Posted on November 15, 2015 by Archer USMLE Reviews
479. A 57 year old female presents for second opinion of a left breast lesion that had been diagnosed as ‘eczema’ by her regular nurse practitioner, which briefly improved after a short course of topical steroids. On physical exam there is an erythematous, scaly lesion involving the left breast. Image is shown below. Her last mammogram was a year ago and it was “fine”. She does not report any family history of breast cancer. What is the next step in the patient’s management?
A – Bilateral breast ultrasound
B – Bilateral mammography and punch biopsy of nipple
C – Maintain regular annual mammography appointment
D – Oral corticosteroids
E – Left breast MRI
Filed under: USMLE STEP III QUESTION BANK, USMLE Test Prep | Tagged: archer dermatology, archer general internal medicine, Archer Gynecology, internal medicine board review, USMLE STEP 3 DERMATOLOGY, usmle step 3 gynecology | 18 Comments »
Posted on January 11, 2015 by Archer USMLE Reviews
Your patient presents at 33 weeks gestation. She is a 27 year old gravida 2 para 1 female with a previous pregnancy complicated by pre-eclampsia, with a vaginal delivery of a healthy infant at 37 weeks. Her current pregnancy has been uncomplicated, but today she is experiencing abdominal pain and uterine contractions that began 5 hours prior to presentation. She states that she has had some fluid leaking from her vagina since the previous evening, but denies vaginal bleeding, trauma, urinary urgency or frequency.
Her temperature is 101.6 degrees Fahrenheit. Blood pressure is 98/60, heart rate is 100/minute, with respirations of 18/minutes. On pelvic examination, she has clear fluid in the posterior fornix, which causes nitrazine paper to turn blue in color. She is dilated to 4 centimeters and her cervix is 60% effaced. Her uterus is diffusely tender on examination and the fetal heart rate is 175 beats per minute, with frequent accelerations. Maternal white blood cell count is 13,000/mm3.
What is the next step in the management of this patient?
A. Initiation of ciprofloxacin
B. Urine culture
C. Initiation of ampicillin and gentamycin
D. Cesarean delivery
E. Induction of labor.
Filed under: USMLE STEP III QUESTION BANK, USMLE Test Prep | Tagged: Archer Gynecology, archer obstetrics, obgyn, usmle step 3 gynecology and obstetrics, usmle step 3 obstetrics | 3 Comments »
Posted on January 9, 2015 by Archer USMLE Reviews
Your patient is a gravida 1 para 0, 19 year old female at 33 weeks gestation that presents with a complaint of heavy vaginal bleeding and severe abdominal pain for an hour. Her pregnancy has been uneventful, and she is in good health, although she continues to smoke cigarettes, admitting to one pack per day.
Blood pressure is 110/80 with a heart rate of 110. The patient is afebrile, with respirations of 20/minute. Examination reveals a contracted uterus with a closed cervical os. The patient expels a large amount of blood from her closed cervix during the examination. Fetal heart rate monitoring reveals severe late decelerations. What is the best treatment option for this patient?
A. Expectant management with bed resT
B. Terbutaline
C. Oxytocin
D. Magnesium sulfate
E. Caesarean section delivery
Filed under: USMLE STEP III QUESTION BANK, USMLE Test Prep | Tagged: Archer Gynecology, archer obstetrics, archer ostetrics and gynecology, obstetrics, usmle step 3 gynecology and obstetrics | 8 Comments »
Posted on January 9, 2015 by Archer USMLE Reviews
Your patient is a gravida 2 para 2 female with a complaint of a vaginal discharge, vulvar irritation, and dysuria. Her symptoms have recurred 4 times within the past year. She had a recent urinary tract infection that was treated with ciprofloxacin, but is in otherwise good health. She is afebrile with normal vital signs, and pelvic examination reveals vulvar and vaginal erythema with a thick white discharge in the vaginal vault. KOH prep reveals pseudo hyphae. Which of the following treatments is most appropriate for this patient?
a. Oral fluconazole 150 mg x 1
b. Probiotic lactobacilli
c. No treatment is necessary
d. Oral Fluconozole induction followed by maintenance.
