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Questions and Answers
What is the most likely diagnosis for the patient with foul-smelling lochia and elevated WBC count?
What is the most likely diagnosis for the patient with foul-smelling lochia and elevated WBC count?
- Vaginitis
- Pelvic inflammatory disease
- Endometritis (correct)
- Urinary tract infection
Which of the following is a likely etiology for the case involving the 20-year-old woman with cervical discharge?
Which of the following is a likely etiology for the case involving the 20-year-old woman with cervical discharge?
- Candidiasis
- Bacterial vaginosis
- Viral cervicitis
- Chlamydia trachomatis infection (correct)
What is a clinical feature of the 27-year-old woman with amenorrhea?
What is a clinical feature of the 27-year-old woman with amenorrhea?
- Mild hirsutism and weight gain (correct)
- Cervical motion tenderness
- Bilateral adnexal tenderness
- Soft abdomen
Which of the following would be a suitable management step for a patient with suspected endometritis?
Which of the following would be a suitable management step for a patient with suspected endometritis?
In a patient presenting with cervical motion tenderness and lower quadrant pain, what diagnostic evaluation would be most appropriate?
In a patient presenting with cervical motion tenderness and lower quadrant pain, what diagnostic evaluation would be most appropriate?
What risk factor is specifically noted in the case of the young woman with new sexual partners?
What risk factor is specifically noted in the case of the young woman with new sexual partners?
What is an important aspect of prevention discussed in the cases involving sexually active young women?
What is an important aspect of prevention discussed in the cases involving sexually active young women?
What might be a common misconception about amenorrhea in a sexually active woman?
What might be a common misconception about amenorrhea in a sexually active woman?
What is the most likely diagnosis for the 18-year-old woman with a yellow frothy discharge and vulvar itching?
What is the most likely diagnosis for the 18-year-old woman with a yellow frothy discharge and vulvar itching?
In the case of the 36-year-old woman with fish-smelling discharge, what is the most likely diagnosis?
In the case of the 36-year-old woman with fish-smelling discharge, what is the most likely diagnosis?
What clinical findings were noted during the examination of the 18-year-old patient?
What clinical findings were noted during the examination of the 18-year-old patient?
What treatment would be most appropriate for the diagnosed condition in the 18-year-old woman?
What treatment would be most appropriate for the diagnosed condition in the 18-year-old woman?
Which of the following is a risk factor identified in the case of the 36-year-old woman?
Which of the following is a risk factor identified in the case of the 36-year-old woman?
What was the pH level of the vaginal discharge in the 18-year-old woman?
What was the pH level of the vaginal discharge in the 18-year-old woman?
What is a common etiology associated with the diagnosis made for the 36-year-old woman's symptoms?
What is a common etiology associated with the diagnosis made for the 36-year-old woman's symptoms?
What complication could be expected in the 28-year-old woman after her cesarean section?
What complication could be expected in the 28-year-old woman after her cesarean section?
What is the most likely diagnosis for the woman experiencing heavy vaginal bleeding at 7 weeks of gestation?
What is the most likely diagnosis for the woman experiencing heavy vaginal bleeding at 7 weeks of gestation?
What is the most likely diagnosis for the 24-year-old woman presenting with severe abdominal pain and profuse vaginal bleeding?
What is the most likely diagnosis for the 24-year-old woman presenting with severe abdominal pain and profuse vaginal bleeding?
What medication was prescribed to the woman with heavy vaginal bleeding?
What medication was prescribed to the woman with heavy vaginal bleeding?
What was observed on the transvaginal sonography of the woman experiencing heavy bleeding?
What was observed on the transvaginal sonography of the woman experiencing heavy bleeding?
What is a significant diagnostic finding in the 24-year-old woman’s case indicating fetal distress?
What is a significant diagnostic finding in the 24-year-old woman’s case indicating fetal distress?
What major risk factor is associated with the 31-year-old woman who has a history of preterm birth?
What major risk factor is associated with the 31-year-old woman who has a history of preterm birth?
