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3,531 questions
A woman complains of amenorrhea for several months following a dilation and curettage. Which of the following is the most likely reason?
A 40-year old man has been treated for chronic paranoid schizophrenia for many years with a typical neuroleptic. To decrease his risk for tardive dyskinesia, his psychiatrist wants to change his medication to an atypical antipsychotic. Which of the following atypical antipsychotics is limited in its use by the risk of agranulocytosis, which occurs in 12% of all patients treated? aripiprazole
A26-year-old female with recurrent pregnancy loss undergoes a laparoscopy and hysteroscopy. She is found to have a Müllerian anomaly with a heart-shaped uterus that has two uterine horns but one common cervix. What is the name of the uterine anomaly?
A 37-year-old woman telephones to alert her psychiatrist that she has developed a severe pain in her right eye that has persisted for about 5 hours. She has no history of migraine headaches. The psychiatrist is treating her with 150 mg imipramine for major depression. She denies any recent injury or infection in this eye. She wears corrective lenses for nearsightedness. Which of the following is the most appropriate step in management?
A 24-year-old G1 presents to you for initiation of obstetric care. She informs you that she is on a medication that was prescribed for acne. The drug is listed as category X in your pharmacy book. The patient reports that she is going to continue the medication because she would be too embarrassed to go to work if her acne were to return. You counsel the patient about the possible risks of this approach but she desires to proceed. You counsel the patient that her best option may be to terminate the pregnancy and continue the medication. Allowing her to make this decision is an example of which of the following?
Narcolepsy is a primary sleep disorder with all of the following symptoms except which of the following?
A 24-year-old G1 presents to you for initiation of obstetric care. She informs you that she is on a medication that was prescribed for acne. The drug is listed as category X in your pharmacy book. The pregnancy risk factor category X for a drug indicates which of the following?
Apatient presents to your office for an annual gynecologic examination. She is an obese, postmenopausal, White female who reports a 4-month history of vulvar pruritis. Otherwise, she is without complaint. On examination, she is noted to have a whitened plaque-like area involving the posterior fourchette. The area is nontender, raised, and approximately 2.0 2.0 0.5 cm. What is the next step in the management of this patient?
The predicted length of the follicular phase of a patient with a consistent 34-day menstrual cycle is which of the following?
An 85-year-old man presents to the emergency room with an acute onset of midepigastric pain, nausea, vomiting, and hiccups starting 2 days ago. He is unable to keep any food down. Past history is pertinent for a long-standing hiatal hernia, hypertension, and diet-controlled diabetes. Examination reveals vital signs of pulse rate 82/min, BP 100/52 mmHg, respiratory rate 16/min, and temperature 97.2°F. The patient is in no acu te distress, but has epigastric tenderness without guarding. Laboratory analysis revealed a hematocrit of 46 and a normal white blood cell (WBC) count. A chest x-ray is shown in Figure. A fluoroscopically guided NG tube was placed using contrast, and his stomach was decompressed.After adequate fluid and electrolyte resuscitation, an upper gastrointestinal (UGI) contrast study was obtained and is shown in Figure. Which of the following is the most appropriate next step in management?
An 85-year-old man presents to the emergency room with an acute onset of midepigastric pain, nausea, vomiting, and hiccups starting 2 days ago. He is unable to keep any food down. Past history is pertinent for a long-standing hiatal hernia, hypertension, and diet-controlled diabetes. Examination reveals vital signs of pulse rate 82/min, BP 100/52 mmHg, respiratory rate 16/min, and temperature 97.2°F. The patient is in no acu te distress, but has epigastric tenderness without guarding. Laboratory analysis revealed a hematocrit of 46 and a normal white blood cell (WBC) count. A chest x-ray is shown in Figure. A fluoroscopically guided NG tube was placed using contrast, and his stomach was decompressed.After adequate fluid and electrolyte resuscitation, an upper gastrointestinal (UGI) contrast study was obtained and is shown in Figure. Which of the following is the most likely diagnosis?
Which of the following statements regarding seizures in pregnancy is true?
A 58-year-old woman with a history of chronic paranoid schizophrenia, who has been continuously treated with antipsychotics for the past 20 years, lives in a community-based residential facility. She has recently suffered an increase in auditory hallucinations, and her haloperidol dose has been increased from 2.5 to 10 mg/day. Four days later, she is brought by a visiting nurse to the emergency room, where she presents with confusion, marked flexor and extensor rigidity in her legs and arms, and a temperature of 103.5°F. Her bl ood pressure is160/120 mmHg, her pulse is 120/min and irregular. Which of the following is most likely to be an effective treatment for this condition?
A 51-year-old woman presents to the physician's office with a 2-month history of a right breast bloodtinged nipple discharge. Past history is unremarkable. Family history is positive for postmenopausal breast cancer in a maternal grandmother. Examination reveals no palpable masses or regional adenopathy, but a serous discharge is easily elicited from a single duct in the right breast. Bilateral mammograms show no abnormalities. Cytology from the discharge was not diagnostic. A ductogram was ordered, and the results are shown in the figure below. Which of the following is the most appropriate next step in management?
Implantation of the embryo into the endometrium occurs how many days after ovulation?
A pregnant woman presents to the ER at 20 weeks' gestation with an acute exacerbation of her chronic bronchial asthma. She complains of a cold of 1 week's duration and admits that she lost her inhaler 2 weeks ago. Her examination reveals a temperature of 38 C, RR of 40, pulse of 110, and fetal heart rate of 150. Her lung examination is notable for diffuse expiratory wheezes and a prolonged I:E ratio. She is utilizing accessory muscles for breathing, which appears labored. Which of the following statements regarding asthma in pregnancy is true?
A 55-year-old-woman presents to the physician's office for evaluation of mammographic findings on a screening mammogram. She denies any breast masses, nipple discharge, pain, or skin changes. Past history is pertinent for insulin-dependent diabetes. Family history is positive for postmenopausal breast cancer in her mother. She has a normal breast examination and no axillary adenopathy. A mediolateral oblique (MLO) view of the right breast is shown in the figure below. Which of the following is the most appropriate next step in management?
A 55-year-old-woman presents to the physician's office for evaluation of mammographic findings on a screening mammogram. She denies any breast masses, nipple discharge, pain, or skin changes. Past history is pertinent for insulin-dependent diabetes. Family history is positive for postmenopausal breast cancer in her mother. She has a normal breast examination and no axillary adenopathy. A mediolateral oblique (MLO) view of the right breast is shown in the figure below. Which of the following is the most likely diagnosis?
A woman with type 1 diabetes is at increased risk for having a fetus with which of the following congenital anomalies?
A2-year-old child presents with a 2-day history of painless rectal bleeding. On examination, the child is pale with tachycardia. The abdomen is nondistended and nontender. There is dark blood on rectal examination. The child has the following imaging study. Which of the following is the most appropriate management?