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Self-Assessment Questions

Pediatric Medicine

Pediatric Gynecology: Review Questions

Frank J. Genuardi, MD, MPH

Dr. Genuardi is an assistant professor, Department of Pediatrics, abd assistant dean for educational affairs, University of Florida Health Science Center, Jacksonville, FL.



Choose the single best answer for each question.

1. A 4-year-old girl is brought to her primary care physician (PCP) because of perineal itching. Her mother states that she has been scratching mainly at night, and that the itching is interfering with sleep. On examination, the patient is noted to have erythema and excoriation in her perianal area as well as mild vulvovaginal erythema with a scant white discharge. Which of the following is the most likely diagnosis?
  1. Candidiasis
  2. Enterobiasis
  3. Pediculosis pubis
  4. Physiologic leukorrhea
  5. Trichomoniasis
Click here to compare your answer.


2. A 6-year-old girl is brought to her PCP because of a vaginal discharge. On examination, she has minimal vulvovaginal erythema without evidence of injury. A purulent, extremely foul-smelling vaginal discharge is noted. Which of the following is the most likely diagnosis?

  1. Endodermal carcinoma
  2. Foreign body
  3. Gonorrhea infection
  4. Physiologic leukorrhea
  5. Trichomoniasis
Click here to compare your answer.


3. A 12-year-old girl is brought to her PCP because of a vaginal discharge. She has not yet begun menstruating. On examination, she is noted to have tanner stage 4 pubic hair. The external genitalia appear normal without signs of irritation. She has a copious, white, mucoid vaginal discharge that has no odor. Which of the following is the most likely diagnosis?

  1. Bacterial vaginosis
  2. Candidiasis
  3. Foreign body
  4. Physiologic leukorrhea
  5. Trichomoniasis
Click here to compare your answer.


4. A 14-year-old girl is brought to her PCP because of irregular menses. Menarche was at age 13. She denies sexual activity. Initially, her menstruation was relatively painless, although she has noted some cramping with her last several periods. Her menses have never been regular, with intervals of 4 to 10 weeks between periods. Bleeding has lasted from 2 to 5 days at a time. She is otherwise healthy and without other complaints. Which of the following is the most appropriate next step in this patient#146;s management?
  1. Begin oral contraceptive pills
  2. Dilatation and curettage
  3. Obtain a pelvic ultrasound
  4. Perform a speculum examination
  5. Reassurance
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5. A 15-year-old girl presents to her PCP because of amenorrhea. She states that her menses were initially irregular, but had been regular for about the last year until 3 months ago, when she had her most recent period. Review of systems is otherwise negative. She is 5 ft 4 in tall and weighs 110 lb, and the remainder of her examination is unremarkable. Which of the following is the most appropriate next step in this patient#146;s management?

  1. Follicle-stimulating hormone and luteinizing hormone measurement
  2. Pregnancy test
  3. Progesterone challenge
  4. Reassurance
  5. Vaginal smear
Click here to compare your answer.
 

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