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Questions and Answers
Questions and Answers
Which historical finding presents the greatest risk factor for osteoporotic fracture?
Which historical finding presents the greatest risk factor for osteoporotic fracture?
- Tobacco use
- Tamoxifen therapy
- Levothyroxine therapy
- Body Mass Index
- Family history of fracture (correct)
A 20-year-old woman reports vaginal discharge and has white verrucous lesions on her vaginal wall and cervix. Her partner was recently treated for syphilis, and HPV testing is negative for high-risk types. What is the most likely diagnosis?
A 20-year-old woman reports vaginal discharge and has white verrucous lesions on her vaginal wall and cervix. Her partner was recently treated for syphilis, and HPV testing is negative for high-risk types. What is the most likely diagnosis?
- Condylomata acuminata (correct)
- Bacterial vaginosis
- Herpes simplex
- Secondary syphilis
- Cervical intraepithelial neoplasia (CIN) 2
Which of the following characteristics of the adnexal mass is most important in determining the next step in management?
Which of the following characteristics of the adnexal mass is most important in determining the next step in management?
- Consistency of the mass
- Laterality of the mass
- Size of the mass (correct)
- Mobility of the mass
What is the most appropriate initial step in managing the 25-year-old woman with pelvic pain and a cystic adnexal mass?
What is the most appropriate initial step in managing the 25-year-old woman with pelvic pain and a cystic adnexal mass?
In the 25-year-old patient's case, the use of condoms inconsistently puts her most at risk for which of the following conditions?
In the 25-year-old patient's case, the use of condoms inconsistently puts her most at risk for which of the following conditions?
A 25-year-old woman presents with right-sided pelvic pain. Which of the following historical details is LEAST relevant in initially evaluating her condition?
A 25-year-old woman presents with right-sided pelvic pain. Which of the following historical details is LEAST relevant in initially evaluating her condition?
The lesions observed on the patient's cervix are described as verrucous. What other feature on the cervix would be MOST concerning?
The lesions observed on the patient's cervix are described as verrucous. What other feature on the cervix would be MOST concerning?
Which of the following best describes the appearance of condylomata acuminata lesions?
Which of the following best describes the appearance of condylomata acuminata lesions?
In the sequence provided, what do the symbols primarily represent?
In the sequence provided, what do the symbols primarily represent?
What can be inferred from the use of multiple directional symbols in the content?
What can be inferred from the use of multiple directional symbols in the content?
Which of the following best describes the structure of the symbols used?
Which of the following best describes the structure of the symbols used?
What aspect is least likely represented by the symbols in the content?
What aspect is least likely represented by the symbols in the content?
What could be a potential interpretation of the horizontal dashes?
What could be a potential interpretation of the horizontal dashes?
What is the most likely explanation for the fetal heart rate pattern observed in a 22-year-old primigravid woman with ruptured membranes and contractions absent for 5 hours?
What is the most likely explanation for the fetal heart rate pattern observed in a 22-year-old primigravid woman with ruptured membranes and contractions absent for 5 hours?
Which condition is least likely to be associated with a stable fetal heart rate in this scenario where the woman has ruptured membranes for 5 hours?
Which condition is least likely to be associated with a stable fetal heart rate in this scenario where the woman has ruptured membranes for 5 hours?
What maternal condition could potentially lead to problems in fetal heart rate patterns aside from positioning?
What maternal condition could potentially lead to problems in fetal heart rate patterns aside from positioning?
If the fetal heart rate pattern is indicative of stress, which of the following conditions could be ruled out based on the information given?
If the fetal heart rate pattern is indicative of stress, which of the following conditions could be ruled out based on the information given?
In the absence of contractions over a significant duration, which condition may exert pressure on the umbilical cord, affecting fetal heart rate?
In the absence of contractions over a significant duration, which condition may exert pressure on the umbilical cord, affecting fetal heart rate?
What is the primary subject discussed in the content?
What is the primary subject discussed in the content?
Which element seems to have the least relevance in the overall context?
Which element seems to have the least relevance in the overall context?
What could the numeric references represent in the content?