What vital sign noted upon the woman’s arrival at the emergency department indicated possible shock?
What vital sign noted upon the woman’s arrival at the emergency department indicated possible shock?
What is a common etiology for the bleeding observed in the multigravid nullipara woman?
What is a common etiology for the bleeding observed in the multigravid nullipara woman?
What management strategy should be considered for the 31-year-old woman with positive fetal fibronectin test and cervical changes?
What management strategy should be considered for the 31-year-old woman with positive fetal fibronectin test and cervical changes?
What is the likely reason for the absence of fetal cardiac activity in the first case described?
What is the likely reason for the absence of fetal cardiac activity in the first case described?
What is a typical sign of hypertension seen in the 23-year-old woman at the antenatal clinic?
What is a typical sign of hypertension seen in the 23-year-old woman at the antenatal clinic?
Which of the following complications is the 20-year-old woman likely experiencing due to her high blood pressure?
Which of the following complications is the 20-year-old woman likely experiencing due to her high blood pressure?
What does a urinalysis showing +2 protein suggest in the context of the 23-year-old woman's symptoms?
What does a urinalysis showing +2 protein suggest in the context of the 23-year-old woman's symptoms?
In the clinical context, what does 'multigravid multipara' indicate about the 31-year-old woman?
In the clinical context, what does 'multigravid multipara' indicate about the 31-year-old woman?
What fetal gestational age was estimated via sonography for the woman who was found seizing?
What fetal gestational age was estimated via sonography for the woman who was found seizing?
Which symptom is NOT associated with severe complications in pregnancy as seen in the 24-year-old woman’s case?
Which symptom is NOT associated with severe complications in pregnancy as seen in the 24-year-old woman’s case?
What condition is suggested by the presence of bilateral uterine adnexal tenderness and nodularity during a pelvic exam?
What condition is suggested by the presence of bilateral uterine adnexal tenderness and nodularity during a pelvic exam?
Which is a common risk factor associated with infertility in women?
Which is a common risk factor associated with infertility in women?
What might be an important step in the management of a patient diagnosed with endometriosis?
What might be an important step in the management of a patient diagnosed with endometriosis?
Which diagnostic evaluation would be most appropriate for a suspected ovarian mass?
Which diagnostic evaluation would be most appropriate for a suspected ovarian mass?
What symptom is commonly associated with cervical irritation or inflammation in women?
What symptom is commonly associated with cervical irritation or inflammation in women?
What is a potential consequence of untreated endometriosis?
What is a potential consequence of untreated endometriosis?
How might a family history impact a woman's risk for developing endometriosis?
How might a family history impact a woman's risk for developing endometriosis?
Which factor can contribute to the onset of mild discomfort during sexual intercourse?
Which factor can contribute to the onset of mild discomfort during sexual intercourse?
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Study Notes
Clinical Case Summaries
Case 16
- Likely diagnosis: Trichomoniasis, indicated by yellow, frothy, malodorous discharge, and vulvar itching.
- Etiology: Caused by the protozoan parasite Trichomonas vaginalis.
- Diagnostic evaluation: Examination reveals vaginal discharge with a pH of 6.5; 10% KOH test negative for amine odor.
- Management: Antibiotics (e.g., metronidazole) for treatment.
- Risk factors: Unprotected sexual activity, multiple partners.
Case 17
- Likely diagnosis: Bacterial vaginosis, suggested by fish-smelling discharge and presence of stippled epithelial cells.
- Etiology: Imbalance of vaginal flora, primarily due to a decrease in Lactobacilli.
- Diagnostic evaluation: Microscopic examination shows decreased Lactobacilli, few WBCs, and specific bacterial flora.
- Management: Metronidazole or clindamycin for treatment.
- Risk factors: Sexual activity, douching, lack of condom use.
Case 18
- Likely diagnosis: Postoperative infection, possibly endometritis, indicated by fever and foul-smelling lochia.
- Etiology: Bacterial infection following cesarean delivery.
