Board Review 4/2/2013. ADOLESCENT (part 2). Test Question. True or False: My March Madness bracket was way off this year True False Um, this is the south… we only care about football. Eating disorders. Etiology.
ADOLESCENT (part 2)
True or False: My March Madness bracket was way off this year
Which of the following is NOT a criteria for the diagnosis of anorexia nervosa?
You are seeing your 18 year old patient with a known history of bulimia. Today, you are concerned that your patient may be doing poorly with her outpatient control, as the parents are noticing more warning signs. Every month you follow the patient’s electrolytes. Which 2 electrolytes should be closely evaluated to help you decide whether or not to admit your patient to the hospital??
What percent of adolescents will become pregnant within the first six months of initiation of sexual activity if ineffective contraceptive measures are used?
All of the following are ABSOLUTE (Class 4) contraindications to combined oral contraceptive use EXCEPT
We didn’t go into OB/GYN for a reason…
You are evaluating a 16 yo female in your office for secondary amenorrhea. She states menarche was at age 11, she typically bleeds for 4-5 days, using 3-4 pads or tampons per day. She has an interval of 21-28 days between her periods. Her last period was 3 months ago. She denies any abdominal pain, weight changes, or medication use but does complain of excessive hair growth on her face and abdomen. On exam, her vitals are all stable and her BMI is 35. Of the following, which is the FIRST step in your evaluation?
You are seeing a 15yo girl for her annual health visit. Menarche was at 12yrs and she had normal menses for 2 years. Over the last year her menses became more irregular and stopped 4 months ago. Her mother notes that she is very health conscious. She has gained no weight over the past 3 years. On exam, her BMI is 17, heart rate is 55 bpm, she has no acne or hirsutism, and she is at SMR 5 genital development. Of the following, the most likely cause for her amenorrhea is:
A 15yo girl is concerned about irregular menses and acne. Menarche was at 11 years and 9 months and she developed pubic hair around age 7. On exam, her BMI is 32.3, she has facial comedonal and pustular acne, as well as darkening of her neck and axilla. She has hypopigmented stretch marks on her abdomen and hair in a linear distribution from her umbilicus to the pubic symphosis. She is at SMR 5. Of the following, the most likely diagnosis is:
A 14 yo girl, who has had irregular bleeding since menarche at age 11 years, presents with painless menstrual bleeding of 14 days’ duration. She is using 8 to 10 pads per day. She is tired and is upset with the number of days of bleeding. The only finding on physical examination is mild pallor. Her heart rate is 82, blood pressure is 120/80, with no postural changes. Labs show a hemoglobin of 9.4 g/dL, normal platelet count, PT, PTT, and von Willebrand panel. Of the following, the MOST appropriate treatment for this girl is
A 15 yo girl presents for treatment of menstrual cramps. She had menarche 3 years ago and over the last year she began having pain with her cycle. The pain is worse on the first day and she occassionally misses school due to the pain. Of the following, which is the BEST initial treatment?
You are seeing a 16 yr old girl for complaints of malodorous vaginal discharge. No abdominal pain or urinary symptoms. GC and chlamydia testing 3 months ago were negative and she has not been sexually active since. On exam there is a homogenous gray discharge, normal cervix, no tenderness. A wet mount shows the following. What is the most likely diagnosis?
You are seeing a 15-year-old sexually active girl who complains of vague lower abdominal pain and a vaginal discharge. She has no systemic symptoms but has experienced intermittent dysuria over the past week. She believes that she needs only a prescription for a yeast infection because she was treated for this a few weeks ago but the discharge did not resolve completely. Of the following, the MOST appropriate next step is to:
An 18 yo boy comes to your office with complaints of burning with urination over the past 24 hours. He also complains of low back pain for 48 hours. He denies rash, but states his eyes are a little irritated. He is sexually active. On exam, he is afebrile, his conjunctivae are mildly injected, and his back is tender over the lower lumbar area. There is no CVA tenderness. Genital exam reveals no scrotal tenderness and scant yellow discharge at the urethral orifice. Of the follow, what is the most likely cause of his symptoms?