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1. A mother brings her 12-year-old daughter to your office for consultation. She is concerned because most of the other girls in her daughter’s class have already started their period. She thinks her daughter hasn’t shown any evidence of going into puberty yet. Knowing the usual first sign of the onset of puberty, you should ask the mother which of the following questions?CorrectIncorrect
2. A 17-year-old consults you for evaluation of disabling pain with her menstrual periods. The pain has been present since menarche, and is accompanied by nausea and headache. Her medical history is otherwise unremarkable, and pelvic examination is normal. She is not currently sexually active, and she has not tried any therapy for her dysmenorrhea.CorrectIncorrect
3. A mother brings her daughter to see you for consultation. The daughter is 17 years old and has not started her period. She is 4 ft 10 in tall. On physical examination, she has no breast buds or pubic hair. Her pelvic examination demonstrates a uterus and cervix, but the ovaries are not palpable. As part of the workup, serum FSH and LH levels are drawn and both are high. Which of the following is the most likely reason for delayed puberty in this patient?CorrectIncorrect
4. A 29-year-old P0 presents to your office with a chief complaint of symptoms of premenstrual syndrome (PMS). A detailed history reveals that she experiences emotional lability and depression for about 10 days prior to her menses. Once her period starts, she feels “back to normal.” She also reports a long history of premenstrual fatigue, breast tenderness, and bloating. Her previous physician prescribed oral contraceptives to treat her PMS 6 months ago, and she reports that the pills have alleviated all her PMS symptoms except for the depression and emotional symptoms. Which of the following is the best next step in the treatment of this patient’s problem?CorrectIncorrect
5. A 21-year-old woman presents to you for management of menstrual migraines. She has no other medical problems, does not smoke, and does not take any medications routinely. Her periods are regular and last 5 days. She says the flow is moderate and she does not have dysmenorrhea. She is sexually active with her partner of 1 year, and she uses condoms for contraception. She says she develops a debilitating migraine for the first 2 days of her period every month. She describes her headaches as unilateral, throbbing, and associated with nausea and photophobia. She has missed work due to these symptoms. What is the best next step in management of her migraines?CorrectIncorrect