What could the numeric references represent in the content?
If the symbols are representative of a process, which interpretation is least likely?
If the symbols are representative of a process, which interpretation is least likely?
What aspect of the content makes it complex for understanding?
What aspect of the content makes it complex for understanding?
Which of the following formats is used in the content?
Which of the following formats is used in the content?
What potential use might the content serve?
What potential use might the content serve?
If one were to categorize the content, which category would likely apply?
If one were to categorize the content, which category would likely apply?
A 42-year-old woman with a history of hypertension and previous Chlamydia infection seeks contraception advice. Considering her desire for a highly effective and easily remembered method, which of the following is the most appropriate recommendation?
A 42-year-old woman with a history of hypertension and previous Chlamydia infection seeks contraception advice. Considering her desire for a highly effective and easily remembered method, which of the following is the most appropriate recommendation?
Which of the following factors makes oral contraceptives a less ideal choice for the 42-year-old patient seeking contraception?
Which of the following factors makes oral contraceptives a less ideal choice for the 42-year-old patient seeking contraception?
What aspect of the patient's gynecological history is most important when considering the suitability of an IUD as a contraceptive method?
What aspect of the patient's gynecological history is most important when considering the suitability of an IUD as a contraceptive method?
A 27-year-old woman develops a fever of $38.2°C$ two days after a cesarean delivery. Which of the following is the most likely underlying diagnosis?
A 27-year-old woman develops a fever of $38.2°C$ two days after a cesarean delivery. Which of the following is the most likely underlying diagnosis?
Which of the following contraceptive methods provides no protection against sexually transmitted infections (STIs)?
Which of the following contraceptive methods provides no protection against sexually transmitted infections (STIs)?
What is the significance of knowing that the 42-year-old patient's last menstrual period was 3 days ago?
What is the significance of knowing that the 42-year-old patient's last menstrual period was 3 days ago?
Which aspect of the 42-year-old patient's medical history is most concerning when considering prescribing a combined hormonal contraceptive (CHC)?
Which aspect of the 42-year-old patient's medical history is most concerning when considering prescribing a combined hormonal contraceptive (CHC)?
In the case of a 27-year-old woman with postpartum fever after cesarean section, why is early diagnosis and treatment of endometritis critical?
In the case of a 27-year-old woman with postpartum fever after cesarean section, why is early diagnosis and treatment of endometritis critical?
What does the symbol '-' typically represent in mathematical notation?
What does the symbol '-' typically represent in mathematical notation?
Which of these symbols is most likely used for indicating a positive number?
Which of these symbols is most likely used for indicating a positive number?
If a problem includes the sequence '1, 2, 3, 4', what is the next logical number?
If a problem includes the sequence '1, 2, 3, 4', what is the next logical number?
In a mathematical context, which symbol might indicate that a number is approaching another number?
In a mathematical context, which symbol might indicate that a number is approaching another number?
What could represent a significant decrement in a numerical sequence?
What could represent a significant decrement in a numerical sequence?
Which symbol typically denotes multiplication in mathematical equations?
Which symbol typically denotes multiplication in mathematical equations?
Which of the following is not a common mathematical operator?
Which of the following is not a common mathematical operator?
What is the primary purpose of symbols in mathematics?
What is the primary purpose of symbols in mathematics?
Questions and Answers
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Flashcards
Flashcards
Risk factor for osteoporotic fracture
Risk factor for osteoporotic fracture
The greatest historical finding indicating increased risk of fractures.
Atypical squamous cells
Atypical squamous cells
Abnormal cells noted in a Pap smear indicating potential issues.
Human papillomavirus testing (HPV)
Human papillomavirus testing (HPV)
Test used to check for high-risk HPV types associated with cervical cancer.
