NMS Q&A Family Medicine

268 NMS Q&A Family Medicinebeing sexually active. She denies any vaginal dischargeor pelvic area pain. At what age should Pap smears beperformed on her?(A) At age 13(B) At age 15(C) At age 20(D) At the age of first sexual activity(E) At the age of regular sexual activity9 A 19-year-old sexually active female college studenthas recently married and has been taking oral contraceptivemedication for 3 months. She complains ofheadaches since starting “the pill.” Her blood pressureis 132/78; she weighs 120 lb (54.4 kg) at a heightof 5 ft, 4 in. (1.63 m). Which of the following alterationsin her regimen would be the most appropriate?(A) Reduce the estrogen component of her birthcontrol pill (BCP)(B) Reduce the progestational component of her BCP(C) Investigate the androgenic effects of her BCP(D) Prescribe a 5-hydroxytryptamine agonist(e.g., sumatriptan)(E) Discontinue the BCP10 Regarding the tolerability of oral contraceptive medications,each of the following is a side effect of theestrogenic component of BCPs, except which one?(A) Increased breast size(B) Enlargement of leiomyomas(C) Hepatocellular adenomas(D) Cyclic weight gain(E) Oily skin11 A 16-year-old female patient visits her family doctorfor treatment of a viral upper respiratory tract infection.She appears to have lost weight since the lastvisit of 6 months ago. The doctor inquires regardingher menstrual history and finds she has missed thelast two periods. Pregnancy testing is negative. Suspectinganorexia, the doctor checks her weight againstthe ideal for her age and sex. Which of the followingweight criteria satisfy the minimal definition ofanorexia nervosa (AN)?(A) Weight 100 lb (45 kg) in a female individual(B) Weight 100 lb plus 5 lb for every inch over 60in. (5 ft or 1.52 m)(C) Ideal body weight (IBW) 60th percentile forage and sex(D) Weight 85% of IBW(E) Caloric intake 500 kcal/day12 A 16-year-old is undergoing a routine health maintenanceexamination. He has had five immunizations ofdiphtheria, tetanus, and pertussis (DTaP; three in thefirst year, one at 2 years, and one at 5 years); four shotsof Hemophilus influenzae type B (Hib); four shots ofinactivated polio vaccine (IPV); two shots of measles,mumps, and rubella (MMR) vaccine; a varicella vaccine;three shots of pneumococcal vaccine (PCV); threedoses of hepatitis B vaccine (HBV); and yearly influenzavaccines. Besides the yearly influenza vaccine,which of the following vaccines is due at this time?(A) DTaP, sixth dose(B) MMR, third dose(C) Diphtheria and tetanus booster (Td)(D) IPV, fifth dose(E) Varicella, second dose