Fitzgerald Female Reproductive And Genitourinary Systems Ch15

Front 1

1. Which of the following is a contraindication to estrogen/progestin-containing methods (combined oralcontraception [COC], patch [Ortho Evra], or ring[NuvaRing])?A. mother with a history of breast cancerB. personal history of hepatitis A at age 10 yearsC. presence of factor V Leiden mutationD. cigarette smoking one pack per day in a 22-year-old

Back 1

1. C.

Front 2

2. A 22-year-old woman taking a 35-mcg ethinyl estradiolCOC calls after forgetting to take her pills for 2 consecutivedays. She is 2 weeks into the pack. You adviseher to:A. take the last pill missed immediately, even if thismeans taking 2 pills today.B. discard two pills and take two pills today.C. discard the rest of the pack and start a new pack withthe first day of her next menses.D. continue taking one pill daily for the rest ofthe cycle.

Back 2

2. A.

Front 3

3. When counseling a woman about COC use, you advisethat:A. long-term use of COC is discouraged because thebody needs a “rest” from birth control pills fromtime to time.B. fertility is often delayed for many months afterdiscontinuation of COC.C. there is an increase in the rate of breast cancer afterprotracted use of COC.D. premenstrual syndrome symptoms are oftenimproved with use of COC.

Back 3

3. D.

Front 4

4. Noncontraceptive benefits of COC use include adecrease in all of the following except:A. iron-deficiency anemia.B. pelvic inflammatory disease (PID).C. cervicitis.D. ovarian cancer.

Back 4

4. C.

Front 5

5. Which of the following women is the best candidate forprogestin-only pill (POP) use?A. an 18-year-old woman who frequently forgets to takeprescribed medicationsB. a 28-year-old woman with multiple sexualpartnersC. a 32-year-old woman with adequately-controlledhypertensionD. a 26-year-old woman who wants to use the pillto help “regulate” her menstrual cycle

Back 5

5. C.

Front 6

6. The most common reasons for discontinuing oralcontraception use is breakthrough bleeding and:A. nausea/vomiting.B. inconvenience of use.C. cost.D. high failure rate.

Back 6

6. B.

Front 7

7. A 38-year-old nulliparous woman who smokes twoand a half packs a day is in an “on-and-off” relationship.The woman presents seeking contraception. Whichof the following represents the most appropriatemethod?A. contraceptive ring (NuvaRing)B. COCC. contraceptive patch (Ortho Evra)D. vaginal diaphragm

Back 7

7. D.

Front 8

8. Due to an increased risk of blood clots, an alternativeto the contraceptive ring (NuvaRing) or patch(Ortho Evra) is preferred in all of the followingwomen except:A. a 42-year-old nulliparous woman.B. 31-year-old woman with history of naturallyoccurring multiple gestation pregnancyC. 28-year-old who smokes one pack per day.D. 33-year-old woman with a family history of venousthrombosis.

Back 8

8. B.

Front 9

9. Which of the following statements is true concerningvaginal diaphragm use?A. When in place, the woman is aware that the diaphragmfits snugly against the vaginal walls.B. This is a suitable form of contraception for womenwith recurrent urinary tract infection.C. After insertion, the cervix should be smoothly covered.D. The device should be removed within 2 hours ofcoitus to minimize the risk of infection.

Back 9

9. C.

Front 10

10. According to the U.S. Medical Eligibility Criteria forContraception Use, which of the following is a clinicalcondition in which use of a copper-containing IUDshould be approached with caution?A. uncomplicated valvular heart diseaseB. AIDS-defining illnessC. hypertensionD. dysmenorrhea

Back 10

10. B.

Front 11

11. Which of the following is the most appropriate responseto a 27-year-old woman who is taking phenytoin(Dilantin) for the treatment of a seizure disorderand is requesting hormonal contraception?A. “A barrier method would be the preferable choice.”B. “COC is the best option.”C. “Depo-Provera (medroxyprogesterone acetatein a depot injection [DMPA]) use will likely notinteract with your seizure medication.”D. “Copper-containing IUD use is contraindicated.”