e. Topical miconazole x 7 days
Filed under: USMLE STEP III QUESTION BANK, USMLE Test Prep | Tagged: Archer Gynecology, archer ostetrics and gynecology, usmle step 3 gynecology | 11 Comments »
Posted on May 6, 2012 by Archer USMLE Reviews
421) A 34-year-old woman with history of oligomenorrhea presents to your clinic to discuss her results of recent work-up. One week ago, she has undergone extensive work-up for her menstrual abnormality. A serum pregnancy test is negative. Thyroid stimulating hormone, serum prolactin level and Follicle Stimulating Hormone levels are within normal limits. Serum total testosterone is 120ng/dl ( N = 30 to 90ng/dl) and serum free testosterone is 0.9 ng/dl ( N= 0.4 to 0.8 ng/dl) . A dehydro-epiandrosterone level is 400 mcg/dl (45- 270 ug/dL) . A pelvic ultrasound reveals multiple cysts in the ovaries bilaterally. On examination, she is obese with a BMI of 32. She has excess thick and pigmented hair above her upper lip and on the chin. Which of the following is indicated in this patient at this time?
A) Fasting Plasma Glucose
B) Random Blood Glucose
C) Hemoglobin A1C
D) Oral Glucose Tolerance Test
E) Start Metformin
Filed under: Uncategorized, USMLE Test Prep | Tagged: Archer endocrinology, Archer Gynecology, endocrinology mcqs, usmle step 3 endocrinology, usmle step 3 gynecology and obstetrics | 18 Comments »
Posted on April 27, 2012 by Archer USMLE Reviews
406) A 65 year old woman is evaluated in your office for urinary problems. She reports involuntary loss of urine upon coughing almost daily for few months. She presented with similar problems 6 months ago and has been advised pelvic floor exercises and lifestyle modifications . These measures have not improved her symptoms. She denies any nocturia, frequency, hesitancy or urgency symptoms. She has no other medical problems On examination, vitals are stable. Pelvic examination reveals changes consistent with vaginal atrophy. When she is asked to cough in lithotomy position, there is large urinary leakage about 30 seconds after coughing which was difficult for her to stop. Complete blood count, Plasma glucose, Serum electrolytes and Urinalysis are within normal limits. Which of the following is the most appropriate next step?
A) Start Vaginal Estrogen
B) Recommend Vaginal Pessary
C) Obtain Urodynamic Studies
D) Mid-Urethral Sling placement
E) Trial of Alpha-Adrenergic Agonists
Filed under: Uncategorized, USMLE Test Prep | Tagged: aRCHER GERIATRICS, Archer Gynecology, usmle step 3 geriatrics, usmle step 3 gynecology | 12 Comments »
Posted on April 27, 2012 by Archer USMLE Reviews
405) A 80 year old woman with advanced dementia is sent to your office for evaluation of a vaginal ulcer. The patient has a history of Stage III uterine prolapse. She had been fitted with a pessary for control of her symptoms about 6 months ago. She has no history of fever or chills. On examination, she is afebrile, blood pressure is 130/80. Pelvic examination revealed complete procidentia with impacted pessary and a 2 x 2 cm ulcer without any exudate. An attempt to remove the pessary is unsuccessful. Biopsies of the ulcer have been obtained. Which of the following is the appropriate initial management?
A) Vaginal Estrogen
B) Oral Antibiotics
C) Surgical removal of Pessary
D) Hysterectomy
E) Admit for parenteral antibiotics
Filed under: Uncategorized, USMLE Test Prep | Tagged: aRCHER GERIATRICS, Archer Gynecology, usmle step 3 geriatrics, usmle step 3 gynecology | 12 Comments »
Posted on April 27, 2012 by Archer USMLE Reviews
404) A 70 year old woman in excellent physical health presents to your office because she has noticed a mass falling out of her vagina for the past one year which is progressively worse. For the past six months, she has difficulty voiding. During voiding, she has to constantly change her position and sometimes, needs to push the mass inside in order to urinate. Lately, voiding has become even more difficult despite all these measures. She has problems with defecation which she describes as having to apply pressure on her vagina in order to completely evacuate her bowel. . She denies any fever or burning urination. She has normal bowel movements and has no problems with defecation. She is embarrassed to have sex anymore after having had urinary incontinence during sex. She blames herself for neglecting the mass without seeking medical attention for such a long time. Otherwise, she is in excellent physical health and has no other co-morbidity. She is willing to consider any option including surgery if feasible. On examination, vitals are stable. Pelvic examination revealed a total prolapse with total eversion of the vagina which was oedematous with marked ulceration in the dependent portion of the mass. Which of the following is the appropriate initial management?
