Cedrick
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An asymptomatic 65 year old woman comes to the gynecologist for a routine examination
physical examination shows a left adnexal enlarment that was not there a 1 year ago
Which of the following is the most likely diagnosis ?
a.-endometriosis
b.-leiomyoma
c.-ovarian tumor
d.-polycystic ovarian disease
e.-ruptured luteal cyst
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| robin082006
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By exclusion, only C is suitable
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| Cedrick
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I agree
Ovarian Tumor
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| DrVirgo
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I agree with C as well, but how would you rule out PCOS?
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| robin082006
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PCOS must have signs of increased androgen
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| DrVirgo
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Ok, if they don't say anything about androgen levels, just assume normal?
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| robin082006
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yes, for USMLE questions, assume normal when not said, this rule is applied for other questions too.
Kaplan qbank also assume this way.
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| leen
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wat abt B guys????
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| mjl1717
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a quick way: ovarian ca is very insidius, ca till proven otherwise, as robin said this is a dx of exclusion.
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| mjl1717
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ill take 2 distractors endometriosis is usually dot like endometrial tissue in women of chil bearing age.
#2 if the cyst ruptured how will you see a gross enlargement?????
someone else take the other 2
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| alpha12
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at this age, it's Ovarian cancer until proven otherwise.
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| spjokes
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Leen
Leiomyoma usually never starts after menopause
Even if it has appeared before menopause, it starts to decrease or regress after menopause because it needs estrogen for its growth
So Leiomyoma should not be considered for this case
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