Condylomata acuminata
Condylomata acuminata
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Cystic adnexal mass
Cystic adnexal mass
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Sexual health history
Sexual health history
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Vaginal discharge
Vaginal discharge
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Pelvic examination
Pelvic examination
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Gravida
Gravida
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Para
Para
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Chlamydia trachomatis
Chlamydia trachomatis
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Low-grade squamous intraepithelial lesion (LSIL)
Low-grade squamous intraepithelial lesion (LSIL)
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Depot medroxyprogesterone
Depot medroxyprogesterone
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IUD
IUD
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Effective contraception
Effective contraception
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Cesarean delivery
Cesarean delivery
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Ruptured membranes
Ruptured membranes
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Primigravid
Primigravid
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Cervical effacement
Cervical effacement
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Occipitoposterior position
Occipitoposterior position
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Fetal heart rate pattern
Fetal heart rate pattern
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Flashcards
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Study Notes
Study Notes
Case Studies - Obstetrics & Gynecology
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Case 1: A 39-year-old woman at 37 weeks' gestation presents to the ER with left-sided chest pain exacerbated by breathing. Her vital signs include: T 38.2°C (100.8°F), pulse 120/min, respirations 24/min, and blood pressure 110/70 mmHg. Fetal heart tones are 170/min. Chest X-ray and ECG are normal. Arterial blood gas analysis on room air shows pH 7.43, PCO2 35 mmHg, and PO2 70 mmHg. Costochondritis is the most likely diagnosis.
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Case 2: A 52-year-old woman with history of breast cancer (stage I, in remission) and hypothyroidism being treated with levothyroxine presents for a routine checkup. Her BMI is 19 kg/m². Family history of a femoral fracture in her mother at the age of 55 is noted. She has smoked 2 cigarettes per week for 25 years. Family history of fracture is the greatest risk factor for osteoporotic fracture in this patient.
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Case 3: A 20-year-old sexually active woman with a one-week history of vaginal discharge presents to the physician. Physical exam is normal. Pelvic exam shows white verrucous lesions on the upper vaginal wall and cervix. Pap smear is reported as atypical squamous cells, and HPV testing is negative for high-risk types. The most likely diagnosis is Condylomata acuminata (genital warts).
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Case 4: A 25-year-old woman with a 4-week history of right-sided pelvic pain. Pelvic exam shows a 12-cm, cystic, mobile, right adnexal mass. Serum CA 125 is 35 U/mL (normal <35) and serum β-hCG is negative. Abdominal X-ray shows calcium deposits in the mass. The most likely diagnosis is Cystic teratoma (dermoid cyst).
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Case 5: A 25-year-old woman, gravida 1, para 1, five weeks postpartum, presents with insomnia, restlessness, extreme fatigue, irritability, and depression. She is not eating well and finds the baby's crying annoying, and is afraid she may hurt her child. Psychiatric evaluation is the most appropriate initial step.
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Case 6: A 36-year-old woman with a one-year history of infertility, complicated by postpartum hemorrhage and endometritis, presenting with normal findings on examination and husband's semen analysis. The most likely cause is Tubal occlusion.
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Case 7: A 32-year-old woman at 27 weeks' gestation presents with 3-hour history of painful contractions every 5 minutes. Vital signs and pelvic exam reveal signs consistent with premature rupture of membranes (PROM).
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Case 8: A 22-year-old woman at 38 weeks' gestation has uncomplicated pregnancy. Her physical exam shows no abnormalities, and her estimated fetal weight is 3629 g. The cervix is 4 cm dilated and 100% effaced, and the vertex is at -1 station. The most likely cause is Normal labor.
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Case 9: A 15-year-old girl presents with a 3-day history of fever, abdominal pain, nausea, and thick white vaginal discharge. Recent sexual activity is noted. Pelvic exam reveals lower abdominal tenderness and adnexal tenderness with a 3-cm mass. A Gram stain of vaginal discharge shows gram-negative diplococci. The most likely explanation for susceptibility is Immature immune system.
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Case 10: A 5-year-old girl presents with a 2-day history of foul-smelling, yellow vaginal discharge and vaginal spotting. Pelvic exam shows mild vulvar erythema and a purulent discharge at the vaginal opening. The most likely cause is Vaginal foreign body.
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Case 11: A 27-year-old woman, gravida 1, para 1, two days postpartum, presents with pain and tenderness in her left thigh. There is pain with dorsiflexion of left foot. The most appropriate next step to confirm diagnosis is Duplex venous ultrasonography.