A) Obtain Urodynamic studies
B) Biopsy
C) Admit for daily Vaginal packing with estrogen
D) Vaginal estrogen and Pessary
E) Vaginal Hysterectomy
Filed under: Uncategorized, USMLE Test Prep | Tagged: aRCHER GERIATRICS, Archer Gynecology, usmle step 3 geriatrics, usmle step 3 gynecology | 10 Comments »
Posted on April 27, 2012 by Archer USMLE Reviews
403) A 68 year old woman with history of Diabetes mellitus is evaluated in your office during routine follow-up visit. She reports that lately she has been experiencing pressure and bulge in her vaginal area and has a sensation of something falling out of her vagina. She denies any fever, burning, frequency or urgency of urination. She has normal bowel movements and has no problems with defecation. She is sexually active with her husband and enjoys it. She denies any urinary incontinence even upon coughing or sneezing. On examination, vitals are stable. Pelvic examination reveals changes consistent with vaginal atrophy and a Grade 1 Cystocele. Which of the following is the most appropriate recommendation?
A) Screen for latent Stress incontinence
B) Observation
C) Pessary
D) Surgery
E) Raloxifene
Filed under: Uncategorized, USMLE Test Prep | Tagged: aRCHER GERIATRICS, Archer Gynecology, usmle step 3 geriatrics, usmle step 3 gynecology | 11 Comments »
Posted on April 27, 2012 by Archer USMLE Reviews
402) A 68 year old woman with history of Diabetes mellitus is evaluated in your office during routine follow-up visit. She reports that lately she has been experiencing pressure and bulge in her vaginal area and has a sensation of something falling out of her vagina. She denies any fever, burning, frequency or urgency of urination. She has normal bowel movements and has no problems with defecation. On examination, vitals are stable. Pelvic examination reveals changes consistent with vaginal atrophy and presence of moderate cystocele. She has marked urinary leakage when she was asked to cough in lithotomy position. Complete blood count, Plasma glucose, Serum electrolytes and Urinalysis are within normal limits. She requests information regarding surgery for vaginal prolapse. Which of the following is the most appropriate statement regarding surgery for her cystocele?
A) Surgery may worsen her Incontinence
B) Surgery may increase urinary obstruction
C) If she were to undergo prolapse surgery, no additional incontinence treatment is needed
D) Surgery may cause defecation problems
E) Surgery is optimal option for her at this time.
Filed under: Uncategorized, USMLE Test Prep | Tagged: aRCHER GERIATRICS, Archer Gynecology, usmle step 3 geriatrics, usmle step 3 gynecology | 12 Comments »
Posted on April 27, 2012 by Archer USMLE Reviews
401) A 78 year old woman presents for annual health-maintenance examination. Her medical problems include Hypertension, Diabetes, Coronary artery disease and Chronic obstructive pulmonary disease. During review of systems, she reports that she has been experiencing involuntary loss of urine upon coughing almost daily for few months. She has been too embarrassed to disclose it and so, has not mentioned it during previous visits. However, the problem has been limiting her social activities and she really would like to “do something about it”. She denies any nocturia, frequency, hesitancy or urgency symptoms. Her medications include albuterol, ipratropium, glyburide, clopidogrel and losartan. She had a myocardial infarction followed by coronary stent placement six months ago. On examination, vitals are stable. Pelvic examination reveals changes consistent with vaginal atrophy and presence of moderate cystocele. She has marked urinary leakage when she was asked to cough in lithotomy position. She has tried pelvic floor exercises and scheduled-voiding for past several weeks and has cut down on her coffee consumption however, these measures have not helped her much. Complete blood count, Plasma glucose, Serum electrolytes and Urinalysis are within normal limits. Which of the following is the most appropriate recommendation for this patient?
A) Check Post-Void Residual volume
B) Vaginal Estrogen
C) Pessary
D) Mid-Urethral Sling placement
E) Oxybutynin
Filed under: Uncategorized, USMLE Test Prep | Tagged: aRCHER GERIATRICS, Archer Gynecology, usmle step 3 geriatrics, usmle step 3 gynecology | 16 Comments »
Posted on March 4, 2012 by Archer USMLE Reviews
332) A 22 year old ballet dancer is evaluated in your office during a routine annual physical examination. She does not have any complaints except for excessive fear of gaining weight. She reports that her mother thinks she has lost a lot of weight in the past two years however, she personally believes she is excessively fat and seeks help to lose more weight. Her menstrual cycles are irregular occurring, once every three to four months. On examination, she is very thin and has a dry, scaly skin. Her Body Mass Index is 15.0. She is afebrile, heart rate is 54/min and blood pressure 86/54 mm Hg. Complete blood count shows mild anemia. Urine pregnancy test is negative. Which of the following findings are consistent with her diagnosis?
