HEALTH QUESTIONS WITH VERIFIED
ANSWERS AND EXPLANATION
A 54-year-old female presents with a small to moderate
amount of vaginal bleeding of recent onset. She has
been postmenopausal for approximately 2 years. What
diagnosis is least likely?
Endometrial
carcinoma
Ovarian cancer
Endometrial
hyperplasia
Uterine polyps
B.
Ovarian cancer may present as an adnexal mass,
pelvic or abdominal symptoms and a variety of others.
,Postmenopausal bleeding (PMB) is an uncommon
presentation of ovarian cancer, but can present this way.
In women with PMB, likely causes of uterine pathology
should be evaluated before considering ovarian
pathology. In early menopause, the most common
etiology is atrophy of the endometrium or vaginal
mucosa. This patient has been postmenopausal for
approximately 2 years. Other common causes of PMB
are polyps, fibroids, and endometrial hyperplasia.
Three of the following interventions are appropriately
used to prevent osteoporosis after menopause. Which one
is NOT?
Avoidance of corticosteroids
Performance of weight-bearing activities for 40
mins at least 5 days/week Estrogen replacement
therapy
Adequate calcium &
,vitamin D intake C.
Prevention of osteoporosis may be optimized by
elimination of risk factors and engaging in interventions
that maximize bone density. Good nutrition from infancy
throughout adulthood is a major component of good bone
health. Others include engaging in weight-bearing
exercises, adequate intake of calcium and vitamin D,
smoking cessation, limiting alcohol consumption to
moderate amounts, and avoidance when possible of
medications that may decrease bone density
(corticosteroids, anticonvulsants). Osteoporosis occurs at
accelerated rates in women who are post-menopausal.
The lack of estrogen can produce rapid bone loss due to
bone resorption. Estrogen replacement is not used to
prevent or treat osteoporosis.
A patient who is scheduled for pelvic exam with PAP
smear should be advised to avoid douching, sexual
intercourse, and tampon use before her exam. For how
long should she be advised to avoid these activities for
optimal evaluation?
24 hours
, 48 hours
36 hours
1
wee
k B.