Answer 25

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.


 

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

Answer 24

24.   Answer A is the correct answer.  This occurs in fat tissue.

Question 24

24.  Where does the conversion of androstenedione to estrogen occur?

 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

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.

Question 22

22.  Your patient is a 19 year old female that presents with an “abnormal pap.”  Which of  the following is the best next step in management?

 A.  Colposcopy

 B.  Total Abdominal Hysterectomy

 C.  LEEP Procedure

 D.  Dilatation and Curettage

Answer 21

21.  Answer C is the correct answer.  Dyspareunia is common symptom of endometriosis.  Ulcerative lesions is seen with herpes.  Dysuria may be seen but is not as common as vulvar itching.

Question 21

21.  What is the most common symptom seen in patients presenting with vulvar carcinoma?

A.  Dysuria
B.  Dyspareunia
C.  Vulvar itching
D.  Ulcerative lesions