A) Metabolic Acidosis
B) Parotid swelling
C) Hyperkalemia
D) Low serum cortisol
E) Increased Pulmonary vital capacity
Filed under: Uncategorized, USMLE Test Prep | Tagged: Archer Gynecology, ARCHER NEPHROLOGY, archer sports medicine, usmle step 3 gynecology, usmle step 3 nephrology, usmle step 3 sports medicine | 15 Comments »
Posted on September 7, 2011 by Archer USMLE Reviews
A 16 year old woman is brought to your office by her mother for medical evaluation. Her mother has been out of country on a long business trip for 8 months and upon her return, she was shocked to notice that her daughter looked much skinnier than she was 8 months ago. The patient has lost about 30 lbs weight in the past 8 months and reports irregular menstruation. She is fearful of gaining weight and has been exercising excessively. Physical examination reveals a very thin woman with a Body Mass Index (BMI) of 16. She has fine, downy dark hair all over her body. Which of the following findings are frequently seen in association with this condition?
A) Diarrhea
B) Tachycardia
C) Hyperkalemia
D) Decreased Bone mineral density
E) Metabolic Acidosis
Filed under: USMLE Test Prep | Tagged: ARCHER GENERAL MEDICINE, Archer Gynecology, archer pediatrics, Archer Psychiatry, usmle step 3 gynecology, usmle step 3 pediatrics, USMLE Step 3 psychiatry | 15 Comments »
Posted on August 21, 2011 by Archer USMLE Reviews
250 ) A 30 year old woman presents to your office with complaints of fatigue and headache. She reports that the headaches occur almost daily and are mild to moderate. They are not associated with nausea or vomiting and are unrelated to menstrual cycles. She also reports chronic diffuse abdominal pain and pelvic pain for the past several months for which she did not seek any medical attention. Her chart reveals that she was seen by your colleague few months ago for similar complaints. She was asked to return after few laboratory investigations but she had been non-compliant with her follow-ups. Physical examination reveals an anxious appearing woman who otherwise appears healthy. She does not make an eye contact. Abdominal and pelvic examination is benign. There are no tender points. There are no neurological deficits. The most appropriate next step in managing this patient:
A) Support and Counseling
B) Refer to Psychiatry
C) Start Selective Serotonin Reuptake Inhibitors
D) Trial of Tricyclic anti-depressants
E) Screen for Domestic Violence
Filed under: USMLE Test Prep | Tagged: Archer Gynecology, archer neurology, Archer Psychiatry, neurology mcqs, Psychiatry, usmle step 3 gynecology and obstetrics, usmle step 3 neurology, USMLE Step 3 psychiatry | 6 Comments »
Posted on June 26, 2011 by Archer USMLE Reviews
207) A 30 year old pregnant woman with 32 week gestation presents with severe itching that is present through out the day and interferes with her sleep at night. The itching is more on palms and soles. She had a similar problem during her previous pregnancy. She denies any history of eczema or liver disease in the past. Physical examination reveals excoriations on the skin. There are no papules, wheals or plaques. There is no scleral icterus. Laboratory investigations reveal an elevated Asparate aminotransferase ( AST) 140u/l , Alanine Aminotransferase (ALT) 150u/l, alkaline phosphatase at 280U/L ( Normal 40 to 120U/L) and Total bilirubin 2.2mg%. Complete blood count is with in normal limits. Hepatitis profile is negative. Which of the following is the most common complication associated with this entity:
A) Hepatic Failure
B) Fetal Prematurity
C) Renal Failure
D) Disseminated Intravascular Coagulation
E) Severe Post-Partum Hemorrhage
Filed under: USMLE Test Prep | Tagged: Archer Gynecology, archer obstetrics, archer ostetrics and gynecology, obstetrics, usmle step 3 gynecology, usmle step 3 gynecology and obstetrics, usmle step 3 obstetrics | 6 Comments »
Posted on June 26, 2011 by Archer USMLE Reviews
206) A 30 year old pregnant woman with 32 week gestation presents with severe itching that is present through out the day and interferes with her sleep at night. The itching is more on palms and soles. She had a similar problem during her previous pregnancy. She denies any history of eczema or liver disease in the past. Physical examination reveals excoriations on the skin. There are no papules, wheals or plaques. There is no scleral icterus. Laboratory investigations reveal an elevated Asparate aminotransferase ( AST) 140u/l , Alanine Aminotransferase (ALT) 150u/l, alkaline phosphatase at 280U/L ( Normal 40 to 120U/L) and Total bilirubin 2.2mg%. Complete blood count is with in normal limits. Hepatitis profile is negative. The most appropriate next step in managing this patient?