- Diagnostic evaluation: Elevated WBC count (17,000 cells/µL) and clinical symptoms post-surgery.
- Management: Antibiotics and supportive care.
- Risk factors: Prolonged rupture of membranes, cesarean delivery.
Case 19
- Likely diagnosis: Pelvic inflammatory disease (PID), signaled by lower abdominal pain and mucopurulent discharge.
- Etiology: Result of untreated STIs, commonly Chlamydia or Gonorrhea.
- Diagnostic evaluation: Pelvic examination showing cervical motion tenderness.
- Management: Broad-spectrum antibiotics.
- Risk factors: Multiple sexual partners, inconsistent condom use.
Case 20
- Likely diagnosis: Polycystic ovary syndrome (PCOS), suggested by amenorrhea, hirsutism, and weight gain.
- Etiology: Hormonal imbalance affecting ovarian function.
- Diagnostic evaluation: Serum hormone levels, ultrasound for ovarian cysts.
- Management: Lifestyle changes, hormonal therapies.
- Risk factors: Family history, obesity.
Case 29
- Likely diagnosis: Complete miscarriage (spontaneous abortion), indicated by heavy vaginal bleeding and non-viable pregnancy on ultrasound.
- Etiology: Often due to chromosomal abnormalities.
- Diagnostic evaluation: Ultrasound shows no fetal cardiac activity and retained products.
- Management: Possible surgical intervention or medication to complete the miscarriage.
- Risk factors: Previous pregnancy losses, advanced maternal age.
Case 30
- Likely diagnosis: Severe preeclampsia or eclampsia, suggested by hypertension and seizures at 33 weeks of pregnancy.
- Etiology: Defective placentation leading to systemic vascular resistance.
- Diagnostic evaluation: Blood pressure monitoring, laboratory tests for kidney function.
- Management: Medications to control hypertension, magnesium sulfate for seizure prevention.
- Risk factors: Previous history of hypertension, obesity.
Case 31
- Likely diagnosis: Placental abruption, indicated by severe abdominal pain, vaginal bleeding, and marked hypotension.
- Etiology: Premature separation of placenta from the uterine wall.
- Diagnostic evaluation: Clinical evaluation and ultrasound may reveal retroplacental hematoma.
- Management: Emergency delivery may be necessary; assess maternal and fetal well-being.
- Risk factors: Trauma, hypertension, smoking.
Case 32
- Likely diagnosis: Preterm labor, indicated by contractions and cervix changes at 31 weeks.
- Etiology: Various factors; potential infection or cervical insufficiency.
- Diagnostic evaluation: Fetal fibronectin test positive, cervical examination reveals effacement.
- Management: Tocolytics to halt contractions, corticosteroids for fetal lung development.
- Risk factors: Previous preterm birth, cervical surgery history.
Case 33
- Likely diagnosis: Gestational hypertension or preeclampsia, indicated by high blood pressure and proteinuria at 35 weeks.
- Etiology: Unclear, but related to placental development.
- Diagnostic evaluation: Urinalysis showing protein, blood pressure monitoring.
- Management: Monitor closely, possibly induce labor if severe.
- Risk factors: First pregnancy, family history of preeclampsia.
Case 37
- Likely diagnosis: Endometriosis, suggested by lower abdominal bloating and infertility.
- Etiology: Presence of endometrial tissue outside the uterine cavity.
- Diagnostic evaluation: Pelvic examination reveals adnexal masses; ultrasound shows ovarian masses.
- Management: Pain management, hormonal therapy, or surgical options.
- Risk factors: Family history, menstrual disorders.
Case 38
- Likely diagnosis: Possible cervical pathology or polyp, inferred from intermenstrual spotting post-intercourse.
- Etiology: Various causes including hormonal imbalances or structural lesions.
- Diagnostic evaluation: Pap smear and possible biopsy needed, given history of unremarkable findings.
- Management: Monitor, treat any underlying conditions found in evaluation.
- Risk factors: History of cervical issues, lack of regular gynecological check-ups.
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