in newborn babies ofmothers infected during pregnancy.(E) Symptoms, if she notes them, are likely toinclude a frankly purulent discharge within48 hours of exposure.15 A woman with secondary amenorrhea is given 10 mgmedroxyprogesterone acetate by mouth per day for 5days and monitored for the onset of bleeding followingprogesterone withdrawal. Which of the causes for