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Case 12: A 21-year-old primigravida at 8 weeks' gestation is concerned about the risk of sickle cell disease transmission to her fetus, and her husband's hemoglobin electrophoresis shows (HbA = 42%, HbA2 = 3%, HbF = 2%, HbS = 53%). The likelihood that the fetus will have sickle cell disease is 50%.
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Case 13: A 37-year-old primigravida at 35 weeks' gestation has gestational hypertension that is well controlled with labetalol. Serum studies show urea nitrogen 8 mg/dL and creatinine 1 mg/dL. Urine shows 800 mg of protein. The most likely cause of the ultrasound findings is Placental insufficiency.
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Case 14: A 57-year-old woman complains of urine loss for 2 weeks, and wears pads constantly and frequently. She received radiation therapy for cervical cancer three years ago. Pelvic exam shows thin, atrophic vaginal mucosa, with a pool of fluid in the vaginal canal. Postvoid residual volume is less than 10 mL. The most likely diagnosis is Vesicovaginal fistula.
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Case 15: A 57-year-old woman with a 6-month history of immediate loss of urine when she coughs or exercises, and never received estrogen therapy. She now has immediate loss of urine with coughing or exercise. Pelvic exam shows downward mobility of the urethral vesical junction. The most likely diagnosis is Stress incontinence.
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Case 16: A 15-year-old girl with a 1-week history of constant abdominal pain, 10 episodes of cramps (3 to 5 days), and no menstrual periods, presenting with a 3cm mass in suprapubic region, and bluish vaginal tissue obscuring the upper vagina. Transvaginal incision and drainage is the most appropriate next step in management.
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Case 17: A 27-year-old woman with a 1-month history of postcoital spotting lasting one to two days. She has bilateral tubal ligation, and is sexually active with a new partner. The most likely diagnosis is Exercise-related menstrual irregularity.
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Case 18: A 32-year-old woman with increasingly irregular menses (45 to 60 days intervals), and a BMI of 39 kg/m². She has velvety pigmented skin. The most likely serum hormone concentration to be increased is Follicle-stimulating hormone.
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Case 19: A 27-year-old woman with a 3-day history of increasing abdominal pain and a one-day history of fever. Five days prior, she underwent a pregnancy termination and received prophylactic antibiotics. The most likely explanation for the patient's increased risk is a Septic abortion.
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Case 20: A 19-year-old woman with moderate lower abdominal pain and vaginal spotting two weeks after her last menstrual period. She had a first trimester abortion 8 months prior. Physical exam shows blood-tinged discharge at the os, and cervical motion tenderness. The most likely cause is Retained products of conception.
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Case 21: A 17-year-old primigravid with decreased fetal movement present for 2 days. Physical exam shows a uterus consistent in size with a 32-week gestation Ultrasonography shows a biparietal diameter consistent with a 31-week gestation. Most likely cause of these findings is Placental insufficiency.
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Case 22: A 34-year-old woman, gravida 4, para 3, at 40 weeks' gestation admitted because of a blood pressure of 160/95 mmHg. The most likely explanation for the fetal heart tracing is Uteroplacental insufficiency.
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Case 23: A 22-year-old woman with vaginal burning and discharge for 2 weeks. She has been sexually active and consistently uses condoms. Microscopic exam shows squamous epithelial cells coated with bacteria and a pH of 5. The most appropriate pharmacotherapy is Vaginal metronidazole gel.
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Case 24: A 23-year-old primigravida at 33 weeks' gestation who has not felt fetal movement for two days. The patient has a history of infertility complications. Uteroplacental artery thrombosis is the most likely cause of the fetal demise.
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Case 25: An 18-year-old woman delivered a newborn 2 days after developing chickenpox. The most appropriate care for the newborn is Varicella-zoster immune globulin therapy.
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Case 26: A 37-year-old woman with heavy but regular menses, with labor-like pains and vaginal bleeding. The most likely diagnosis is Incomplete abortion.