Back 11

11. C.

Front 12

12. Which of the following is commonly found after 1 yearof using DMPA (Depo-Provera)?A. weight gainB. hypermenorrheaC. acneD. rapid return of fertility when discontinued

Back 12

12. A.

Front 13

13 to 21. The following questions should be answered byresponding yes or no.According to the U.S. Medical Eligibility Criteria for ContraceptionUse, who is a category 1 or 2 COC candidate?

13. a 22-year-old woman who smokes one pack per day

Back 13

13. Yes

Front 14

13 to 21. The following questions should be answered byresponding yes or no.According to the U.S. Medical Eligibility Criteria for ContraceptionUse, who is a category 1 or 2 COC candidate?

14. a 29-year-old woman with PID

Back 14

14. Yes

Front 15

13 to 21. The following questions should be answered byresponding yes or no.According to the U.S. Medical Eligibility Criteria for ContraceptionUse, who is a category 1 or 2 COC candidate?

15. a 45-year-old woman with tension-type headache

Back 15

15. Yes

Front 16

13 to 21. The following questions should be answered byresponding yes or no.According to the U.S. Medical Eligibility Criteria for ContraceptionUse, who is a category 1 or 2 COC candidate?

16. a 32-year-old woman breastfeeding a 6-month-oldinfant

Back 16

16. Yes

Front 17

13 to 21. The following questions should be answered byresponding yes or no.According to the U.S. Medical Eligibility Criteria for ContraceptionUse, who is a category 1 or 2 COC candidate?

17. a 28-year-old woman with type 1 diabetes mellitus

Back 17

17. Yes, in theabsence ofadvancedvasculardisease

Front 18

18 to 21. According to the U.S. Medical Eligibility Criteriafor Contraception Use, who is a candidate for a coppercontainingintrauterine device (IUD)?

18. a 45-year-old woman with fibroids with uterinecavity distortion

Back 18

18. No

Front 19

18 to 21. According to the U.S. Medical Eligibility Criteriafor Contraception Use, who is a candidate for a coppercontainingintrauterine device (IUD)?

19. a 33-year-old woman who smokes two packs per day

Back 19

19. Yes

Front 20

18 to 21. According to the U.S. Medical Eligibility Criteriafor Contraception Use, who is a candidate for a coppercontainingintrauterine device (IUD)?

20. a 25-year-old woman with hypertension

Back 20

20. Yes

Front 21

18 to 21. According to the U.S. Medical Eligibility Criteriafor Contraception Use, who is a candidate for a coppercontainingintrauterine device (IUD)?

21. a 33-year-old woman with low-grade squamousintraepithelial lesions noted on Pap test

Back 21

21. Yes

Front 22

22. As you prescribe COC containing the progestindrospirenone (Loryna, Ocella, Vestura, Yasmin, Yaz),you offer the following advice:A. “Always take this pill on a full stomach.”B. “You should not take acetaminophen when usingthis birth control pill.”C. “Avoid using potassium-containing salt substitutes.”D. “You will likely notice that premenstrualsyndrome symptoms might become worse.”

Back 22

22. C.

Front 23

23. A 26-year-old mother who breastfeeds her 10-montholdchild queries about contraceptives. In counselingher on the use of the progestin-only pill (POP), youmention all of the following except:A. the pill is taken every day.B. POP is a more effective contraceptive than COC.C. POP does not alter the quality or quantity of breastmilk.D. POP is associated with bleeding irregularity, rangingfrom prolonged flow to amenorrhea.

Back 23

23. B.

Front 24

24. By using a diaphragm with spermicide nonoxynol-9during sexual intercourse, a woman is likely atincreased risk for:A. cervical stenosis.B. urinary tract infection.C. increased perivaginal lactobacilli colonization.D. ovarian malignancy.

Back 24

24. B.

Front 25

25. With the use of a levonorgestrel intrauterine system(Mirena), which one of the following is normally noted?A. endometrial hyperplasiaB. hypermenorrheaC. increase in PID ratesD. reduction in menstrual flow

Back 25

25. D.

Front 26

26. The reduction in free androgens noted in a womanusing COC can yield an improvement in:A. cycle control.B. acne vulgaris.C. breast tenderness.D. rheumatoid arthritis.

