nbme 2 q 4 - acebutol

[ArchivalUser]

4. A 57-year-old woman comes to the physician
because of a 2-year
history of increasing menstrual flow. She has not had
hot flashes,
insomnia, or change in bowel or bladder function. Her
last menstrual period
was 2 weeks ago. Pelvic examination shows a
normal-appearing vulva,
vagina, and cervix. The uterus is consistent in size
with an 8-week
gestation. Bimanual examination shows a 4-cm, firm,
nontender left ovary. An
endometrial biopsy specimen shows atypical complex
endometrial
hyperplasia. Which of the following is the most likely
cause of this patient's
hyperplasia?

A
) Adrenal adenoma

B
) Brenner tumor

C
) Carcinoid tumor

D
) Granulosa cell tumor

E
) Hyperthecosis

F
) Islet cell tumor

G
) Sertoli-Leydig cell tumor

[ArchivalUser]

28.) A 32-year-old woman comes to the physician because of a 3-month history of
increasing pain and stiffness in her wrists, hands, and ankles. During this period,
she also has had progressive fatigue and morning stiffness lasting 2 hours. She has
a 1-year history of rheumatoid arthritis treated with naproxen. Examination shows
redness, swelling, and warmth over the wrist, hand, and ankle joints bilaterally.
There are nontender subcutaneous nodules over the extensor surfaces of both
elbows. X-ray films of the hands show diffuse osteopenia and erosions over several
of the distal metacarpal bones. Which of the following is the most appropriate
pharmacotherapy?

A) Add oral cyclophosphamide

B) Add oral gold

C) Add oral methotrexate

D) Add oral penicillamine

E ) Switch to oral ibuprofen

[ArchivalUser]

1) Granulosa cell tumor
2)Oral MTX

[ArchivalUser]

1) Granulosa cell tumor
2)Oral MTX