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9 Cards in this Set
- Front
- Back
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A 24-year-old woman experiences sudden onset of severe lower abdominal pain. Physical examination shows no
masses, but there is severe tenderness in the right lower quadrant. A pelvic examination shows no lesions of the cervix or vagina. Bowel sounds are detected. An abdominal ultrasound scan shows a 4-cm focal enlargement of the proximal right fallopian tube. A dilation and curettage procedure shows only decidua from the endometrial cavity. Which of the following laboratory findings is most likely to be reported for this patient? □ (A) Cervical culture positive for Neisseria gonorrhoeae □ (B) 69,XXY karyotype on decidual tissue □ (C) Positive result of serum pregnancy test □ (D) Positive result of serologic testing for syphilis □ (E) Pap smear showing Candida |
C
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A 30-year-old, sexually active woman has had a mucopurulent vaginal discharge for 1 week. On pelvic examination, the
cervix appears reddened around the os, but no erosions or mass lesions are present. A Pap smear shows numerous neutrophils, but no dysplastic cells. A cervical biopsy specimen shows marked follicular cervicitis. Which of the following infectious agents is most likely to produce these findings? □ (A) Chlamydia trachomatis □ (B) Candida albicans □ (C) Gardnerella vaginalis □ (D) Herpes simplex virus □ (E) Human papillomavirus □ (F) Neisseria gonorrhoeae □ (G) Trichomonas vaginalis |
A
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A 33-year-old woman has taken oral contraceptives for a year. For the past 5 weeks she has noted vaginal bleeding that is not severe, but it occurs nearly every day. On pelvic examination, there is a 0.7 cm polypoid mass noted to extend outward from the endocervical region. The ectocervix appears normal. The uterus is normal in size. The adnexa have no palpable masses. A biopsy of this lesion is performed. Which of the following pathologic findings is most likely to be found on microscopic examination of this lesion?
A Endocervical adenocarcinoma B Clear cell adenocarcinoma C Microglandular hyperplasia D Sarcoma botryoides E Endocervical polyp F Follicular cervicitis |
C
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A 48-year-old woman has noted a small amount of irregular vaginal bleeding for the past 2 months. She has a pelvic examination that reveals no cervical lesions, and a Pap smear that shows no abnormal cells. Next, an endometrial biopsy is performed, and there is microscopic evidence for endometrial hyperplasia. An abdominal ultrasound reveals a solid right ovarian mass. Which of the following neoplasms is this woman is most likely to have?
A Mature cystic teratoma B Choriocarcinoma C Sertoli-Leydig cell tumor D Fibrothecoma E Krukenberg tumor F Cystadenocarcinoma |
D
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A 49-year-old perimenopausal woman has had vaginal bleeding for the past 6 months. On physical examination she has an enlarged, nodular uterus. A hysterectomy is performed. The surgeon notes several 0.2 to 1 cm translucent, smooth-surfaced, thin-walled, fluid-filled cysts near the fimbriated end of the right fallopian tube. Which of the following is the most likely diagnosis for these cysts?
A Gartner duct cysts B Krukenberg tumors C Parovarian cysts D Pelvic inflammatory disease E Mucinous cystadenomas F Fibrocystic disease G Omphalomesenteric duct cyst |
C
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A 36-year-old woman has had menorrhagia and pelvic pain for several months. She had a normal, uncomplicated
pregnancy 10 years ago. She has been sexually active with one partner for the past 20 years and has had no dyspareunia. On physical examination, she is afebrile. A pelvic examination shows a symmetrically enlarged uterus, with no apparent nodularity or palpable mass. A serum pregnancy test result is negative. What is the most likely diagnosis? (A) Endometriosis (B) Leiomyoma (C) Endometrial hyperplasia (D) Adenomyosis (E) Chronic endometritis |
D
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A 36-year-old woman has had episodes of lower abdominal and pelvic pain for the past 10 years. A bimanual pelvic examination reveals no abnormalities. A Pap smear is negative. She has an abdominal ultrasound scan that reveals no abnormalities. Finally, she undergoes laparoscopy, and her physician notes the presence of several 0.2 to 0.5 cm brown nodular lesions located on serosal surfaces of the uterus, fallopian tubes, and appendix. These lesions are excised. Which of the following microscopic findings is most likely to be present in these lesions?
A Endometrial glands with stroma B Mesothelioma C Metastatic adenocarcinoma D Small capillary proliferation E Caseating granulomatous inflammation |
A
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A 47-year-old woman has noted a pressure sensation, but no pain, in her pelvic region for the past 5 months. On physical examination there is a right adnexal mass. An ultrasound scan shows a 10 cm fluid-filled cystic mass in the right ovary. A fine needle aspirate of the mass is performed and cytologic examination of clear fluid aspirated from the mass reveals clusters of malignant epithelial cells surrounding psammoma bodies. Which of the following neoplasms is she most likely to have?
A Endometrioid carcinoma B Serous cystadenocarcinoma C Malignant mesothelioma D Mature cystic teratoma E Tubal adenocarcinoma |
B
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A representative of the law firm of Flotsam, Flotsam & Jetsam enters your office and serves you with a subpoena that requires you to appear in regard to litigation by one of your former patients, a 31-year-old woman who is claiming that your malpractice led to medical expenses, pain, and suffering because she developed invasive cervical carcinoma. She was last seen in your office 10 years ago. She had been your patient for 5 years, receiving Pap smears in 4 of those 5 years. Your records indicate that she had no abnormal Pap smears. After discussion with your malpractice carrier's attorney, which of the following conclusions is most appropriate?
A The patient should have continued to return for yearly Pap smears B You are at fault in this case and should avoid a trial C The laboratory to which the Pap smears were sent is at fault for missing abnormal cells D Nothing anyone could have done would have prevented this carcinoma E The patient's health insurer is at fault for not covering the full cost of Pap smear testing |
A
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