Gyneco(201-250)

A Primigravida with Hypertension. A 35-year-old pregnant woman (gravida 2, para 1) comes into the office for her 18-week prenatal appointment. Her blood pressure is 140/94 mmHg when taken by your nurse and is confirmed by your own measurement. She has no protein in her urine and has no headaches, blurred vision, nausea, or vomiting. The rest of the examination is consistent with dates; there is no lower extremity edema.Which one of the following intrapartum conditions is associated with preeclampsia/eclampsia?

A Primigravida with Hypertension. A 35-year-old pregnant woman (gravida 2, para 1) comes into the office for her 18-week prenatal appointment. Her blood pressure is 140/94 mmHg when taken by your nurse and is confirmed by your own measurement. She has no protein in her urine and has no headaches, blurred vision, nausea, or vomiting. The rest of the examination is consistent with dates; there is no lower extremity edema.Which of the following are risks for recurrence of preeclampsia?

A Primigravida with Hypertension. A 35-year-old pregnant woman (gravida 2, para 1) comes into the office for her 18-week prenatal appointment. Her blood pressure is 140/94 mmHg when taken by your nurse and is confirmed by your own measurement. She has no protein in her urine and has no headaches, blurred vision, nausea, or vomiting. The rest of the examination is consistent with dates; there is no lower extremity edema.The patient delivers vaginally. The following are considered steps to use in the active management of the third stage of labor except

A Primigravida with Hypertension. A 35-year-old pregnant woman (gravida 2, para 1) comes into the office for her 18-week prenatal appointment. Her blood pressure is 140/94 mmHg when taken by your nurse and is confirmed by your own measurement. She has no protein in her urine and has no headaches, blurred vision, nausea, or vomiting. The rest of the examination is consistent with dates; there is no lower extremity edema.Risk factors for postpartum hemorrhage include

MB is a 24-year-old (gravida 1, para 0) female who is 30 weeks pregnant. Her last menstrual period is certain. She presented for care at 9 weeks of gestation and has kept her monthly follow-up appointments. Her initial body mass index was 21, and she has gained 3kg during the past 8 weeks. Fundal height has been consistent with dates, but today the fundal measurement is 25 cm. She smokes one and a half packs of cigarettes a day and is unable to cut down. She denies alcohol or other substance use. She denies any recent infections. An ultrasound at 16 weeks was consistent with her last menstrual period and showed normal fetal anatomy. A repeat ultrasound shows estimated fetal weight consistent with a 25-week gestation (fetal weight below the 10th percentile for 30-week gestation). The amniotic fluid index is normal.Which of the following statements regarding intrauterine growth restriction (IUGR) is true?

MB is a 24-year-old (gravida 1, para 0) female who is 30 weeks pregnant. Her last menstrual period is certain. She presented for care at 9 weeks of gestation and has kept her monthly follow-up appointments. Her initial body mass index was 21, and she has gained 3kg during the past 8 weeks. Fundal height has been consistent with dates, but today the fundal measurement is 25 cm. She smokes one and a half packs of cigarettes a day and is unable to cut down. She denies alcohol or other substance use. She denies any recent infections. An ultrasound at 16 weeks was consistent with her last menstrual period and showed normal fetal anatomy. A repeat ultrasound shows estimated fetal weight consistent with a 25-week gestation (fetal weight below the 10th percentile for 30-week gestation). The amniotic fluid index is normal.What is the leading cause of fetal growth restriction in human pregnancies?

A 24-year-old (gravida 1, para 0) female who is 30 weeks pregnant. Her last menstrual period is certain. She presented for care at 9 weeks of gestation and has kept her monthly follow-up appointments. Her initial body mass index was 21, and she has gained 3kg during the past 8 weeks. Fundal height has been consistent with dates, but today the fundal measurement is 25 cm. She smokes one and a half packs of cigarettes a day and is unable to cut down. She denies alcohol or other substance use. She denies any recent infections. An ultrasound at 16 weeks was consistent with her last menstrual period and showed normal fetal anatomy. A repeat ultrasound shows estimated fetal weight consistent with a 25-week gestation (fetal weight below the 10th percentile for 30-week gestation). The amniotic fluid index is normal.All of the following types of maternal substance use are linked with IUGR except