Back 26

26. B.

Front 27

27. With DMPA in depot injection (Depo-Provera), therecommended length of use is usually:A. less than 1 year.B. no more than 2 years.C. as long as the woman desires this form of contraception.D. as determined by her lipid response to themedication

Back 27

27. B.

Front 28

28. Irregular bleeding associated with DMPA (Depo-Provera)can be minimized with the use of all of the followingexcept:A. acetaminophen.B. ibuprofen.C. naproxen sodium.D. estrogen supplements.

Back 28

28. A.

Front 29

29. When can a woman safely conceive after discontinuingCOC use?A. immediatelyB. after 1 to 2 monthsC. after 3 to 4 monthsD. after 5 to 6 months

Back 29

29. A.

Front 30

30. When prescribing the contraceptive patch(Ortho Evra) or vaginal ring (NuvaRing), theNP considers that:A. these are progestin-only products.B. candidates include women who have difficultyremembering to take a daily pill.C. there is significant drug interactions with bothproducts.D. contraceptive efficacy is less than with COC.

Back 30

30. B.

Front 31

31 to 33. Answer the following questions true or false.

31. The use of combined oral contraception(COC) reduces menstrual volume by approximately60%, thereby reducing the risk of irondeficiency anemia.

Back 31

31. T

Front 32

31 to 33. Answer the following questions true or false.

32. Nausea with oral contraceptive use can beminimized by taking the pill on an emptystomach.

Back 32

32. F

Front 33

31 to 33. Answer the following questions true or false.

33. Calcium and vitamin D supplementation isrecommended for those taking DMPA (Depo-Provera) injections to minimize the risk of aloss in bone density.

Back 33

33. T

Front 34

34. An 18-year-old woman requests emergency contraceptionafter having unprotected vaginal intercourse approximately18 hours ago. Today is day 12 of hernormally 27- to 29-day menstrual cycle and she has nocontraindications to the use of any currently availableforms of emergency contraception. You advise her that:A. emergency hormonal contraception use reduces therisk of pregnancy by approximately 33%.B. all forms of emergency contraception must be usedwithin 12 hours after unprotected intercourse.C. the likelihood of conception is minimal.D. insertion of a copper-containing IUD offers aeffective form of emergency and ongoingcontraception.

Back 34

34. D.

Front 35

35. Which of the following is likely not among the proposedmechanisms of action of all forms of oralemergency contraception?A. inhibits ovulationB. acts as an abortifacientC. slows sperm transportD. slows ovum transport

Back 35

35. B.

Front 36

36. A 24-year-old woman who requests emergency contraceptionpills wants to know the effects if pregnancydoes occur. You respond that there is the risk ofincreased rate of:A. spontaneous abortion.B. birth defects.C. placental abruption.D. none of the above.

Back 36

36. D.

Front 37

37. In contrast to progestin-only emergency contraception,a possible mechanism of action of ulipristal is:A. inhibiting embryo implantation.B. impairing sperm transport.C. through spontaneous abortion.D. impairing ovum transport.

Back 37

37. A.

Front 38

38. You see a 34-year-old woman who reports having unprotectedsexual intercourse 4 days ago and requestsemergency contraception. She has a recent history ofgonorrhea that was treated successfully. The mostacceptable and effective option in this clinicalscenario is:A. progestin-only emergency contraception.B. ulipristal.C. copper-containing IUD.D. nothing, as 4 days is too long for emergency contraceptionto be effective.

Back 38

38. B.

Front 39

39. Which of the following statements is false?A. Progestin-only emergency contraception can betaken as one dose or two doses.B. Ulipristal is available by prescription only.C. Progestin-only emergency contraception is availableOTC for women 17 years old and older.D. Ulipristal is taken in two doses 12 hours apart.

Back 39

39. D.

Front 40

40. A woman who has used emergency contraception pillsshould be advised that if she does not have a normalmenstrual period within _____ weeks, a pregnancy testshould be obtained.A. 1 to 2B. 2 to 3C. 3 to 4D. 4 to 5

Back 40

40. C.

Front 41

41. The average onset of perimenopause is between theages of:A. 35 to 40 years.B. 40 to 45 years.C. 45 to 50 years.D. 50 to 55 years.

