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Category: Obstetrics & Gynecology--->Infertility, Endocrinology, and Menstrual Dysfunction
Page: 2

Question 6# Print Question

A 68-year-old Caucasian woman comes to your office for advice regarding her risk factors for developing osteoporosis. She is 5 ft 1 in tall and weighs 105 lb. She stopped having periods at the age of 42 years. She is healthy and walks on a treadmill daily. She does not take any medications. She has never taken hormone replacement therapy (HRT). Her mother died at the age of 71 after she suffered a spontaneous hip fracture. 

The patient has a DEXA study that demonstrates a T-score of –2.0.

What is the best next step in management?

A. Begin a bisphosphonate
B. Encourage her to engage in weight bearing exercise and take a calcium supplement
C. Repeat the study in 1 year
D. Begin raloxifene therapy
E. Recommend she begin combined HRT


Question 7# Print Question

A 17-year-old consults you for evaluation of disabling pain with her menstrual periods. The pain has been present since menarche, and is accompanied by nausea and headache. Her medical history is otherwise unremarkable, and pelvic examination is normal. She is not currently sexually active, and she has not tried any therapy for her dysmenorrhea.

For this patient, select the most ideal treatment for dysmenorrhea.

A. Acupuncture
B. Prostaglandin inhibitors
C. Gonadotropin-releasing hormone (GnRH) analogues
D. Oral contraceptives
E. Narcotic analgesics


Question 8# Print Question

A 19-year-old college student is seen for severe primary dysmenorrhea. She has no medical problems and a normal pelvic examination. A heating pad has not helped her pain. She has recently become sexually active and does not currently desire pregnancy.

For this patient, select the most ideal treatment for dysmenorrhea.

 

A. Acupuncture
B. Prostaglandin inhibitors
C. Gonadotropin-releasing hormone (GnRH) analogues
D. Oral contraceptives
E. Narcotic analgesics


Question 9# Print Question

An 18-year-old patient presents to you for evaluation because she has not yet started her period. On physical examination, she is 5 ft 7 in tall. She has minimal breast development and no axillary or pubic hair. On pelvic examination, she has a normally developed vagina. A cervix is visible. The uterus is palpable, as are normal ovaries.

Which of the following is the best next step in the evaluation of this patient?

A. Draw her blood for a karyotype
B. Test her sense of smell
C. Draw her blood for TSH, FSH, and LH levels
D. Order an MRI of the brain to evaluate the pituitary gland
E. Prescribe a progesterone challenge to see if she will have a withdrawal bleed


Question 10# Print Question

A 7-year-old girl is brought in to see you by her mother because the girl has developed breasts and a few pubic hairs. Evaluation demonstrates a pubertal response to a GnRH-stimulation test and a prominent increase in luteinizing hormone (LH) pulses during sleep.

These findings are characteristic of patients with which of the following?

A. Theca cell tumors
B. Iatrogenic sexual precocity
C. Premature thelarche
D. Granulosa cell tumors
E. Central precocious puberty




Category: Obstetrics & Gynecology--->Infertility, Endocrinology, and Menstrual Dysfunction
Page: 2 of 13