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UPDATED 2024 CARE OF WOMEN KSA WITH GUARANTEED ANSWERS
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UPDATED 2024 CARE OF WOMEN KSA WITH GUARANTEED ANSWERS
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UPDATED 2024 CARE OF WOMEN KSAWITH GUARANTEED ANSWERS
,UPDATED 2024 CARE OF WOMEN KSA
WITH GUARANTEED ANSWERS
Because of the wide range of manifestations of thyroid disease and its high frequency in women with
menstrual disorders, a TSH level should be checked in women with possible PCOS. A prolactin level
should also be obtained to rule out hyperprolactinemia as a cause of anovulation in women with
suspected PCOS.
HAIR-AN syndrome, a rare subphenotype of PCOS, consists of hyperandrogenism, severe insulin
resistance, and acanthosis nigricans, and occurs in nearly 5% of women with hyperandrogenism.
An androgen-secreting tumor is characterized by a rapid onset of virilization symptoms, including
changes in voice, male pattern androgenic balding, and clitoromegaly. Testing is not indicated in the
absence of these symptoms. Primary ovarian insufficiency involves amenorrhea (as opposed to
oligomenorrhea) combined with symptoms of estrogen deficiency, including hot flashes or urogenital
symptoms. The patient does not have any of these symptoms so testing for this would not be
appropriate at this point.
A 24-year-old graduate student comes to your office to be tested for sexually transmitted infections. The
medical assistant tells you that the patient was upset when she saw how much she weighed. On
questioning, the patient says that for the past year she has experienced episodes of uncontrollable
eating followed by self-induced vomiting. Her weight is 82 kg (181 lb) and her BMI is 32 kg/m2. Which
one of the following is true regarding treatment for this condition?
A. Cognitive behavioral therapy has the best evidence for treatment
B. SSRI monotherapy is a first-line treatment option
C. Anemia is an indication for hospitalization
D. More than half of patients will relapse after treatment - CORRECT ANSWERSANSWER: A
Eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder, and the DSM-5
added avoidant/restrictive food intake disorder, rumination disorder, and pica to this group in 2014.
Mood disorders, anxiety, substance use, and personality or somatic disorders are common in these
patients. Screening can include regularly asking questions about mood, body image concerns, and eating
behaviors. Before establishing the diagnosis based on history, it is important to perform a physical
examination that includes measurement of orthostatic vital signs and obtain a metabolic panel that
includes magnesium and phosphate levels.
,This patient appears to have bulimia nervosa, which consists of eating an excessive amount of food in a
short period of time (often >2000 calories in one sitting), with a concomitant feeling of loss of control.
Because patients with bulimia base their self-worth on their body shape and weight, they follow this
binge eating with compensatory behaviors to prevent weight gain, such as vomiting, laxative use, food
restriction, excessive exercise, or taking diuretics. Episodes occur, on average, one or more times a week
for 3 months or longer, and the disorder is associated with a two- to sixfold increase in age-adjusted
mortality.
After the diagnosis is established and a goal weight has been accepted, the patient is best served with
treatment delivered by a team that includes a therapist, a nutritionist, and a clinician, preferably with
each having prior experience in caring for patients with eating disorders. Cognitive behavioral therapy
(CBT) has the best evidence for treatment of adults with bulimia, while family-based therapy is the first-
line treatment for adolescents with this condition. Early behavioral response, with rapidly declining
episodes of binge eating, is associat
A 35-year-old female presents to your office for treatment of insomnia. You ask if she has experienced
any trauma in her life and she discloses that she was sexually assaulted 6 weeks ago. She has not sought
medical, legal, or psychological counseling since the assault. During today's visit, you should do which
one of the following?
A. Assess for symptoms of posttraumatic stress disorder
B. Prescribe levonorgestrel (Plan B One-Step), 1.5 mg
C. Prescribe HIV postexposure prophylaxis
D. Perform a forensic examination to collect evidence, such as a rape kit evaluation
E. Refer her for cognitive behavioral therapy - CORRECT ANSWERSANSWER: A
Sexual assault affects 43.6% of women in the United States during their lifetimes, with increased risks
seen in adolescents, college students, LGBTQ persons, and active-duty military personnel. The risk is also
increased by physical or mental disabilities, poverty, homelessness, incarceration, and substance use
disorders. The majority of assaults are committed by someone known to the victim, and assaults are
often unreported. It has been estimated that only 16%-38% of victims seek help from law enforcement
or obtain a medical evaluation.Both short- and long-term consequences can occur after sexual assault.
Short-term consequences include physical injuries, unintended pregnancy, and sexually transmitted
infections (most commonly Chlamydia, gonorrhea, and trichomoniasis). Over time, additional sequelae
may include chronic pelvic pain, headaches, fibromyalgia and other chronic pain syndromes, and
irritable bowel syndrome. The most common long-term consequence is posttraumatic stress disorder
(PTSD), while other psychological sequelae include insomnia, depression, anxiety, substance use
disorder, eating disorders, and suicidality.
, The American College of Obstetrics and Gynecology recommends screening all women for sexual
violence, while the U.S. Preventive Services Task Force recommends intimate partner violence (IPV)
screening for women of reproductive age. Most women will not disclose IPV or sexual violence unless
asked, and a validated two-question screening tool can be most easily incorporated into a primary care
practice: "Have you ever been hit, slapped, kicked, or otherwise hurt by your partner? Have you ever
been forced to participate in sexual activities?"This patient should have a urine pregnancy test and be
tested for Chlamydia, gonorrhea, bacterial vaginosis, syphilis, and trichomoniasis. Blood shoul
You are developing a practice improvement activity in your office centered on substance use disorder
(SUD). As part of the training for your clinical staff, you plan to review a variety of clinical vignettes of
patients with SUD. One of your goals is to illustrate how SUD has different clinical presentations in
women and men. Which one of the following statements is accurate regarding these differences?
A. Compared to men, women have a quicker progression from first using a substance to developing
dependence
B. Compared to men, women with SUD have less severe adverse consequences
C. Smaller quantities of drug consumption are associated with development of SUD among men
compared to women
D. Women are less likely to relapse after treatment than men - CORRECT ANSWERSANSWER: A
Substance use disorder (SUD) in women is often associated with more severe adverse medical,
psychiatric, and functional consequences than in men, often related to the interacting contributions of
biological and environmental factors. Physiologically, women with SUD have variation in cravings and
drug consumption at different times of the menstrual cycle. There is also evidence that women
metabolize nicotine more rapidly than men, making it harder for them to quit using nicotine-containing
products. This differential metabolism is a possible reason that nicotine replacement therapies are less
efficacious in women.
Environmentally, women often attribute their substance use to different reasons than men, including
self-treatment of mental health problems, management of chronic pain, and controlling weight. Use of
smaller quantities of drugs and a shorter time progression from initial use to dependence are both more
likely among women with SUD. Treatment outcomes are not substantially different by sex, but women
are more likely to relapse after treatment.
A 23-year-old patient comes to your office 4 weeks after the uncomplicated vaginal birth of her first
child, and reports that she feels tired all the time. On further questioning, she describes significant
emotional lability during the first week after delivery. She has continued to have a low mood most days
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