Multiple Choice Questions (MCQ)

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Category: Medicine--->Women’s Health
Page: 2

Question 6# Print Question

A 50-year-old woman presents with chest discomfort for 2 days. It lasted for 3 hours on the first day and 6 hours the second. Onset was while she was playing cards. She describes it as indigestion. She walks 2 miles a day, and has never smoked. She has a family history of atherosclerosis in her father. Her BMI is 25, blood pressure is 124/74, and heart rate is 72. HDL is 55, LDL is 78, TG 120, and total cholesterol is 188. She is in mild discomfort as you examine her. Her EKG during the discomfort shows 3 mm ST elevation. Troponin I rises to 4.2 µg/L (normal < 0.04). Her treadmill stress test shows mild apical T-wave inversion. Her cardiac catheterization shows no luminal defects.

How do you counsel her for future treatment? 

A. Vasodilators such as nitrates and calcium-channel blockers help prevent micro-vascular vasospasm
B. A statin is not needed since this patient’s cholesterol is at goal already
C. Warfarin has been shown to decrease risk of myocardial infarction in women
D. Proton pump inhibitor and over-the-counter antacid are the most appropriate therapies for her symptoms
E. Benzodiazepines will alleviate this patient’s chest pain from panic attacks

Question 7# Print Question

A 25-year-old woman presents to your office with complaints of pain during intercourse for 2 months. The pain occurs with initial penetration and continues throughout the entire episode. She relates that she and her husband have been married for a year and previously had a pleasurable, pain-free relationship. She tells you that shehas been to several area doctors, and had a “full workup” without a diagnosis, including a pelvic examination, pap smear with cultures, and sonogram. When you examine her, she has a normal pelvic examination with no pain. You are unsure of the differential diagnosis, so you continue taking more history. She admits to vaginal dryness and low libido during this same timeframe. You ask if anything in her life changed 2 months ago. She suddenly begins to cry and states she found evidence of her husband’s infidelity 2 months ago.

What is the most appropriate recommendation for your patient?

A. Marriage counseling
B. Estrogen vaginal cream for vaginal dryness
C. Vaginal dilators for treatment of vaginismus
D. Antidepressant therapy
E. Physical therapy for pelvic floor spasms

Question 8# Print Question

A 65-year-old woman presents for her annual examination. She has been feeling well and has no complaints, except for vaginal itching. She used antibiotics about 4 months ago for a sinus infection, but reports no other medications. She denies vaginal discharge. On examination, you see that the labia minora have regressed, the clitoral hood is fused, and the skins of the labia majora, perineum, and anus are smooth and whitish. After treating her with topical steroid ointment for 6 weeks, examination reveals an area of the labia which failed to return to pink.

What is your best next choice in management? 

A. Trial of antifungal suppositories
B. Punch biopsy of the remaining lesion
C. Treatment with calcipotriene for psoriasis
D. Trial of metronidazole vaginal gel
E. Subcutaneous injection of hydrocortisone into the remaining lesion

Question 9# Print Question

A 33-year-old woman presents to your office with complaints of inability to become pregnant. She and her husband have been having regular intercourse for 10 years without contraception. Her husband has normal sperm count and motility. Her menses are irregular, occurring every 28 to 60 days. She has noticed some facial and upper back acne, as well as increased amount of pubic hair. On examination, her waist circumference is 36 in and she has cystic acne on her neck, forehead, and upper back. She also has acanthosis nigricans in her groin and posterior neck.

Lab results:

  • fasting blood glucose: 106 mg/dL
  • Urine glucose: absent
  • DHEA-S: 360 µg/dL (follicular 32.2-308 µg/dL) (luteal 29.5-269 µg/dL)
  • Total testosterone: 1.1 ng/mL (0.1-0.6 ng/mL)
  • Pelvic sonogram: normal

What is the best plan for the initial management of this patient? 

A. Weight loss through diet and exercise
B. Metformin
C. Isotretinoin
D. OTC appetite suppressants
E. Gastric bypass surgery

Question 10# Print Question

A 28-year-old woman complains of fatigue and a sense of fullness at the base of her neck. She has no significant past medical history, gave birth to a healthy infant 4 months ago, and is only taking oral contraceptives. On examination, vital signs show pulse 88, blood pressure 110/66, temperature 37°C (98.6°F), and respirations 12. Her thyroid gland is homogeneously enlarged, and she has a very mild tremor of the outstretched hands. The rest of the examination is normal. Laboratory evaluation reveals the following:

  • WBC: 7800/µL
  • Hgb: 12.3 g/dL
  • Hct: 36%
  • Plt: 220,000/µL
  • Na: 138 mEq/L
  • K: 4.0 mEq/L
  • Cl: 106 mEq/L
  • CO2 : 26 mEq/L
  • BUN: 12 mg/dL
  • Creatinine: 0.7 mg/dL
  • TSH: 0.01 mIU/L (normal 0.4-4)
  • T4 : 19 nmol/L (normal 5-12)
  • Antithyroid antibody test (TPO antibodies): elevated

What is the most likely diagnosis? 

A. Thyrotoxicosis factitia
B. Subacute thyroiditis
C. Toxic multinodular goiter
D. Postpartum thyroiditis
E. Struma ovarii

Category: Medicine--->Women’s Health
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