Back 41

41. B.

Front 42

42. Which of the following statements regarding perimenopauseis false?A. Menstruation ceases during perimenopause.B. Hot flashes and flushes are common during theweek before menses.C. Pregnancy is still possible during perimenopause.D. Ovulation becomes more erratic during perimenopause.

Back 42

42. A.

Front 43

43. In advising a woman about menopause, the NP considersthat:A. the average age at last menstrual period for a NorthAmerican woman is 47 to 48 years.B. hot flashes and night sweats occur in about 60% to90% of women.C. women with surgical menopause usually havemilder symptoms.D. follicle-stimulating hormone (FSH) and luteinizinghormone (LH) levels are suppressed.

Back 43

43. B.

Front 44

44. Findings in estrogen deficiency (atrophic) vaginitisinclude:A. a malodorous vaginal discharge.B. an increased number of lactobacilli.C. a reduced number of white blood cells.D. a pH greater than 5.0.

Back 44

44. D.

Front 45

45. A 53-year-old woman who is taking hormone therapy(HT) with conjugated equine estrogen, 0.45 mg/d, withMPA, 1.5 mg, has bothersome atrophic vaginitis symptoms.You advise that:A. her oral estrogen dose should be increased.B. the addition of a topical estrogen can be helpful.C. the MPA component should be discontinued.D. baking soda douche should be tried.

Back 45

45. B.

Front 46

46. For a woman with bothersome hot flashes who cannottake HT, alternative options with demonstrated efficacyand limited adverse effects include the use of all of thefollowing except:A. venlafaxine.B. sertraline.C. gabapentin.D. clonidine.

Back 46

46. D.

Front 47

47. Absolute contraindications to postmenopausalHT include:A. unexplained vaginal bleeding.B. seizure disorder.C. dyslipidemia.D. migraine headache.

Back 47

47. A.

Front 48

48. In advising a perimenopausal woman about HT, youconsider that it may:A. reduce the risk of venous thrombotic events.B. significantly reduce serum triglyceride levels.C. worsen hypertension in most women.D. help preserve bone density.

Back 48

48. D.

Front 49

49. Postmenopausal HT used for use can result in:A. a reduction in the rate of cardiovascular disease.B. an increase in the rate of rheumatoid arthritis.C. a reduction in the frequency and severity ofvasomotor symptoms.D. a disturbance in sleep patterns.

Back 49

49. C.

Front 50

50. The progestin component of HT is given to:A. counteract the negative lipid effects of estrogen.B. minimize endometrial hyperplasia.C. help with vaginal atrophy symptoms.D. prolong ovarian activity.

Back 50

50. B.

Front 51

51. Concerning selective estrogen receptor modulator therapysuch as raloxifene (Evista), which of the followingstatements is correct?A. Concurrent progestin opposition is needed.B. Hot flashes are reduced in frequency and severity.C. Use is contraindicated when a woman has a historyof breast cancer.D. Osteoporosis risk is reduced with use.

Back 51

51. D.

Front 52

52. During perimenopause, which of the following is likelyto be noted?A. Symptoms are most likely in the week before theonset of the menses.B. The length of the perimenopausal period is predictable.C. Symptoms are less severe in women who smoke.D. Hot flashes are uncommon.

Back 52

52. A.

Front 53

53. A 48-year-old woman complains of increased frequencyand severity of hot flashes. Her last mensesoccurred 6 months ago. You would expect all of the followinglaboratory findings except:A. increased levels of LH.B. elevated levels of testosterone.C. reduced levels of estradiol.D. reduced levels of progesterone.

Back 53

53. B.

Front 54

54. Which of the following is likely to be noted withshort-term (less than 1 to 2 years) HT use in a postmenopausalwoman?A. reduction in dementia riskB. significant increase in breast cancer riskC. minimized hot flashes.D. increase in cardiovascular risk

Back 54

54. C.

Front 55

55. Which body area has the greatest concentration ofestrogen receptors?A. vulvaB. vascular bedC. heartD. brain

Back 55

55. A.

Front 56

56. When counseling a 46-year-old woman who is experiencingdebilitating hot flashes, you advise all of thefollowing regarding higher and lower dose hormonereplacement therapy (HT) except:A. current clinical guidelines recommend using thelowest effective dose possible.B. higher-dose HT will relieve hot flashes faster thanlower-dose regimens.C. lower-dose HT is better tolerated than higherdoseHT.D. the duration of lower-dose HT is usually shorterthan that of higher-dose regimens.

