Multiple Choice Questions (MCQ)

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Category: Medicine--->Women’s Health
Page: 3

Question 11#Print Question

A 51-year-old woman presents to your office with questions about whether postmenopausal hormone therapy (HT) is “dangerous.” She heard this on the news and read about it in a women’s magazine. She denies hot flushes, irregular menses, emotional lability, or vaginal dryness. She has hypertension, but is otherwise healthy. Her family history is negative for breast cancer and cardiovascular disease.

According to data from the Women’s Health Initiative study, what advice should you give her? 

a. She should start HT for cardiovascular protection
b. HT is not indicated for this patient
c. She should start vaginal estrogen cream
d. She should start HT for breast cancer risk reduction
e. Hormone therapy is too risky to give to any woman

Question 12#Print Question

A 25-year-old white woman presents to your office for an annual examination. She is a G2P2 and had a bilateral tubal ligation after her last child was born (3 years ago). Her menstrual periods are regular; her LMP was 2 weeks before her visit. On review of systems she describes two to three headaches per month for the past year, usually unilateral and occasionally associated with nausea. The headaches last for several hours. She denies visual changes or other neurological changes when the headaches occur. She had migraine headaches in high school, but they stopped when she was about 20. She has not noted that foods, alcohol, stress, or fatigue trigger the headaches. Her headaches usually happen within the same several-day period and are not spread out over the month. Her last bout with the headaches occurred about 2 1 /2 weeks ago.

What is the most likely diagnosis? 

a. Tension headache
b. Cluster headache
c. Sinus headache
d. Classic migraine
e. Menstrual migraine

Question 13#Print Question

 A 21-year-old woman complains of fatigue and difficulty swallowing. She describes the difficulty swallowing as a choking sensation that occurs randomly and not with eating. She denies fever, chills, nausea, or vomiting. She notes some difficulty sleeping at night. She is 28 weeks pregnant with her first child. You note that she is wearing long sleeves in warm weather to cover up bruising on her forearms; she also has a bruise on her left lateral thoracic area. How would you most appropriately introduce your concern about domestic violence? 

a. “Those bruises look uncomfortable. Do you want to talk about how you got them?”
b. “Who hit you?”
c. “How long has your partner been abusing you?”
d. “I will have to report these injuries to the appropriate authorities if you can’t explain them.”
e. “Ran into the door again, huh?”

Question 14#Print Question

A 28-year-old nonsmoking woman presents to discuss birth control methods. She requests a contraceptive option that is not associated with weight gain. She and her husband agree that they desire no children for the next few years. Her periods are regular, but heavy and painful. She frequently stays home from work on the first day due to severe lower abdominal cramping and back pain. She changes her pad every 4 hours. This pattern of bleeding has been present since she was 15 years old. For a week before her period begins, she is uncharacteristically tearful, irritable, and depressed. These behavioral changes are beginning to affect her work relationships. Her physical examination reveals blood pressure 110/75, BMI 22, and moderate acne on her face and neck.

What recommendation will best address her mood, skin, and contraceptive needs? 

a. Tubal ligation
b. Drospirenone/ethinyl estradiol combination pill
c. Progesterone-infused intrauterine device
d. Progesterone shots every 3 months
e. Condoms

Question 15#Print Question

Four months after an unremarkable vaginal delivery, a previously healthy 34-year-old G1P1 develops fatigue, dyspnea on minimal exertion, and paroxysmal nocturnal dyspnea. She is no longer breastfeeding. Physical examination reveals a fatigued appearing woman, with normal heart sounds and bibasilar crackles in her lungs. She has no evidence of lower extremity edema, calf tenderness, or ascites. Echocardiogram shows global systolic dysfunction without hypertrophy; her ejection fraction is 40%.

Which of the following statements regarding her condition is correct? 

a. Peripartum cardiomyopathy may occur unexpectedly years after pregnancy and delivery
b. The postpartum state will require a different therapeutic approach than treatment for typical dilated cardiomyopathy
c. For patients with persistent LV dysfunction, future pregnancy carries no increased risk of cardiac decompensation
d. Fifty percent of patients will recover with normal ejection fraction
e. Intravenous immune globulin (IVIG) is the cornerstone of treatment

Category: Medicine--->Women’s Health
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