25. Answer A is the correct answer. This patient has an ovarian torsion which should be treated as a seconds to minutes emergency. The ovary starts to die after about 4 hours and can be salvaged. Pelvic masses are best imaged by ultrasound and a CT scan is not indicated.
OB Questions 21-25
Thursday, November 14, 2013
Question 25
25. Your patient is a 25 year old female that presents with sudden onset of left lower pelvic pain and nausea and vomiting. This started 90 minutes prior to arrival. Pelvic ultrasound demonstrates decreased doppler flow to the left ovary. Which of the following is the best management plan?
A. Consult OB for the patient to go to OR for laparoscopy
B. Discharge home on analgesics
C. Refer to OB as an outpatient
D. Order CT scan of the Pelvis with IV contrast looking for pelvic mass
A. Consult OB for the patient to go to OR for laparoscopy
B. Discharge home on analgesics
C. Refer to OB as an outpatient
D. Order CT scan of the Pelvis with IV contrast looking for pelvic mass
Question 24
24. Where does the conversion of androstenedione to estrogen occur?
A. In adipose tissue
B. Bone Marrow
C. Muscle tissue
D. Brain
A. In adipose tissue
B. Bone Marrow
C. Muscle tissue
D. Brain
Answer 23
23. Answer D is the correct answer. Uterine fibroids are benign growths of the uterus that are estrogen dependent. They can present with pelvic pain, vaginal bleeding, and pelvic pressure. They also may be asymptomatic.
Question 23
23. Which of the following is not a clinical finding commonly seen in uterine fibroids?
A. Pelvic Pain
B. Vaginal Bleeding
C. Pelvic Pressure
D. Constipation
A. Pelvic Pain
B. Vaginal Bleeding
C. Pelvic Pressure
D. Constipation
Answer 22
22. Choice A is the correct answer. Colposcopy is often the next step with abnormal cervical cells. LEEP procedure is indicated for removal of certain types of cells. Dilation and Curettage is indicated more for dysmenorrhea or when there is a thickened endometrium. A hysterectomy would be an aggressive procedure for just abnormal cells on a pap.
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