The surgical equipment used during a craniectomy is sterilized using pressurized steam at 121°C for 15 minutes. Reuse of these instruments can cause transmission of which of the following pathogens?
ANon-enveloped viruses
BSporulating bacteria
CPrions
DEnveloped viruses
EYeasts
A 19-year-old woman presents to her gynecologist for evaluation of amenorrhea and occasional dull right-sided lower abdominal pain that radiates to the rectum. She had menarche at 11 years of age and had regular 28-day cycles by 13 years of age. She developed menstrual cycle irregularity approximately 2 years ago and has not had a menses for 6 months. She is not sexually active. She does not take any medications. Her weight is 94 kg (207.2 lb) and her height is 166 cm (5.4 ft). Her vital signs are within normal limits. The physical examination shows a normal hair growth pattern. No hair loss or acne are noted. There is black discoloration of the skin in the axillae and posterior neck. Palpation of the abdomen reveals slight tenderness in the right lower quadrant, but no masses are appreciated. The gynecologic examination reveals no abnormalities. The hymen is intact. The rectal examination reveals a non-tender, mobile, right-sided adnexal mass. Which of the following management plans would be best for this patient?
APelvic MRI should be the first-line imaging since both transvaginal and transabdominal ultrasound are inappropriate for this virginal, obese patient
BClinical examination is sufficient for diagnosis since the adnexal mass was clearly palpable on rectal examination, making imaging unnecessary
CTransabdominal ultrasound is the appropriate first-line imaging for this virginal patient, despite reduced sensitivity due to her obesity, as transvaginal ultrasound would be inappropriate given her intact hymen
DThe patient's obesity will not significantly affect transabdominal ultrasound quality, so transvaginal ultrasound is unnecessary even though she is virginal
ETransvaginal ultrasound should be performed first as it provides superior resolution for adnexal masses, regardless of the patient's sexual history or hymenal status
A 57-year-old female presents to general gynecology clinic for evaluation of a pelvic mass. The mass was detected on a routine visit to her primary care doctor during abdominal palpation. In the office, she receives a transvaginal ultrasound, which reveals a mass measuring 11 cm in diameter. In the evaluation of this mass, elevation of which tumor marker would be suggestive of an ovarian cancer?
AAlpha fetoprotein
BCA-125
CCA-19-9
DBeta-hCG
ES-100
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