02-05-2008, 06:28 AM
40. A 13-year-old girl is brought for a well-child examination. Menses have occurred every other month since menarche 10 months ago. Her last menstrual period was 1 week ago. She is not sexually active. Sexual development is Tanner stage 3. Examination shows no abnormalities. Which of the following is the most appropriate next step in management?
A
) Discussion of pregnancy prevention
B
) Measurement of serum luteinizing and follicle-stimulating hormone levels
C
) Urine β-hCG test
D
) Pelvic examination
E
) Estrogen therapy
F
) Diagnostic laparoscopy
20. An asymptomatic 32-year-old woman comes for a routine health maintenance examination. Her mother and sister have a history of low back pain and disc herniation. The patient is a postal worker. She weighs 86 kg (190 lb) and is 165 cm (65 in) tall. Her blood pressure is 130/78 mm Hg, pulse is 74/min, and respirations are 16/min. Range of motion of the spine is normal and without pain. There is no scoliosis or excessive kyphosis of the back. Which of the following is the most effective strategy to decrease this patient's risk for developing low back pain?
A
) Change in job
B
) Limit physical activity
C
) Stretching exercises
D
) Weight-loss program
E
) Nonsteroidal anti-inflammatory drug therapy
F
) Prophylactic brace
A
) Discussion of pregnancy prevention
B
) Measurement of serum luteinizing and follicle-stimulating hormone levels
C
) Urine β-hCG test
D
) Pelvic examination
E
) Estrogen therapy
F
) Diagnostic laparoscopy
20. An asymptomatic 32-year-old woman comes for a routine health maintenance examination. Her mother and sister have a history of low back pain and disc herniation. The patient is a postal worker. She weighs 86 kg (190 lb) and is 165 cm (65 in) tall. Her blood pressure is 130/78 mm Hg, pulse is 74/min, and respirations are 16/min. Range of motion of the spine is normal and without pain. There is no scoliosis or excessive kyphosis of the back. Which of the following is the most effective strategy to decrease this patient's risk for developing low back pain?
A
) Change in job
B
) Limit physical activity
C
) Stretching exercises
D
) Weight-loss program
E
) Nonsteroidal anti-inflammatory drug therapy
F
) Prophylactic brace