02-16-2011, 07:13 PM
A 26-year-old woman comes to the physician for an annual visit. She states that she has
overall been feeling well over the past year except for a few flares of her systemic lupus
erythematosus (SLE). She has had SLE for the past 5 years. Her past medical history is
significant for depression, for which she takes fluoxetine, and occasional tension headaches,
which she is able to control with acetaminophen. She has never had surgery. She has no
known drug allergies. Her mother has ovarian cancer and two of her maternal aunts have
endometrial cancer. She lives with her husband and works as a hair stylist. Her physical
examination, including breast and pelvic examination, is entirely normal. She states that she
and her husband use condoms for contraception but that they do not like this method. She
wants to know if she can "go on the pill." Which of the following represents an absolute
contraindication to the use of the combined oral contraceptive pill in this patient?
A. Depression
B. Family history of endometrial cancer
C. Family history of ovarian cancer
D. Systemic lupus erythematosus
E. Tension headaches
overall been feeling well over the past year except for a few flares of her systemic lupus
erythematosus (SLE). She has had SLE for the past 5 years. Her past medical history is
significant for depression, for which she takes fluoxetine, and occasional tension headaches,
which she is able to control with acetaminophen. She has never had surgery. She has no
known drug allergies. Her mother has ovarian cancer and two of her maternal aunts have
endometrial cancer. She lives with her husband and works as a hair stylist. Her physical
examination, including breast and pelvic examination, is entirely normal. She states that she
and her husband use condoms for contraception but that they do not like this method. She
wants to know if she can "go on the pill." Which of the following represents an absolute
contraindication to the use of the combined oral contraceptive pill in this patient?
A. Depression
B. Family history of endometrial cancer
C. Family history of ovarian cancer
D. Systemic lupus erythematosus
E. Tension headaches