07-21-2009, 10:45 PM
38. A 32-year-old woman comes to the physician because of vaginal discharge for 2 weeks. She has been sexually active with one female partner for 5 years. She has not been treated with antibiotics over the past 2 years. Her last Pap smear was 6 years ago when she was sexually active with a male partner. She has not used illicit drugs or alcohol. Examination shows a grayish vaginal discharge with a pH greater than 4.5. A wet mount preparation of the vaginal discharge is most likely to show which of the following?
A) Budding yeast
B) Clue cells
C) Ferning
D) Leukocytes in sheets
E) Trichomonas vaginalis
39. A 57-year-old woman with breast cancer comes to the physician because of increasing neck pain over the past 3 days. She has fallen frequently because of muscle weakness. Vital signs are within normal limits. Examination shows hyperreflexia of all extremities. There is tenderness over the cervical spine. Serum calcium level is 11 mg/dL. X-ray films show metastases to the cervical spine. Which of the following is the most appropriate next step in management?
A) Application of a soft cervical collar
B) Physical therapy
C) Mithramycin therapy
D) Tamoxifen therapy
E) Spinal cord decompression and cervical stabilization
A) Budding yeast
B) Clue cells
C) Ferning
D) Leukocytes in sheets
E) Trichomonas vaginalis
39. A 57-year-old woman with breast cancer comes to the physician because of increasing neck pain over the past 3 days. She has fallen frequently because of muscle weakness. Vital signs are within normal limits. Examination shows hyperreflexia of all extremities. There is tenderness over the cervical spine. Serum calcium level is 11 mg/dL. X-ray films show metastases to the cervical spine. Which of the following is the most appropriate next step in management?
A) Application of a soft cervical collar
B) Physical therapy
C) Mithramycin therapy
D) Tamoxifen therapy
E) Spinal cord decompression and cervical stabilization