Back 56

56. D.

Front 57

57. You see a 45-year-old woman who is considering HT.She has a family history of cervical dysplasia, hyperlipidemia,and VTE. You advise her on all of the followingexcept:A. the use of progestin can minimize the risk of endometrialcancer for a woman on HT and who hasnot had a hysterectomy.B. supplemental estrogen should be avoided in womenwho are at high risk of breast cancer or uterinecancer.C. supplemental estrogen should be avoided inwomen who are at high risk of cardiovasculardisease.D. short-term studies demonstrate that oral HT isassociated with lower thromboembolic risk thantransdermal forms of HT.

Back 57

57. D.

Front 58

58. Examples of phytoestrogens include all of the followingexcept:A. red clover.B. ginseng.C. vitamin E.D. soy products.

Back 58

58. C.

Front 59

59. The typical HT regimen contains ______ or less of theestrogen dose of COC.A. one-eighthB. one-fourthC. one-halfD. three-fourths

Back 59

59. B.

Front 60

60. For the woman with a history of DVT who is havingsignificant vasomotor symptoms, which of the followingcan be can be used for symptom management?A. 17- 17β-estradiol patchB. drospirenoneC. estrone.D. paroxetine.

Back 60

60. D.

Front 61

61. Long term calcium supplementation is recommendedin postmenopausal women as its use reduces the risk offracture by approximately:A. 25%.B. 50%.C. 65%.D. 80%.

Back 61

61. B.

Front 62

62. In postmenopausal women, a major benefit from theuse of topical or local estrogen is:A. decreased rate of breast cancer.B. reduced risk of recurrent UTIs.C. reduced risk of type 2 diabetes.D. increased levels of androgens

Back 62

62. B.

Front 63

63. When reviewing the use of nutritional supplements forthe management of menopausal symptoms, the NPconsiders that:A. few high-quality studies support the use of theseproducts.B. the use of these products is consistently reported tobe helpful.C. the products can be safely used as long as blood hormonelevels are carefully evaluated.D. the use of these products is associated with a greaterreduction in menopausal symptoms than with prescriptionHT.

Back 63

3. A.

Front 64

64. Which of the following statements is true?A. Many over-the-counter progesterone creamscontain sterols that the human body is unableto use.B. All progesterones are easily absorbed viathe skin.C. Alfalfa is an example of a phytoprogesterone.D. Progesterones, whether synthetic or plant-based,should not be used by a woman who has undergonea hysterectomy.

Back 64

64. A.

Front 65

65. Chlamydial infections occur most frequently amongwomen in which age group?A. younger than 25 yearsB. 25 to 35 yearsC. 40 to 50 yearsD. over 60 years

Back 65

65. A.

Front 66

66. Common sites of C. trachomatis infection in womeninclude all of the following except:A. ovaries.B. cervix.C. endometrium.D. urethra.

Back 66

66. A.

Front 67

67. The incubation period for C. trachomatis is approximately:A. 24 hours.B. 3 days.C. 7 to 14 days.D. 24 days.

Back 67

67. C.

Front 68

68. Which of the following include characteristics of afriable cervix?A. presence of a dull pain, particular prior to mensesB. a constant burning sensationC. presence of multiple polypsD. easily irritated and prone to bleeding, especiallyfollowing intercourse

Back 68

68. D.

Front 69

69. An annual screening for C. trachomatis infection isrecommended for:A. all sexually active women.B. sexually active women 25 years of age andyounger.C. sexually active women who have had 2 or morepartners in the past 12 months.D. sexually active men 25 years of age and younger.

