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Abnormal uterine bleeding (AUB) has multiple causes. When a woman presents and reports menstrual irregularity with amenorrhea, which is the most common cause of amenorrhea? Ectopic pregnancy Adeno... myosis Coagulopathy Anovulation • The Tanner scale of sexual maturity rating allows for accurate classification of physical pubertal maturation. During the examination of your patient, you notice that the pubic hair is increased in quantity, is darker, and is present in the typical female triangle but in a smaller quantity. Which of the following Tanner stages does this description meet? Tanner stage I Tanner stage II Tanner stage III Tanner stage IV • A twenty-five-year-old patient presents with urinary frequency and urgency. These symptoms have been occurring for three days without fever. A patient with interstitial cystitis would most likely describe their symptoms as _______. urinary urgency and frequency in the morning and at night pain with urination with scant bleeding terminal dysuria urinary urgency only • The most common cause of chronic pelvic pain for women in the prime of their reproductive years is PID Fibroids CORRECT Endometriosis Endometritis • A fifty-two-year-old female patient comes in for her annual well-woman examination. Her LMP was fourteen months ago without any breakthrough bleeding. She has also developed some hirsutism. You would document this as __. secondary amenorrhea menopause perimenopause polycystic ovary syndrome (PCOS) • Polycystic ovaries predispose women to a higher incidence of: Adrenal tumors Ovarian cancer Endometrial cancer Endometriosis • A definitive diagnosis of endometriosis cannot be made until which of these is completed? CT scan Transvaginal ultrasound Exploratory laparoscopy MRI • After a thorough history, you note that Marie resides in a community with very high risk factors. These include poverty, violence, and lack of recreational facilities. She tells you that she “hangs out” at a convenience store near the apartment complex she lives at with her mother. “All the group hangs there,” she reports proudly. She shares that she has been menstruating for two years now although she has irregular cycles. She also lets you know that she has had coitus only one time and that he “pulled out.” She does not want to get pregnant, and this is why she is here today. What is your management plan for Marie today? Student Answer: CORRECT You will assess all predisposing factors that lead to premarital sex and the negative consequences, tell Marie to be careful, and prescribe birth-control pills. CORRECT One by one, you will plan to carefully address the risks (red flags) in Marie’s history. Your goal will be to clarify and address misconceptions, as well as share valuable sex education in a sensitive, nonjudgmental way. You will let her know you are her advocate and are very protective of her health. Without preaching, you want her to be aware of the negative possibilities of premarital, unprotected sexual activities. You will also share a clear understanding of the risk of STIs with Marie. CORRECT After processing all of the history Marie has shared, you will write a referral for psychiatric evaluation and tell her she needs ongoing counseling for her behavior at such a young age and she likely needs to learn to cope within her environment (home and community). CORRECT Your goal is to include healthy sexual-health decision making, including decisions regarding abstinence, birthcontrol efficacy and choice, and condom use. Depending on the need, you may include a referral to an effective program for teens (for example, a program that deals with STI prevention and or a family-based intervention program if available). • A well-woman visit for an adolescent should include which of the following? A general health history and physical examination, including a breast examination, pelvic with Pap smear, screening tests, counseling, immunizations, risk factors, and patient concerns A general health history focusing on reproductive and sexual health concerns (menses, gynecologic, and pregnancy related) and psychosocial (family related, peer related, emotional, and physical as well as related to abuse, drug use, and alcohol use) concerns Physical exam, screening tests, and immunizations as indicated by the health history and gynecologic considerations for an external-only inspection of the genitalia CORRECT Both b and c [Show More]

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