A 35-year-old (gravida 1, para 0) female visits your office at 40 weeks of gestation. Her last menstrual period (LMP) is “certain.” Her history is significant for regular menstrual cycles and no oral contraceptive use within 3 months of becoming pregnant. A 13-week ultrasound was consistent with her LMP. The pregnancy has been unremarkable. The patient is quite concerned because today is her due date and she is not in labor. She states that her mother did not “go into labor until after 44 weeks” and she is worried that “late babies run in the family.” On physical examination, fundal height is 39 cm. Her weight has increased by 1 pound and vital signs are stable. Fetal heart tones are 140. The cervix is closed, thick, and high. Estimated fetal weight is 3.5kg. Which of the following gestational ages is considered post-term?

A 35-year-old (gravida 1, para 0) female visits your office at 40 weeks of gestation. Her last menstrual period (LMP) is “certain.” Her history is significant for regular menstrual cycles and no oral contraceptive use within 3 months of becoming pregnant. A 13-week ultrasound was consistent with her LMP. The pregnancy has been unremarkable. The patient is quite concerned because today is her due date and she is not in labor. She states that her mother did not “go into labor until after 44 weeks” and she is worried that “late babies run in the family.” On physical examination, fundal height is 39 cm. Her weight has increased by 1 pound and vital signs are stable. Fetal heart tones are 140. The cervix is closed, thick, and high. Estimated fetal weight is 3.5kg.Which of the following conditions is not associated with increased risk of post-term pregnancy?

A 35-year-old (gravida 1, para 0) female visits your office at 40 weeks of gestation. Her last menstrual period (LMP) is “certain.” Her history is significant for regular menstrual cycles and no oral contraceptive use within 3 months of becoming pregnant. A 13-week ultrasound was consistent with her LMP. The pregnancy has been unremarkable. The patient is quite concerned because today is her due date and she is not in labor. She states that her mother did not “go into labor until after 44 weeks” and she is worried that “late babies run in the family.” On physical examination, fundal height is 39 cm. Her weight has increased by 1 pound and vital signs are stable. Fetal heart tones are 140. The cervix is closed, thick, and high. Estimated fetal weight is 3.5kg.What is the most common cause of post-term pregnancy?

A 35-year-old (gravida 1, para 0) female visits your office at 40 weeks of gestation. Her last menstrual period (LMP) is “certain.” Her history is significant for regular menstrual cycles and no oral contraceptive use within 3 months of becoming pregnant. A 13-week ultrasound was consistent with her LMP. The pregnancy has been unremarkable. The patient is quite concerned because today is her due date and she is not in labor. She states that her mother did not “go into labor until after 44 weeks” and she is worried that “late babies run in the family.” On physical examination, fundal height is 39 cm. Her weight has increased by 1 pound and vital signs are stable. Fetal heart tones are 140. The cervix is closed, thick, and high. Estimated fetal weight is 3.5kg.The patient progresses to 41 weeks. She now wants to be managed expectantly because she heard that the risk of cesarean is higher if she is induced. Which of the following statements about labor induction at 41 weeks is not true?

A 35-year-old (gravida 1, para 0) female visits your office at 40 weeks of gestation. Her last menstrual period (LMP) is “certain.” Her history is significant for regular menstrual cycles and no oral contraceptive use within 3 months of becoming pregnant. A 13-week ultrasound was consistent with her LMP. The pregnancy has been unremarkable. The patient is quite concerned because today is her due date and she is not in labor. She states that her mother did not “go into labor until after 44 weeks” and she is worried that “late babies run in the family.” On physical examination, fundal height is 39 cm. Her weight has increased by 1 pound and vital signs are stable. Fetal heart tones are 140. The cervix is closed, thick, and high. Estimated fetal weight is 3.5kg.The patient agrees to proceed with labor induction. Her cervical exam at this time is as follows: 2-cm dilation, 60% effacement, −2 station, firm consistency, and posterior. Which of the following statements is correct?

