05-04-2008, 02:43 PM
22. A 3-year-old girl is brought to the physician after her mother noted blood on her underpants. Examination shows genital condylomata acuminata in the perineal, peri-introital, labial, and anal areas. Some of the pedunculated condylomata appear to have caused the bleeding. She has no visible intravaginal condylomata or vaginal or anal tears. Her mother has a palmar wart on her hand but no history of condylomata acuminata. Her mother has a boyfriend who does not live with them and who has never been left alone with the girl. They live with the mother's 27-year-old brother who only baby-sits the children when they are asleep. Which of the following is the most appropriate next step in management?
A
) Psychiatric assessment of the mother
B
) DNA typing of the mother's palmar wart for papillomavirus
C
) Treatment of the mother's palmar wart
D
) Vaginal, anal, and throat cultures for Chlamydia trachomatis and Neisseria gonorrhoeae in the child
E
) Laser therapy of the condylomata acuminata in the child
A
) Psychiatric assessment of the mother
B
) DNA typing of the mother's palmar wart for papillomavirus
C
) Treatment of the mother's palmar wart
D
) Vaginal, anal, and throat cultures for Chlamydia trachomatis and Neisseria gonorrhoeae in the child
E
) Laser therapy of the condylomata acuminata in the child