Back 69

69. B.

Front 70

70. Which of the following is not a normal finding in awoman during the reproductive years?A. vaginal pH of 4.5 or lessB. Lactobacillus as the predominant vaginal organismC. thick, white vaginal secretions during the luteal phaseD. vaginal epithelial cells with adherent bacteria

Back 70

70. D.

Front 71

71. Which of the following findings is most consistent withvaginal discharge during ovulation?A. dry and stickyB. milky and mucoidC. stringy and clearD. tenacious and odorless

Back 71

71. C.

Front 72

72. What is the approximate incubation period forNeisseria gonorrhoea?A. 1 to 5 daysB. 7 to 10 daysC. 18 daysD. 28 days

Back 72

72. A.

Front 73

73. A recommended treatment for rectal gonorrhea is:A. oral amoxicillin.B. oral azithromycin.C. oral ciprofloxacin.D. ceftriaxone injection.

Back 73

73. D.

Front 74

74. Physical examination of a 19-year-old woman with a3-day history of vaginal itch reveals moderate perinealexcoriation, vaginal erythema, and a white, clumpingdischarge. Expected microscopic examination findingsinclude:A. a pH greater than 6.0.B. an increased number of lactobacilli.C. hyphae.D. an abundance of white blood cells.

Back 74

74. C.

Front 75

75. Women with bacterial vaginosis typically present with:A. vulvitis.B. pruritus.C. dysuria.D. malodorous discharge.

Back 75

75. D.

Front 76

76. Treatment of vulvovaginitis caused by Candida albicansincludes:A. metronidazole gel.B. clotrimazole cream.C. hydrocortisone ointment.D. clindamycin cream.

Back 76

76. B.

Front 77

77. A 24-year-old woman presents with a 1-week history ofthin, green-yellow vaginal discharge with perivaginal irritation.Physical examination findings include vaginalerythema with petechial hemorrhages on the cervix,numerous white blood cells, and motile organisms onmicroscopic examination. These findings most likelyrepresent:A. motile sperm with irritative vaginitis.B. trichomoniasis.C. bacterial vaginosis.D. condyloma acuminatum.

Back 77

77. B.

Front 78

78. A preferred treatment option for trichomoniasis is:A. oral metronidazole.B. clindamycin vaginal cream.C. topical acyclovir.D. oral azithromycin.

Back 78

78. A.

Front 79

79. Treatment options for bacterial vaginosis include all ofthe following except:A. oral metronidazole.B. clindamycin cream.C. oral clindamycin.D. oral azithromycin.

Back 79

79. D.

Front 80

80. A 30-year-old woman presents without symptoms butstates that her male partner has dysuria without peniledischarge. Examination reveals a friable cervix coveredwith thick yellow discharge. This description is mostconsistent with an infection caused by:A. Chlamydia trachomatis.B. Neisseria gonorrhoeae.C. human papillomavirus (HPV).D. Trichomonas vaginalis.

Back 80

80. A.

Front 81

81. Which of the following agents is active againstN. gonorrhoeae?A. ceftriaxoneB. metronidazoleC. ketoconazoleD. amoxicillin

Back 81

81. A.

Front 82

82. Which of the following agents is most active againstC. trachomatis?A. amoxicillinB. metronidazoleC. azithromycinD. ceftriaxone

Back 82

82. C.

Front 83

83. Which of the following statements is true of gonococcalinfection?A. The risk of transmission from an infected woman toa male sexual partner is about 80%.B. Most men have asymptomatic infection.C. The incubation period is about 2 to 3 weeks.D. The organism rarely produces beta-lactamase.

Back 83

83. B.

Front 84

84. Complications of gonococcal and chlamydial genitourinaryinfection in women include all of the followingexcept:A. pelvic inflammatory disease (PID).B. tubal scarring.C. acute pyelonephritis.D. acute peritoneal inflammation.

Back 84

84. C.

Front 85

85. What percentage of sexually active adults has serologicalevidence of human herpes virus 2 (HHV-2 or herpessimplex type 2)?A. 5.8%B. 14.5%C. 18.9%D. 35.6%

Back 85

85. C.

Front 86

86. All of the following are likely reported in a woman withan initial episode of genital HSV-2 (HHV-2) infectionexcept:A. painful ulcer.B. inguinal lymphadenopathy.C. thin vaginal discharge.D. pustular lesions.