A 35-year-old (gravida 1, para 0) female visits your office at 40 weeks of gestation. Her last menstrual period (LMP) is “certain.” Her history is significant for regular menstrual cycles and no oral contraceptive use within 3 months of becoming pregnant. A 13-week ultrasound was consistent with her LMP. The pregnancy has been unremarkable. The patient is quite concerned because today is her due date and she is not in labor. She states that her mother did not “go into labor until after 44 weeks” and she is worried that “late babies run in the family.” On physical examination, fundal height is 39 cm. Her weight has increased by 1 pound and vital signs are stable. Fetal heart tones are 140. The cervix is closed, thick, and high. Estimated fetal weight is 3.5kg.Which of the following statements about the use of prostaglandin for cervical ripening is incorrect?

An 18-year-old (gravida 1) female at 39 weeks and 5 days gestation. The pregnancy has been uneventful. She arrives on the floor with her mother, boyfriend, and two friends. Her presenting complaint is contractions for 3 hours. The contractions are 5 minutes apart and irregular. She denies bleeding, fluid leakage, or decreased fetal movement. On physical examination, her cervix is dilated to 3 cm and is 20% effaced, firm, and posterior. A non-stress test is reassuring. She is monitored for 2 hours and has no significant cervical change. 59. Women admitted to labor and delivery in this patient’s stage of labor are at increased risk for all of the following except

An 18-year-old (gravida 1) female at 39 weeks and 5 days gestation. The pregnancy has been uneventful. She arrives on the floor with her mother, boyfriend, and two friends. Her presenting complaint is contractions for 3 hours. The contractions are 5 minutes apart and irregular. She denies bleeding, fluid leakage, or decreased fetal movement. On physical examination, her cervix is dilated to 3 cm and is 20% effaced, firm, and posterior. A non-stress test is reassuring. She is monitored for 2 hours and has no significant cervical change.What is the working diagnosis at this time?

An 18-year-old (gravida 1) female at 39 weeks and 5 days gestation. The pregnancy has been uneventful. She arrives on the floor with her mother, boyfriend, and two friends. Her presenting complaint is contractions for 3 hours. The contractions are 5 minutes apart and irregular. She denies bleeding, fluid leakage, or decreased fetal movement. On physical examination, her cervix is dilated to 3 cm and is 20% effaced, firm, and posterior. A non-stress test is reassuring. She is monitored for 2 hours and has no significant cervical change.Which of the following outcomes is not associated with continuity of care during pregnancy?

The patient is sent home. She returns 2 days later with continued contractions that are now 3 minutes apart and regular. On sterile vaginal exam, her cervix is 4 cm dilated, 50% effaced, −2 position, mid-station, and soft. The patient is admitted to labor and delivery. Her mother and boyfriend are quite excited and want to know exactly when the baby will deliver. The patient wants to talk about whether an epidural is a good idea. Her mother wants to know when her daughter will receive an enema and “be shaved.” She also warns the patient that an episiotomy is required for the baby to deliver safely. What is the expected rate of cervical dilatation during active labor in nulliparous women?

The patient is sent home. She returns 2 days later with continued contractions that are now 3 minutes apart and regular. On sterile vaginal exam, her cervix is 4 cm dilated, 50% effaced, −2 position, mid-station, and soft. The patient is admitted to labor and delivery. Her mother and boyfriend are quite excited and want to know exactly when the baby will deliver. The patient wants to talk about whether an epidural is a good idea. Her mother wants to know when her daughter will receive an enema and “be shaved.” She also warns the patient that an episiotomy is required for the baby to deliver safely.Which statement regarding active management of labor is false?

The patient is sent home. She returns 2 days later with continued contractions that are now 3 minutes apart and regular. On sterile vaginal exam, her cervix is 4 cm dilated, 50% effaced, −2 position, mid-station, and soft. The patient is admitted to labor and delivery. Her mother and boyfriend are quite excited and want to know exactly when the baby will deliver. The patient wants to talk about whether an epidural is a good idea. Her mother wants to know when her daughter will receive an enema and “be shaved.” She also warns the patient that an episiotomy is required for the baby to deliver safely.Which of these types of general care during labor is supported by evidence-based studies?