A) Serum Bile Acid level
B) Liver Biopsy
C) Ursodeoxycholic acid
D) Immediate delivery
E) Long-chain 3-hydroxyacyl CoA dehydrogenase (LCHAD) mutation testing
Filed under: USMLE Test Prep | Tagged: Archer Gynecology, archer obstetrics, archer ostetrics and gynecology, obstetrics, usmle step 3 gynecology, usmle step 3 gynecology and obstetrics, usmle step 3 obstetrics | 8 Comments »
Posted on June 26, 2011 by Archer USMLE Reviews
205) A 27 year old woman, primigravida at 35 week gestation is evaluated in your office for extreme itching associated with rash. The rash and itching first started on her abdomen but now spread to her buttocks and legs as well. She denies similar complaints in any of her family members. On physical examination, an eruption consisting of small erythematous wheals is noted mostly in the abdominal striae with sparing of the peri-umbilical skin. Some rash is also noted on her lower extremities. There is no involvement of palms and soles. A picture of her abdomen is shown below:
Most likely diagnosis:
A) Scabies
B) Pemphigoid Gestationis
C) Intahepatic Cholestasis of Pregnancy (ICP)
D) Pruritic Urticarial Papules of Pregnancy (PUPP)
E) Pruritic folliculitis of Pregnancy
Filed under: USMLE Test Prep | Tagged: archer dermatology, Archer Gynecology, archer obstetrics, archer ostetrics and gynecology, obstetrics, USMLE STEP 3 DERMATOLOGY, usmle step 3 dermatology images, usmle step 3 gynecology, usmle step 3 gynecology and obstetrics, usmle step 3 obstetrics | 5 Comments »
Posted on June 25, 2011 by Archer USMLE Reviews
200) A 26 year old pregnant woman is evaluated in the emergency Room for severe weakness and dehydration from persistent vomiting. She is a primigravida at 9 weeks gestation. She reports that her nausea and vomiting started at 5 weeks of pregnancy and have progressively become worse. She denies any abdominal pain or vaginal bleeding. She denies any headache. Her bowel movements are normal. Her past medical history is unremarkable. Her pre-pregnancy weight was 60lbs but now she weighs about 55lbs. Physical examination reveals dry oral mucosa. Laboratory tests reveal Serum sodium 140 meq/l, potassium 3.2meq/L, Chloride 102meq/l, Bicarbonate 34meq/L. hematocrit of 52 (normal = 36 to 46%). Urine reveals ketonuria. The most appropriate next step in investigating this patient:
A) Hemoglobin A1C level
B) Serum Uric acid
C) Urine for total protein
D) Ultrasound Pelvis
E) Plain X-Ray abdomen
Filed under: USMLE Test Prep | Tagged: Archer Gynecology, archer obstetrics, archer ostetrics and gynecology, obstetrics, usmle step 3 gynecology, usmle step 3 gynecology and obstetrics, usmle step 3 obstetrics | 8 Comments »
Posted on June 25, 2011 by Archer USMLE Reviews
199) A 32 year old pregnant woman with 32 week gestation is evaluated in your office during a regular follow up visit. She denies any abdominal pain or vomiting or vaginal bleeding or headache. She denies any headache or pruritis. She feels healthy and is hoping for a normal delivery. Physical examination is consistent with 32 week gestation. Extremities do not reveal any edema. Laboratory investigations reveal a mild anemia at 12.0gm%. Rest of the lab results are normal except for elevated alkaline phosphatase at 280U/L ( Normal 40 to 120U/L) . The patient is very concerned. Most appropriate next step in managing this patient?