Back 86

86. D.

Front 87

87. In the person with HSV-2 infection, the virus canspread via:A. genital secretions.B. oral secretions.C. normal-looking skin.D. all of the above

Back 87

87. D.

Front 88

88. During asymptomatic HSV-2 infections, genital sheddingof virus occurs during approximately ________of days.A. 10%B. 25%C. 50%D. 100%

Back 88

88. A.

Front 89

89. Diagnostic testing of a person with primary HSV-2 infectionwould likely show:A. negative virological and serological test results.B. negative virological test result and positive serologicaltest result.C. positive virological test result and negative serologicaltest result.D. positive virological and serological test results.

Back 89

89. C.

Front 90

90. Treatment options for HSV-2 genital infection include:A. ribavirin.B. indinavir.C. famciclovir.D. cyclosporine.

Back 90

90. C.

Front 91

91. Suppressive therapy reduces the frequency of genitalherpes recurrences by:A. 5% to 10%.B. 20% to 25%.C. 40% to 50%.D. 70% to 80%.

Back 91

91. D.

Front 92

92. Recommended comprehensive STI testing includestesting for all of the following except:A. hepatitis B.B. syphilis.C. hepatitis A.D. HIV.

Back 92

92. C.

Front 93

93. Women with PID typically present with all of the followingexcept:A. dysuria.B. leukopenia.C. cervical motion tenderness.D. abdominal pain.

Back 93

93. B.

Front 94

94. A 22-year-old woman complains of pelvic pain. Physicalexamination reveals cervical motion tenderness anduterine tenderness. Which of the following would furthersupport a diagnosis of PID?A. temperature less than 100ºF (37.8ºC)B. absence of white blood cells in vaginal fluidC. mucopurulent vaginal dischargeD. laboratory documentation of cervical infection withE. coli

Back 94

94. C.

Front 95

95. The most likely causative pathogen in a 23-year-oldwoman with PID is:A. Escherichia coli.B. Enterobacteriaceae.C. C. trachomatis.D. Pseudomonas.

Back 95

95. C.

Front 96

96. The presence of an adnexal mass in the woman withPID most likely indicates the presence of:A. uterine fibroids.B. an ectopic pregnancy.C. ovarian malignancy.D. a tubo-ovarian abscess.

Back 96

96. D.

Front 97

97. Expected laboratory findings for the woman with PIDinclude all of the following except:A. elevated ESR.B. elevated CRP.C. elevated CrCl.D. leukocytosis.

Back 97

97. C.

Front 98

98. A transvaginal ultrasound in the woman with PIDwill likely show:A. tubal thickening with or without free pelvic fluid.B. cervical thickening.C. endometrial thinning.D. inflammation of the ovaries.

Back 98

98. A.

Front 99

99. Which of the following is a treatment option for a 28-year-old woman with PID who has no history of medicationallergy and has undergone a bilateral tuballigation?A. ofloxacin with metronidazoleB. gentamicin with cefpodoximeC. ceftriaxone with doxycyclineD. clindamycin with azithromycin

Back 99

99. C.

Front 100

100. Which of the following is a treatment option for a30-year-old woman with PID and a history of severehive-form reaction when taking a penicillin orcephalosporin?A. ofloxacin with metronidazoleB. amoxicillin with gentamicinC. cefixime with vancomycinD. clindamycin with azithromycin

Back 100

100. A.

Front 101

101. Which of the following best describes lesions associatedwith condyloma acuminatum?A. verruciformB. plaque-likeC. vesicular-formD. bullous

Back 101

101. A.

Front 102

102. Treatment options for patients with condylomaacuminatum include all of the following except:A. topical acyclovir.B. cryotherapy.C. podofilox.D. trichloroacetic acid.