The patient is sent home. She returns 2 days later with continued contractions that are now 3 minutes apart and regular. On sterile vaginal exam, her cervix is 4 cm dilated, 50% effaced, −2 position, mid-station, and soft. The patient is admitted to labor and delivery. Her mother and boyfriend are quite excited and want to know exactly when the baby will deliver. The patient wants to talk about whether an epidural is a good idea. Her mother wants to know when her daughter will receive an enema and “be shaved.” She also warns the patient that an episiotomy is required for the baby to deliver safely.Which of the following statements regarding amniotomy is true?

The patient is sent home. She returns 2 days later with continued contractions that are now 3 minutes apart and regular. On sterile vaginal exam, her cervix is 4 cm dilated, 50% effaced, −2 position, mid-station, and soft. The patient is admitted to labor and delivery. Her mother and boyfriend are quite excited and want to know exactly when the baby will deliver. The patient wants to talk about whether an epidural is a good idea. Her mother wants to know when her daughter will receive an enema and “be shaved.” She also warns the patient that an episiotomy is required for the baby to deliver safely.How should expectant women be counseled regarding episiotomy?

The patient is sent home. She returns 2 days later with continued contractions that are now 3 minutes apart and regular. On sterile vaginal exam, her cervix is 4 cm dilated, 50% effaced, −2 position, mid-station, and soft. The patient is admitted to labor and delivery. Her mother and boyfriend are quite excited and want to know exactly when the baby will deliver. The patient wants to talk about whether an epidural is a good idea. Her mother wants to know when her daughter will receive an enema and “be shaved.” She also warns the patient that an episiotomy is required for the baby to deliver safely.Which of the following is not included in active management of the third stage of labor?

A 27-year-old female (gravida 2, para 1) at 39 weeks of gestation presents to labor and delivery in active labor. Her pregnancy has been uncomplicated and her prior two deliveries were vaginal. Her cervix is checked by the nurse and judged to be 6 cm, 90% effaced, midposition, and soft. The fetus is not engaged and is thought to be vertex. Initial fetal monitoring shows a heart rate in the 140s with good accelerations and is reassuring. Contractions are 4 minutes apart and the patient is comfortable. Twenty minutes later, the patient experiences a large gush of clear fluid, and severe variable decelerations appear on the fetal heart rate monitor. What is the most likely diagnosis at this time?

A 27-year-old female (gravida 2, para 1) at 39 weeks of gestation presents to labor and delivery in active labor. Her pregnancy has been uncomplicated and her prior two deliveries were vaginal. Her cervix is checked by the nurse and judged to be 6 cm, 90% effaced, midposition, and soft. The fetus is not engaged and is thought to be vertex. Initial fetal monitoring shows a heart rate in the 140s with good accelerations and is reassuring. Contractions are 4 minutes apart and the patient is comfortable. Twenty minutes later, the patient experiences a large gush of clear fluid, and severe variable decelerations appear on the fetal heart rate monitor.Which of the following conditions is not considered a risk factor for cord prolapse?

A 27-year-old female (gravida 2, para 1) at 39 weeks of gestation presents to labor and delivery in active labor. Her pregnancy has been uncomplicated and her prior two deliveries were vaginal. Her cervix is checked by the nurse and judged to be 6 cm, 90% effaced, midposition, and soft. The fetus is not engaged and is thought to be vertex. Initial fetal monitoring shows a heart rate in the 140s with good accelerations and is reassuring. Contractions are 4 minutes apart and the patient is comfortable. Twenty minutes later, the patient experiences a large gush of clear fluid, and severe variable decelerations appear on the fetal heart rate monitor.Which of the following statements about cord prolapse diagnosis is false?

A 27-year-old female (gravida 2, para 1) at 39 weeks of gestation presents to labor and delivery in active labor. Her pregnancy has been uncomplicated and her prior two deliveries were vaginal. Her cervix is checked by the nurse and judged to be 6 cm, 90% effaced, midposition, and soft. The fetus is not engaged and is thought to be vertex. Initial fetal monitoring shows a heart rate in the 140s with good accelerations and is reassuring. Contractions are 4 minutes apart and the patient is comfortable. Twenty minutes later, the patient experiences a large gush of clear fluid, and severe variable decelerations appear on the fetal heart rate monitor.What is the recommended immediate management of this patient?