A) Ultrasound of the liver and gall bladder
B) Immediate Delivery
C) Ursodeoxycholic acid
D) Reassurance
E) Obtain Peripheral Smear
Filed under: USMLE Test Prep | Tagged: Archer Gynecology, archer obstetrics, archer ostetrics and gynecology, obstetrics, usmle step 3 gynecology, usmle step 3 gynecology and obstetrics, usmle step 3 obstetrics | 4 Comments »
Posted on June 25, 2011 by Archer USMLE Reviews
198) A 26 year old pregnant woman is evaluated in the emergency Room for severe weakness and dehydration from persistent vomiting. She is a primigravida at 9 weeks gestation. She reports that her nausea and vomiting started at 5 weeks of pregnancy and have progressively become worse. She denies any abdominal pain or vaginal bleeding. She denies any headache. Her bowel movements are normal. Her past medical history is unremarkable. Her pre-pregnancy weight was 60lbs but now she weighs about 55lbs. Physical examination reveals dry oral mucosa. Laboratory tests reveal Serum sodium 140 meq/l, potassium 3.2meq/L, Chloride 102meq/l, Bicarbonate 34meq/L. hematocrit of 52 (normal = 36 to 46%); Total bilirubin of 2mg/dl; ALT of 160U/L and AST of 140U/L. Urine is positive for ketones. Ultrasound reveals normal fetus appropriate for 9 week gestation. Which of the following explains her jaundice and elevated liver function tests:
A) Acute pancreatitis
B) Acute Fatty Liver of pregnancy
C) Cholestatis of Pregnancy
D) Hyperemesis Gravidarum
E) HELLP Syndrome
Filed under: USMLE Test Prep | Tagged: Archer Gynecology, archer obstetrics, archer ostetrics and gynecology, obstetrics, usmle step 3 gynecology, usmle step 3 gynecology and obstetrics, usmle step 3 obstetrics | 6 Comments »
Posted on June 25, 2011 by Archer USMLE Reviews
197) A 26 year old pregnant woman is evaluated in the emergency Room for severe weakness and dehydration from persistent vomiting. She is a primigravida at 9 weeks gestation. She reports that her nausea and vomiting started at 5 weeks of pregnancy and have progressively become worse. She denies any abdominal pain or vaginal bleeding. She denies any headache. Her bowel movements are normal. Her past medical history is unremarkable. Her pre-pregnancy weight was 60lbs but now she weighs about 55lbs. Physical examination reveals dry oral mucosa. Laboratory tests reveal hematocrit of 52 ( normal = 36 to 46%) ; Total bilirubin of 2mg/dl; ALT of 160U/L and AST of 140U/L . Urine is positive for ketones. Ultrasound reveals normal fetus appropriate for 9 week gestation. The most likely diagnosis:
A) Diabetic Ketoacidosis
B) Acute Pancreatitis
C) Hyperemesis Gravidarum
D) Cholestasis of Pregnancy
E) Morning Sickness
Filed under: USMLE Test Prep | Tagged: Archer Gynecology, archer obstetrics, archer ostetrics and gynecology, obstetrics, usmle step 3 gynecology, usmle step 3 gynecology and obstetrics, usmle step 3 obstetrics | 2 Comments »
Posted on June 14, 2011 by Archer USMLE Reviews
183) A 65 year old woman presents with a white plaque on her vulva. It is associated with occasional itching. She has no other hypo-pigmented lesions on her body. She denies any post-coital bleeding. Physical examination reveals a white colored plaque on the vulva. The lesion is atrophic, thin with a crinkled surface and is well-demarcated. There is atrophy of the labia minora. Most appropriate next step in managing this patient?
A) Topical Corticosteroids
B) Fluconazole
C) Vulvar Biopsy
D) HPV testing
E) Topical Testosterone
Filed under: USMLE Test Prep | Tagged: Archer Gynecology, archer usmle step 3, dermatology usmle, dermatology usmle step 3 questions, USMLE STEP 3 DERMATOLOGY, usmle step 3 gynecology, usmle step 3 questions, Vulvar Lesions, vulvar white plaque | 4 Comments »
Posted on June 14, 2011 by Archer USMLE Reviews
Q182) A 65 year old woman presents with a white plaque on her vulva. She has no other hypo-pigmented lesions on her body. She reports history of repeated itching in the area for past several years. She has seen by her gynecologist in the past. Repeated evaluation did not reveal any infection or candidiasis. She says the lesion has not changed in appearance but the itching bothers her. She denies any vaginal bleeding. Physical examination reveals a raised white colored plaque on the vulva. There are excoriations adjacent to and overlying the lesion. Most likely diagnosis:
A) Lichen Sclerosus
B) Lichen Simplex Chronicus
C) Lichen planus
D) Vulvar Cancer
E) Vitiligo
Filed under: Uncategorized, USMLE Test Prep | Tagged: Archer Gynecology, USMLE STEP 3 DERMATOLOGY, usmle step 3 dermatology images, USMLE Step 3 question bank, usmle step 3 questions, Vulvar Lesions, vulvar white plaque | 3 Comments »
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