06-19-2007, 11:49 AM
1. A 42-year-old woman, gravida 2, para 2, comes to
the physician
because of a 3-month history of swelling of her legs
and mild abdominal
pain and bloating. Abdominal examination shows no
abnormalities.
Rectovaginal examination shows fullness in the right
adnexa. Transvaginal
ultrasonography shows an irregular mass in the right
ovary with some
solid components to a predominantly cystic lesion.
Her serum CA 125 level
is 120 U/mL (N<35). Treatment with which of the
following is most
likely to have prevented this patient's symptoms?
A
) Antiestrogens
B
) Antiprogestationals
C
) Medroxyprogesterone
D
) Oral contraceptives
E
) Ovulation-inducing drugs
2. A 15-year-old girl is brought to the physician 3
months after she
had a blood pressure of 150/95 mm Hg at a routine
examination prior to
participation in school sports. She is asymptomatic
and has no history
of serious illness. Twelve months ago, she was
diagnosed with a
urinary tract infection and treated with oral
trimethoprim-sulfamethoxazole.
She currently takes no medications. Subsequent blood
pressure
measurements on three separate occasions since the
last visit have been: 155/94
mm Hg, 145/90 mm Hg, and 150/92 mm Hg. She is at the
50th percentile
for height and 95th percentile for weight. Her blood
pressure today is
150/90 mm Hg confirmed by a second measurement, pulse
is 80/min, and
respirations are 12/min. Examination shows no other
abnormalities. Her
hematocrit is 40%. Urinalysis is within normal limits.
Cardiac and
renal ultrasonography shows no abnormalities. Which
of the following is
the most appropriate next step in management?
A
) Exercise and weight reduction program
B
) Measurement of urine catecholamine levels
C
) Measurement of urine corticosteroid levels
D
) Captopril therapy
E
) Hydrochlorothiazide therapy
the physician
because of a 3-month history of swelling of her legs
and mild abdominal
pain and bloating. Abdominal examination shows no
abnormalities.
Rectovaginal examination shows fullness in the right
adnexa. Transvaginal
ultrasonography shows an irregular mass in the right
ovary with some
solid components to a predominantly cystic lesion.
Her serum CA 125 level
is 120 U/mL (N<35). Treatment with which of the
following is most
likely to have prevented this patient's symptoms?
A
) Antiestrogens
B
) Antiprogestationals
C
) Medroxyprogesterone
D
) Oral contraceptives
E
) Ovulation-inducing drugs
2. A 15-year-old girl is brought to the physician 3
months after she
had a blood pressure of 150/95 mm Hg at a routine
examination prior to
participation in school sports. She is asymptomatic
and has no history
of serious illness. Twelve months ago, she was
diagnosed with a
urinary tract infection and treated with oral
trimethoprim-sulfamethoxazole.
She currently takes no medications. Subsequent blood
pressure
measurements on three separate occasions since the
last visit have been: 155/94
mm Hg, 145/90 mm Hg, and 150/92 mm Hg. She is at the
50th percentile
for height and 95th percentile for weight. Her blood
pressure today is
150/90 mm Hg confirmed by a second measurement, pulse
is 80/min, and
respirations are 12/min. Examination shows no other
abnormalities. Her
hematocrit is 40%. Urinalysis is within normal limits.
Cardiac and
renal ultrasonography shows no abnormalities. Which
of the following is
the most appropriate next step in management?
A
) Exercise and weight reduction program
B
) Measurement of urine catecholamine levels
C
) Measurement of urine corticosteroid levels
D
) Captopril therapy
E
) Hydrochlorothiazide therapy