No Prenatal Care and Bleeding A 23-year-old female (gravida 6, para 3114) presents to labor and delivery with severe abdominal pain. She has no prenatal care, and she thinks her last menstrual period was approximately 9 months ago. She denies a history of medical problems or surgery. All previous deliveries were vaginal. She smokes one and a half packs of cigarettes a day and admits to remote “crank” use. Fundal height measures 39 cm, and there is copious bleeding from the vagina. The fetal monitor shows contractions every minute with elevated baseline uterine tone. Fetal tachycardia at 180 beats/minute, and late decelerations are also present.What is the most likely diagnosis?

No Prenatal Care and Bleeding. A 23-year-old female (gravida 6, para 3114) presents to labor and delivery with severe abdominal pain. She has no prenatal care, and she thinks her last menstrual period was approximately 9 months ago. She denies a history of medical problems or surgery. All previous deliveries were vaginal. She smokes one and a half packs of cigarettes a day and admits to remote “crank” use. Fundal height measures 39 cm, and there is copious bleeding from the vagina. The fetal monitor shows contractions every minute with elevated baseline uterine tone. Fetal tachycardia at 180 beats/minute, and late decelerations are also present.Maternal risks associated with this diagnosis include all of the following except

No Prenatal Care and Bleeding. A 23-year-old female (gravida 6, para 3114) presents to labor and delivery with severe abdominal pain. She has no prenatal care, and she thinks her last menstrual period was approximately 9 months ago. She denies a history of medical problems or surgery. All previous deliveries were vaginal. She smokes one and a half packs of cigarettes a day and admits to remote “crank” use. Fundal height measures 39 cm, and there is copious bleeding from the vagina. The fetal monitor shows contractions every minute with elevated baseline uterine tone. Fetal tachycardia at 180 beats/minute, and late decelerations are also present.Which gestational age has the highest incidence of placental abruption?

No Prenatal Care and Bleeding. A 23-year-old female (gravida 6, para 3114) presents to labor and delivery with severe abdominal pain. She has no prenatal care, and she thinks her last menstrual period was approximately 9 months ago. She denies a history of medical problems or surgery. All previous deliveries were vaginal. She smokes one and a half packs of cigarettes a day and admits to remote “crank” use. Fundal height measures 39 cm, and there is copious bleeding from the vagina. The fetal monitor shows contractions every minute with elevated baseline uterine tone. Fetal tachycardia at 180 beats/minute, and late decelerations are also present.Which of the following conditions is not strongly associated with placental abruption?

A 37-year-old female (gravida 2, para 1001) at 39 weeks of gestation progresses to complete and pushing. Her pregnancy has been complicated by type 2 diabetes, for which she takes metformin. She has gained 45 pounds during the pregnancy, despite both nutritional consultation and repeated counseling. She is 5 feet 2 inches tall and has a prepregnancy body mass index of 34. Descent of the fetal head is slower than anticipated with “positive turtle sign” during contractions. The head is delivered after 2 hours of pushing. The anterior shoulder is difficult to deliver without increased traction. Sixty seconds pass without successful delivery.What is the most important action to take at this time?

A 37-year-old female (gravida 2, para 1001) at 39 weeks of gestation progresses to complete and pushing. Her pregnancy has been complicated by type 2 diabetes, for which she takes metformin. She has gained 45 pounds during the pregnancy, despite both nutritional consultation and repeated counseling. She is 5 feet 2 inches tall and has a prepregnancy body mass index of 34. Descent of the fetal head is slower than anticipated with “positive turtle sign” during contractions. The head is delivered after 2 hours of pushing. The anterior shoulder is difficult to deliver without increased traction. Sixty seconds pass without successful delivery.Which of the following statements about shoulder dystocia is true?

A 37-year-old female (gravida 2, para 1001) at 39 weeks of gestation progresses to complete and pushing. Her pregnancy has been complicated by type 2 diabetes, for which she takes metformin. She has gained 45 pounds during the pregnancy, despite both nutritional consultation and repeated counseling. She is 5 feet 2 inches tall and has a prepregnancy body mass index of 34. Descent of the fetal head is slower than anticipated with “positive turtle sign” during contractions. The head is delivered after 2 hours of pushing. The anterior shoulder is difficult to deliver without increased traction. Sixty seconds pass without successful delivery.Which of the following statements regarding macrosomia and shoulder dystocia is true?

