a 17 year old female patient complains of amenorrhea for the last 8 months, weight gain,
excessive hair growth on the arms and chest, and development of acne. Pelvic examination is
normal. The clinician should recognize these are signs of - ✔✔✔-hormonal imbalances
A 22-year-old architecture major comes to your office, complaining of severe burning with
urination, a fever of 101 degrees, and aching all over. She denies any upper respiratory,
gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of severe
acne. She is currently on an oral contraceptive. She has had no pregnancies or surgeries. She
reports one new partner within the last month. She does not smoke but does drink occasionally.
Her parents are both in good health. On examination you see a young woman appearing slightly
ill. Her temperature is 100.3 and her pulse and blood pressure are unremarkable. Her head,
ears,
eyes, nose, throat, cardiac, pulmonary, and abdominal examinations are unremarkable.
Palpation of the inguinal nodes shows lymphadenopathy bilaterally. On visualization of the
perineum there
are more than 10 shallow ulcers along each side of the vulva. Speculum and bimanual ex -
✔✔✔-genital herpes
A 24-year-old travel agent comes to your clinic, complaining of pain and swelling in her vulvar
area. She states that 2 days earlier she could feel a small tender spot on the left side of her
vagina but now it is larger and extremely tender. Her last period was 1 year ago and she is
sexually active. She uses the Depo-Provera shot for contraception. She denies any nausea,
vomiting, constipation, diarrhea, pain with urination, or fever. Her past medical history is
significant for ankle surgery. Her mother is healthy and her father has type 2 diabetes. On
examination she appears her stated age and is standing up. She states she cannot sit down
without excruciating pain. Her blood pressure, temperature, and pulse are unremarkable. On
visualization of her perineum, a large, red, tense swelling is seen to the left of her introitus.
Palpation of the mass causes a great deal of pain. What disorder of the vulva is most likely -
✔✔✔-Bartholin's gland infection
A 30-year-old paralegal analyst comes to your clinic, complaining of a bad-smelling vaginal
discharge with some mild itching, present for about 3 weeks. She tried douching but it did not
help. She has had no pain with urination or with sexual intercourse. She has noticed the smell