Back 102

102. A.

Front 103

103. Which HPV types are most likely to cause genitalcondyloma acuminatum?A. 1, 2, and 3B. 6 and 11C. 16 and 18D. 22 and 24

Back 103

103. B.

Front 104

104. Which HPV types are most often associated withcervical and anogenital cancer?A. 1, 2, and 3B. 6 and 11C. 16 and 18D. 22 and 24

Back 104

104. C.

Front 105

105. What percentage of anogenital and cervical cancerscan be attributed to HPV infection?A. less than 30%B. at least 50%C. at least 70%D. 95% or greater

Back 105

105. C.

Front 106

106. Which of the following terms describes the mechanismof action of imiquimod (Aldara)?A. keratolyticB. immune modulatorC. cryogenicD. cytolytic

Back 106

106. B.

Front 107

107. About ____ of patients with genital warts have spontaneousregression of the lesions?A. 10%B. 25%C. 50%D. 75%

Back 107

107. C.

Front 108

108. How long after contact do clinical manifestations ofsyphilis typically occur?A. less than 1 weekB. 1 to 3 weeksC. 2 to 4 weeksD. 4 to 6 weeks

Back 108

108. C.

Front 109

109. Which of the following is not representative of thepresentation of primary syphilis?A. painless ulcerB. localized lymphadenopathyC. flu-like symptomsD. spontaneously healing lesion

Back 109

109. C.

Front 110

110. Which of the following is not representative of thepresentation of secondary syphilis?A. generalized rashB. chancreC. arthralgiaD. lymphadenopathy

Back 110

110. B.

Front 111

111. Which of the following is found in tertiary syphilis?A. arthralgiaB. lymphadenopathyC. macular or papular lesions involving the palmsand solesD. gumma

Back 111

111. D.

Front 112

112. Syphilis is most contagious during which of thefollowing?A. before onset of signs and symptomsB. at the primary stageC. at the secondary stageD. at the tertiary stage

Back 112

112. C.

Front 113

113. First-line treatment options for primary syphilisinclude:A. penicillin.B. ciprofloxacin.C. erythromycin.D. ceftriaxone.

Back 113

113. A.

Front 114

114. You see an 18-year-old woman with a history ofC. trachomatis infection and a total of five lifetimepartners. You recommend:A. Pap smear only.B. Pap smear and HPV testing.C. Pap smear and STI testing.D. STI testing only

Back 114

114. D.

Front 115

115. During well-women visits for 21- to 29-year-oldsexually active women who report more than 1 sexpartner within the past 6 months, all of the followingare appropriate screening tests except:A. Pap smear.B. HPV testing.C. Pelvic examination.D. STI screening.

Back 115

115. B.

Front 116

116. A 45-year-old woman just had a normal Pap test resultand has an absence of high-risk HPV. You recommendher next Pap test in:A. 1 year.B. 3 years.C. 5 years.D. 7 years.

Back 116

116. C.

Front 117

117. Which of the following is not part of the criteria foran older woman to cease having any future Pap testsperformed?A. over 55 years of ageB. negative screening results on three consecutivecytology or two consecutive co-test resultswithin 10 yearsC. the most recent cytology occurring within the past5 yearsD. no history of cervical intraepithelial neoplasm(CIN) 2 or greater within the past 20 years

Back 117

117. A.

Front 118

118. You see a 48-year-old woman who underwent an abdominalhysterectomy with cervical removal for uterinefibroids 6 months ago. She last had a normal Paptest 11⁄2 years ago. You recommend her next Pap test.A. immediately.B. in 1 1⁄2 years.C. in 3 1⁄2 years.D. She does not need to have a pap test now or in thefuture.

Back 118

118. D.

Front 119

119. You see a 24-year-old woman who received the HPVvaccine (three doses) as a teenager. She had a normalPap test 3 years ago. You recommend:A. conducting a Pap test.B. conducting a Pap test and HPV testing.C. waiting 2 years for the next Pap test.D. ceasing future Pap tests until she turns 30 years old.

Back 119

119. A.

Front 120

120. You see a 33-year-old woman whose Pap smear resultreveals atypical cells of undetermined significance(ASC-US). She is also positive for HPV, withgenotype testing revealing the presence of HPVtype 16. You recommend:A. repeating Pap test immediately.B. repeating the Pap test in 3 to 4 months.C. referral for colposcopy.D. administering the HPV vaccine.

Back 120

120. C.

Front 121

121. You see a 41-year-old woman whose Pap smear resultreveals high-grade squamous intraepithelial lesion(HSIL). The HPV test is negative. You recommend:A. repeating the Pap test in 3 to 4 months.B. repeating the Pap test in 1 year.C. referral for colposcopy.D. referral for biopsy.

Back 121

121. C.