Hypotension and Bleeding after Delivery. The patient in Clinical Case Problem 3 delivers atraumatically using a combination of McRoberts’ maneuver, suprapubic pressure, and an episiotomy. Profuse vaginal bleeding is noted both prior to and following delivery of the placenta. The patient becomes lightheaded and tachycardic. Blood pressure drops to 60/40 mmHg.Which of the following is the least likely cause of this problem?

Hypotension and Bleeding after Delivery. The patient in Clinical Case Problem 3 delivers atraumatically using a combination of McRoberts’ maneuver, suprapubic pressure, and an episiotomy. Profuse vaginal bleeding is noted both prior to and following delivery of the placenta. The patient becomes lightheaded and tachycardic. Blood pressure drops to 60/40 mmHg.Which of the following steps is not included in active management of the third stage of labor?

A 61-year-old postmenopausal female comes to your office for a routine health exam. She has a history of osteoarthritis, and she smokes one pack of cigarettes per day. She fractured her left wrist at age 50 years after falling down some stairs. Her mother has osteoporosis and fractured her hip after a fall. Her diet is low in calcium-rich foods, and she is not currently taking a calcium supplement. She is on no medications. Her blood pressure is 120/80 mmHg, her height is 160cm, and she weighs 52kg. The rest of her physical exam is normal.Which of the following is not an established major risk factor for osteoporosis?

A 61-year-old postmenopausal female comes to your office for a routine health exam. She has a history of osteoarthritis, and she smokes one pack of cigarettes per day. She fractured her left wrist at age 50 years after falling down some stairs. Her mother has osteoporosis and fractured her hip after a fall. Her diet is low in calcium-rich foods, and she is not currently taking a calcium supplement. She is on no medications. Her blood pressure is 120/80 mmHg, her height is 160cm, and she weighs 52kg. The rest of her physical exam is normal.Which of the following is not an associated risk factor for osteoporosis?

A 61-year-old postmenopausal female comes to your office for a routine health exam. She has a history of osteoarthritis, and she smokes one pack of cigarettes per day. She fractured her left wrist at age 50 years after falling down some stairs. Her mother has osteoporosis and fractured her hip after a fall. Her diet is low in calcium-rich foods, and she is not currently taking a calcium supplement. She is on no medications. Her blood pressure is 120/80 mmHg, her height is 160cm, and she weighs 52kg. The rest of her physical exam is normal.What is the most common presenting fracture in osteoporosis?

A 61-year-old postmenopausal female comes to your office for a routine health exam. She has a history of osteoarthritis, and she smokes one pack of cigarettes per day. She fractured her left wrist at age 50 years after falling down some stairs. Her mother has osteoporosis and fractured her hip after a fall. Her diet is low in calcium-rich foods, and she is not currently taking a calcium supplement. She is on no medications. Her blood pressure is 120/80 mmHg, her height is 160cm, and she weighs 52kg. The rest of her physical exam is normal.Which of the following sites for osteoporotic fracture is most commonly associated with morbidity and mortality?

A 61-year-old postmenopausal female comes to your office for a routine health exam. She has a history of osteoarthritis, and she smokes one pack of cigarettes per day. She fractured her left wrist at age 50 years after falling down some stairs. Her mother has osteoporosis and fractured her hip after a fall. Her diet is low in calcium-rich foods, and she is not currently taking a calcium supplement. She is on no medications. Her blood pressure is 120/80 mmHg, her height is 160cm, and she weighs 52kg. The rest of her physical exam is normal.Which of the following conditions is not associated with an increased risk for osteoporosis?

A 61-year-old postmenopausal female comes to your office for a routine health exam. She has a history of osteoarthritis, and she smokes one pack of cigarettes per day. She fractured her left wrist at age 50 years after falling down some stairs. Her mother has osteoporosis and fractured her hip after a fall. Her diet is low in calcium-rich foods, and she is not currently taking a calcium supplement. She is on no medications. Her blood pressure is 120/80 mmHg, her height is 160cm, and she weighs 52kg. The rest of her physical exam is normal.Which of the following is not a therapy approved by the Food and Drug Administration (FDA) for the prevention of osteoporosis?

