FHEA Study questions 116 Detailed
Solutions.
FHEA Study questions 116 Detailed
Solutions.
First stage of labor is defined as lasting from the onset of:
AContractions until active cervical dilation occurs.
B Regular contractions with cervical change until complete dilation.
C Regular contractions with cervical change until transition.
D Cervical change until the delivery of the infant. - ANSWER Feedback
Correct answer: Regular contractions with cervical change until complete dilation.
Childbirth occurs in three stages. The first stage of labor is usually the longest and lasts from the time of
onset of labor (i.e., regular contractions) until the cervix is completely dilated to 10 cm. The second
stage comprises the period after the cervix is fully dilated until the baby is de livered. The third stage
involves the delivery of the placenta.
Dysfunctional uterine bleeding (DUB), secondary to ovarian dysfunction, is abnormal uterine bleeding
resulting from: (Select all that apply.)
Endometriosis.
Progesterone deficiency.
Sexually transmitted infections.
,FHEA Study questions 116 Detailed
Solutions.
Congenital abnormalities in the uterine structure.
Estrogen excess. - ANSWER Correct answer:
Progesterone deficiency
Estrogen excess
Dysfunctional uterine bleeding (DUB) refers to irregular bleeding that occurs in the absence of pelvic
disease, general medical issues, or pregnancy. DUB results from a disruption in the normal cyclic pattern
of ovulatory stimulation to the endometrial lining. About 90% of DUB cases are anovulatory and
bleeding in these patients is unpredictable (heavy or light, short or prolonged, frequent or random). As a
result of cyclic disruption, patients have constant, non-cycling estrogen levels along with progesterone
deficiency (normally released during the luteal phase) that stimulates endometrial grow th.
The diagnosis of irritable bowel syndrome (IBS) is defined by Rome II criteria, which includes the
following symptoms except:
Abdominopelvic pain for 12 weeks (not necessarily consecutive) in the preceding 12 months and
symptoms relieved with defecation plus a history of childhood sexual or physical abuse.
Abdominopelvic pain for 12 weeks (not necessarily consecutive) in the preceding 12 months with a
change in the frequency of bowel movements (constipation or diarrhea) and symptoms relieved with
defecation.
Abdominopelvic pain for 12 weeks (not consecutive) over the past 12 months associated with an onset
of a change in the frequency of bowel movements (diarrhea or constipation) and a change in the form of
stool (loose, watery, with mucus, or pellet-like) and no history of bloody stools.
Abdominopelvic pain for 12 weeks (not consecutive) over the past 12 months associated with an onset
of a change in the frequen - ANSWER Correct answer: Abdominopelvic pain for 12 weeks (not
necessarily consecutive) in the preceding 12 months and symptoms relieved with defecation plus a
history of childhood sexual or physical abuse.
,FHEA Study questions 116 Detailed
Solutions.
The Rome II criteria for IBS include abdominal discomfort or pain lasting at least 12 weeks, which need
not be consecutive, in the preceding 12 months that has 2 of the following 3 features: 1) relieved with
defecation, and/or 2) onset associated with a change in frequency of stool, and/or 3) onset associated
with a change in form (appearance) of stool. A history of childhood sexual or physical abus e is not
required for the diagnosis.
A 29-year-old well woman of Mediterranean ancestry presents for her first healthcare visit in many
years. She relocated to North America from Italy after marrying a member of the Armed Forces. A
routine CBC reveals the following results:
-Hgb=9.6 g/dL (12-14 g/dL) (96 g/L {120-140 g/L})
-Hct=30% (36-42%) (.30 proportion {.36-.40 proportion})
-MCV=66 fL (80-96 fL)
-RDW=12% (<15%) (.12 proportion) (<.15 proportion)
-RBC=5.9 million cells/mm3 (3.2-4.3 million cells/mm³)
These findings are most consistent with:
Acute blood loss.
Beta thalassemia minor.
Iron deficiency anemia.
Cooley's anemia. - ANSWER Feedback
Correct answer: Beta thalassemia minor.
The mean cell volume (MCV) of 66 fL indicates microcytic anemia (normal MCV=80-96 fL). Iron
deficiency anemia and thalassemia are the two most common microcytic anemias encountered in
, FHEA Study questions 116 Detailed
Solutions.
primary care and represent the leading differential diagnoses. Iron deficiency is most commonly a
consequence of slow, steady blood loss and resulting depletion of iron, whereas thalassemia is a genetic
disorder and not related to iron or any micronutrient deficiency. The normal red blood cell distribution
width (RDW) indicates a stable anemia of long duration. Mediterranean ancestry is a risk factor for
thalassemia, and the fact that the patient is a 29-year-old well woman suggests that this is a thalassemia
minor form, with no impact on health. Consideration should be given to providing genetic counseling
prior to pregnancy.
A 36-year-old woman presents with a 12-h history of anorexia, nausea, and right lower quadrant
abdominal pain. A white blood cell count with differential demonstrates:
-Total WBC=16,500 cells/mm³
-Neutrophils=66%
-Bands=8%
-Lymphocytes=22%
Expected physical examination findings include:
Murphy's sign.
A palpable left lower quadrant mass.
Periumbilical ecchymosis.
A positive obturator sign. - ANSWER Feedback
Correct answer: A positive obturator sign.
This constellation of clinical symptoms is highly suggestive of appendicitis. The obturator and psoas signs
are both consistent with pain during peritoneal stretch in the region of the appendix and are closely
associated with appendicitis; the coincident abdominal pain, anorexia, and nausea strengthen the
Solutions.
