AAFP Board Review – Gyn questions well
answered to pass
1. 36-year-old obese female presents to your
C. Metformin (Glu-
office with a chief complaint of amenorrhea.
cophage)
On
examination you note hirsutism and body acne. She is PCOS
characterized by hy-
on no medications and a pregnancy test
is negative. Serum testosterone is at the upper 2. A 30-year-
limits of normal and TSH is within normal old female
limits. comes to
your office
In addition to weight loss and exercise, because she
which one of the following would be the is concerned
most about
appropriate initial management? irregular
(check one) menses
A. High-dose combined oral contraceptives (fewer than
B. Progestin-only contraceptives 9/year),
C. Metformin (Glucophage) acne, and
D. Levothyroxine (Synthroid) hirsutism.
Her BMI is
36.0 kg/m2.
She has no
other
medical
problems
and would
like to have
a baby. Her
fasting
blood
,AAFP Board Review – Gyn questions well
answered to pass
glucose level is 140 perandrogenism,
polycys- tic ovaries on
pelvic ultra-
sonography, and
ovulatory dysfunction.
Hyperandrogenism
and either polycystic
ovaries or ovulatory
dysfunction are
necessary to make the
di- agnosis. The first-line
rec- ommendation in
obese patients is
lifestyle mod- ification,
but metformin may
improve abnormal
menstruation (SOR
A).
Low-dose combined
oral contraceptives
are more frequently
used to reduce the risk
of endometrial cancer
in pa- tients with chronic
anovu- lation and the
resulting unopposed
estrogen se- cretion.
C. lifestyle modification
+ Metformin
This patient has classic
,AAFP Board Review – Gyn questions well
answered to pass
features of polycystic ovary syndrome (PCOS). The di-
, AAFP Board Review – Gyn questions well
answered to pass
mg/dL. agnosis is based on
Which one of the following would be the the presence of two of
most ap- propriate treatment for this the fol- lowing:
patient's condition and concerns? -oligomenorrhea
(check one) or amenorrhea
A. Lifestyle modification only -clinical or
B. Lifestyle modification and pioglitazone biochemical
(Actos) hyperandrogenis
C.Lifestyle modification and metformin m
(Glucophage) -polycystic ovaries
D. Lifestyle modification and an oral visible on
contraceptive
ultrasonography.
E. Lifestyle modification and oral testosterone
3. In a 27-year-old white female with irregular A. Easy bruising
men- strual cycles and infertility, which one of -also moon facies,
the follow- ing would be more indicative of buttalo hump,
Cushing's syndrome rather than the more abdominal striae,
common polycystic ovarian syn- drome? (check hypertension, and
one) prox- imal myopathy
A. Easy bruising suggest Cushing's
B. Acne syndrome.
C. Hirsutism -very rare compared
D. Androgenic alopecia to polycystic ovarian syn-
E. Acanthosis nigricans drome, routine
screen- ing is not
indicated in women
with hypoandro- genic
anovulation
4. A 19-year-old college freshman consults you at the re- C. increase
answered to pass
1. 36-year-old obese female presents to your
C. Metformin (Glu-
office with a chief complaint of amenorrhea.
cophage)
On
examination you note hirsutism and body acne. She is PCOS
characterized by hy-
on no medications and a pregnancy test
is negative. Serum testosterone is at the upper 2. A 30-year-
limits of normal and TSH is within normal old female
limits. comes to
your office
In addition to weight loss and exercise, because she
which one of the following would be the is concerned
most about
appropriate initial management? irregular
(check one) menses
A. High-dose combined oral contraceptives (fewer than
B. Progestin-only contraceptives 9/year),
C. Metformin (Glucophage) acne, and
D. Levothyroxine (Synthroid) hirsutism.
Her BMI is
36.0 kg/m2.
She has no
other
medical
problems
and would
like to have
a baby. Her
fasting
blood
,AAFP Board Review – Gyn questions well
answered to pass
glucose level is 140 perandrogenism,
polycys- tic ovaries on
pelvic ultra-
sonography, and
ovulatory dysfunction.
Hyperandrogenism
and either polycystic
ovaries or ovulatory
dysfunction are
necessary to make the
di- agnosis. The first-line
rec- ommendation in
obese patients is
lifestyle mod- ification,
but metformin may
improve abnormal
menstruation (SOR
A).
Low-dose combined
oral contraceptives
are more frequently
used to reduce the risk
of endometrial cancer
in pa- tients with chronic
anovu- lation and the
resulting unopposed
estrogen se- cretion.
C. lifestyle modification
+ Metformin
This patient has classic
,AAFP Board Review – Gyn questions well
answered to pass
features of polycystic ovary syndrome (PCOS). The di-
, AAFP Board Review – Gyn questions well
answered to pass
mg/dL. agnosis is based on
Which one of the following would be the the presence of two of
most ap- propriate treatment for this the fol- lowing:
patient's condition and concerns? -oligomenorrhea
(check one) or amenorrhea
A. Lifestyle modification only -clinical or
B. Lifestyle modification and pioglitazone biochemical
(Actos) hyperandrogenis
C.Lifestyle modification and metformin m
(Glucophage) -polycystic ovaries
D. Lifestyle modification and an oral visible on
contraceptive
ultrasonography.
E. Lifestyle modification and oral testosterone
3. In a 27-year-old white female with irregular A. Easy bruising
men- strual cycles and infertility, which one of -also moon facies,
the follow- ing would be more indicative of buttalo hump,
Cushing's syndrome rather than the more abdominal striae,
common polycystic ovarian syn- drome? (check hypertension, and
one) prox- imal myopathy
A. Easy bruising suggest Cushing's
B. Acne syndrome.
C. Hirsutism -very rare compared
D. Androgenic alopecia to polycystic ovarian syn-
E. Acanthosis nigricans drome, routine
screen- ing is not
indicated in women
with hypoandro- genic
anovulation
4. A 19-year-old college freshman consults you at the re- C. increase