A 61-year-old postmenopausal female comes to your office for a routine health exam. She has a history of osteoarthritis, and she smokes one pack of cigarettes per day. She fractured her left wrist at age 50 years after falling down some stairs. Her mother has osteoporosis and fractured her hip after a fall. Her diet is low in calcium-rich foods, and she is not currently taking a calcium supplement. She is on no medications. Her blood pressure is 120/80 mmHg, her height is 160cm, and she weighs 52kg. The rest of her physical exam is normal.Which of the following statements regarding non-pharmacologic management for the prevention and treatment of postmenopausal osteoporosis is true?

A 41-year-old female comes to your office after finding a breast lump during a routine self-examination. She has been examining her breasts regularly for the past 5 years; this is the first lump she has found. On examination, there is a lump located in the right breast. The lump’s anatomic location is in the upper outer quadrant. It is approximately 3 cm in diameter and is not fixed to skin or muscle. It has a hard consistency. There are three axillary nodes present on the right side; each node is approximately 1 cm in diameter. No lymph nodes are present on the left.At this time, what would you do?

A 41-year-old female comes to your office after finding a breast lump during a routine self-examination. She has been examining her breasts regularly for the past 5 years; this is the first lump she has found. On examination, there is a lump located in the right breast. The lump’s anatomic location is in the upper outer quadrant. It is approximately 3 cm in diameter and is not fixed to skin or muscle. It has a hard consistency. There are three axillary nodes present on the right side; each node is approximately 1 cm in diameter. No lymph nodes are present on the left.What is the first diagnostic procedure that should be performed in this patient?

A 41-year-old female comes to your office after finding a breast lump during a routine self-examination. She has been examining her breasts regularly for the past 5 years; this is the first lump she has found. On examination, there is a lump located in the right breast. The lump’s anatomic location is in the upper outer quadrant. It is approximately 3 cm in diameter and is not fixed to skin or muscle. It has a hard consistency. There are three axillary nodes present on the right side; each node is approximately 1 cm in diameter. No lymph nodes are present on the left.What is the definitive procedure that should be performed in this patient?

A Female with a Suspicious Lesion Discovered on Mammography A mammographic examination uncovered a very suspicious lesion in the right breast of a 49-year-old female. Clinically, the lesion is a 3-cm mass present in the left upper outer quadrant. No axillary lymph nodes are palpable. You refer her to a surgeon who books her for a surgical procedure. What surgical procedure should be used in this patient?

A Female with a Suspicious Lesion Discovered on Mammography A mammographic examination uncovered a very suspicious lesion in the right breast of a 49-year-old female. Clinically, the lesion is a 3-cm mass present in the left upper outer quadrant. No axillary lymph nodes are palpable. You refer her to a surgeon who books her for a surgical procedure.The risk factors for carcinoma of the breast include which of the following?

A Painful Bilateral Breast Masses That Wax and Wane with Her Period A 42-year-old female comes to your office with bilateral breast masses that are painful and seem to “come and go” depending on the stage of the menstrual cycle. There is significant pain with these masses during menstruation. On examination, there are two areas of dense tissue, one in each breast, and each is approximately 4 cm in diameter. No axillary lymph nodes are palpable.What is the most likely diagnosis in this patient?

A Painful Bilateral Breast Masses That Wax and Wane with Her Period A 42-year-old female comes to your office with bilateral breast masses that are painful and seem to “come and go” depending on the stage of the menstrual cycle. There is significant pain with these masses during menstruation. On examination, there are two areas of dense tissue, one in each breast, and each is approximately 4 cm in diameter. No axillary lymph nodes are palpable.If medical treatment is indicated and prescribed for the condition described here, which of the following should be considered as the therapeutic agent of first choice?

A 23-year-old female consults her physician because of a breast mass; the mass is mobile, firm, and approximately 1 cm in diameter. It is located in the upper outer quadrant of the right breast. No axillary lymph nodes are present.What is the most likely diagnosis in this patient?