FHEA Study questions 116 Detailed
Solutions.
First stage of labor is defined as lasting from the onset of:
AContractions until active cervical dilation occurs.
B Regular contractions with cervical change until complete dilation.
C Regular contractions with cervical change until transition.
D Cervical change until the delivery of the infant. - ANSWER Feedback
Correct answer: Regular contractions with cervical change until complete dilation.
Childbirth occurs in three stages. The first stage of labor is usually the longest and lasts from the time of
onset of labor (i.e., regular contractions) until the cervix is completely dilated to 10 cm. The second
stage comprises the period after the cervix is fully dilated until the baby is de livered. The third stage
involves the delivery of the placenta.
Dysfunctional uterine bleeding (DUB), secondary to ovarian dysfunction, is abnormal uterine bleeding
resulting from: (Select all that apply.)
Endometriosis.
Progesterone deficiency.
Sexually transmitted infections.
,FHEA Study questions 116 Detailed
Solutions.
Congenital abnormalities in the uterine structure.
Estrogen excess. - ANSWER Correct answer:
Progesterone deficiency
Estrogen excess
Dysfunctional uterine bleeding (DUB) refers to irregular bleeding that occurs in the absence of pelvic
disease, general medical issues, or pregnancy. DUB results from a disruption in the normal cyclic pattern
of ovulatory stimulation to the endometrial lining. About 90% of DUB cases are anovulatory and
bleeding in these patients is unpredictable (heavy or light, short or prolonged, frequent or random). As a
result of cyclic disruption, patients have constant, non-cycling estrogen levels along with progesterone
deficiency (normally released during the luteal phase) that stimulates endometrial grow th.
The diagnosis of irritable bowel syndrome (IBS) is defined by Rome II criteria, which includes the
following symptoms except:
Abdominopelvic pain for 12 weeks (not necessarily consecutive) in the preceding 12 months and
symptoms relieved with defecation plus a history of childhood sexual or physical abuse.
Abdominopelvic pain for 12 weeks (not necessarily consecutive) in the preceding 12 months with a
change in the frequency of bowel movements (constipation or diarrhea) and symptoms relieved with
defecation.
Abdominopelvic pain for 12 weeks (not consecutive) over the past 12 months associated with an onset
of a change in the frequency of bowel movements (diarrhea or constipation) and a change in the form of
stool (loose, watery, with mucus, or pellet-like) and no history of bloody stools.
Abdominopelvic pain for 12 weeks (not consecutive) over the past 12 months associated with an onset
of a change in the frequen - ANSWER Correct answer: Abdominopelvic pain for 12 weeks (not
necessarily consecutive) in the preceding 12 months and symptoms relieved with defecation plus a
history of childhood sexual or physical abuse.
,FHEA Study questions 116 Detailed
Solutions.
The Rome II criteria for IBS include abdominal discomfort or pain lasting at least 12 weeks, which need
not be consecutive, in the preceding 12 months that has 2 of the following 3 features: 1) relieved with
defecation, and/or 2) onset associated with a change in frequency of stool, and/or 3) onset associated
with a change in form (appearance) of stool. A history of childhood sexual or physical abus e is not
required for the diagnosis.
A 29-year-old well woman of Mediterranean ancestry presents for her first healthcare visit in many
years. She relocated to North America from Italy after marrying a member of the Armed Forces. A
routine CBC reveals the following results:
-Hgb=9.6 g/dL (12-14 g/dL) (96 g/L {120-140 g/L})
-Hct=30% (36-42%) (.30 proportion {.36-.40 proportion})
-MCV=66 fL (80-96 fL)
-RDW=12% (<15%) (.12 proportion) (<.15 proportion)
-RBC=5.9 million cells/mm3 (3.2-4.3 million cells/mm³)
These findings are most consistent with:
Acute blood loss.
Beta thalassemia minor.
Iron deficiency anemia.
Cooley's anemia. - ANSWER Feedback
Correct answer: Beta thalassemia minor.
The mean cell volume (MCV) of 66 fL indicates microcytic anemia (normal MCV=80-96 fL). Iron
deficiency anemia and thalassemia are the two most common microcytic anemias encountered in
, FHEA Study questions 116 Detailed
Solutions.
primary care and represent the leading differential diagnoses. Iron deficiency is most commonly a
consequence of slow, steady blood loss and resulting depletion of iron, whereas thalassemia is a genetic
disorder and not related to iron or any micronutrient deficiency. The normal red blood cell distribution
width (RDW) indicates a stable anemia of long duration. Mediterranean ancestry is a risk factor for
thalassemia, and the fact that the patient is a 29-year-old well woman suggests that this is a thalassemia
minor form, with no impact on health. Consideration should be given to providing genetic counseling
prior to pregnancy.
A 36-year-old woman presents with a 12-h history of anorexia, nausea, and right lower quadrant
abdominal pain. A white blood cell count with differential demonstrates:
-Total WBC=16,500 cells/mm³
-Neutrophils=66%
-Bands=8%
-Lymphocytes=22%
Expected physical examination findings include:
Murphy's sign.
A palpable left lower quadrant mass.
Periumbilical ecchymosis.
A positive obturator sign. - ANSWER Feedback
Correct answer: A positive obturator sign.
This constellation of clinical symptoms is highly suggestive of appendicitis. The obturator and psoas signs
are both consistent with pain during peritoneal stretch in the region of the appendix and are closely
associated with appendicitis; the coincident abdominal pain, anorexia, and nausea strengthen the
