QUESTIONS WITH SOLUTIONS
◉ A 28-year-old multipara who is at 32 weeks of gestation presents
to your office complaining of a sudden onset of small amounts of
bright red vaginal bleeding. She has had several episodes and
appears anxious. On exam, her uterus is soft to palpation. Which of
the following is most likely?
A) Placenta abruptio
B) Placenta previa
C) Acute cervicitis
D) Molar pregnancy (hydatidiform mole). Answer: B) Placenta
previa
Placenta previa occurs when abnormal implantation of the placenta
occurs. A common symptom of placenta previa is painless, bright red
bleeding.
◉ Epidemiologic studies show that Hashimoto's disease occurs most
commonly in:
,A) Middle-aged to older women
B) Smokers
C) Obese individuals
D) Older men. Answer: A) Middle-aged to older women
Hashimoto's disease commonly occurs in middle-aged to older
women.
◉ A 48-year-old woman is told by a physician that she is starting
menopause. All of the following are possible findings except:
A) Hot flashes
B) Irregular menstrual periods
C) Severe vaginal atrophic changes
D) Cyclic mood swings. Answer: C) Severe vaginal atrophic changes
As women reach menopause, changes that may occur include hot
flashes, irregular menstrual periods, and cyclic mood swings. Vaginal
changes, such as dryness and thinning, may also begin to occur
◉ A 63-year-old patient with a 10-year history of poorly controlled
hypertension presents with a cluster of physical exam findings.
Which of the following indicate target organ damage commonly seen
in hypertensive patients?
,A) Pedal edema, hepatomegaly, and enlarged kidneys
B) Hepatomegaly, AV nicking, bibasilar crackles
C) Renal infection, S3, neuromuscular abnormalities
D) Glaucoma, jugular vein atrophy, heart failure. Answer: B)
Hepatomegaly, AV nicking, bibasilar crackles
With long-term, uncontrolled hypertension, organ damage may
occur. Organs commonly affected include: brain (stroke), eyes
(retinopathy, AV nicking, bleeding, blindness), heart (heart dis- ease,
left ventricular hypertrophy, MI, and/or CHF), and kidneys (renal
failure, proteinuria).
◉ A 30-year-old primigravida is diagnosed with a possible
threatened abortion. The result of the urine pregnancy test is
positive. Which of the following statements is true regarding a
threatened abortion?
A) Vaginal bleeding and cramping are present, but the cervix
remains closed
B) Vaginal bleeding and cramping are present along with a dilated
cervix
C) The fetus and placenta are all expelled
, D) The products of conception and the placenta remain inside the
uterus along
with a dilated cervix. Answer: A) Vaginal bleeding and cramping are
present, but the cervix remains closed
Threatened abortion is defined as vaginal bleeding and cramping
with- out the presence of cervical dilation.
◉ A 30-year-old female who is sexually active complains of a large
amount of milk- like vaginal discharge for several weeks. A
microscopy slide reveals a large amount of squamous epithelial cells
that have blurred margins. Very few white blood cells are seen. The
vaginal pH is at 6.0. What is most likely?
A) Trichomonas infection
B) Bacterial vaginosis
C) Candidal infection
D) A normal finding. Answer: B) Bacterial vaginosis
Bacterial vaginosis is a bacterial infection of the vagina. Signs and
symptoms include copious off-white to gray discharge with foul odor
without vaginal erythema or irritation. Wet prep will show positive
for clue cells. When performing a wet prep, the "whiff test" will be