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Case 27: A 27-year-old primigravida at 7 weeks' gestation for her first prenatal visit. The most appropriate next step in diagnosis is Measurement of serum vitamin B12 (cobalamin) concentration.
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Case 28: A 42-year-old woman at 20 weeks' gestation reports a positive factor V Leiden mutation, and a history of repeated pregnancies and cesareans sections. Smoking is the greatest predisposing factor in this case.
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Case 29: A 36-year-old woman at 41 weeks' gestation presents with ruptured membranes without contractions for 8 hours. The most likely explanation for the fetal heart rate pattern is Postdates pregnancy.
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Case 30: A 42-year-old woman with a 3-month history of urinary urgency, frequency, and occasional incontinence. Her most likely cause is Overflow incontinence secondary to bladder outlet obstruction.
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Case 31: A 32-year-old primigravida at term with a 5 cm dilated cervix that has remained dilated for 4 hours despite oxytocin administration, now presenting with contractions every 3 minutes. The most likely diagnosis is Normal second stage.
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Case 32: A 32-year-old woman with bright red vaginal bleeding for 1 hour. Contractions have been occurring at two to three minutes intervals for 5 hours. The most appropriate course of action is to Obtain approval from the hospital administrator to perform emergency cesarean delivery.
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Case 33: A 25-year-old woman in labor at 39 weeks' gestation. The cervix is 6 cm dilated and 100% effaced. The most appropriate next step in management is Cesarean delivery.
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Case 34: A 52-year-old nulligravid woman with a history of smoking. The most appropriate additional test is Bone densitometry.
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Case 35: A 42-year-old woman presents with a 1-year history of vaginal bleeding every 2 weeks, with varying flow and clotting. The most appropriate next step in management is Hysterectomy.
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Case 36: A 30-year-old woman at 10 weeks' gestation presents with fever, minimal vaginal bleeding, and severe pelvic pain. Her most likely diagnosis is Septic abortion.
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Case 37: A 32-year-old woman at 10 weeks' gestation presents with a history of seizures and phenytoin therapy. The serum phenytoin level is 5 ug/mL. The most appropriate next step is to continue phenytoin at the current dose.
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Case 38: A 27-year-old woman at 30 weeks' gestation presents with pain, numbness, and weakness. The most likely diagnosis is Thoracic outlet syndrome.
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Case 39: A 14-year-old girl with painful menstrual cramping. The most likely cause is Prostaglandin production.
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Case 40: A 32-year-old woman at 34 weeks' gestation with complications of blurred vision and weight gain. The most likely obstetric complication is Preeclampsia.
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Case 41: A 52-year-old postmenopausal woman with no smoking or alcohol history. The most significant cancer risk factor is Endometrial.
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Case 42: A 27-year-old primigravida at 37 weeks' gestation presenting with fetal heart bradycardia, contractions. The most likely diagnosis is Ruptured uterus.
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Case 43: A 24-year-old woman who delivered three months ago, complaining of painful intercourse. The most appropriate next step in management is Recommendation for use of a lubricant.
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Case 44: A 21-year-old primigravida at 41 weeks with variable decelerations and meconium-stained fluid. The most appropriate next step in management is Amniocentesis.
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Case 45: A 28-year-old nulligravid woman present with sever dysmenorrheal and dyspareunia. The most likely diagnosis is Endometriosis.
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Case 46: A 27-year-old women with a right-sided lower abdominal pain. Pelvic exam, and culdocentesis indicated a likely diagnosis of Ruptured corpus luteum cyst.
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Case 47: A 37-year-old woman withbloody nipple discharge from left breast for 5 weeks. The most likely diagnosis is Intraductal papilloma
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Case 48: A 22-year-old gravida at 39 weeks who had ruptured membranes for five hours, without contractions. The most likely cause of this pattern is Post-term pregnancy.
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Case 49: A 42-year-old woman requesting advice regarding contraception. The most appropriate recommendation is Depot medroxyprogesterone.
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Case 50: A 27-year-old woman who presented two days post-cesarean delivery with fever and complaints. The most likely diagnosis is Endometritis.
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