USMLEGladiator
2009 & still in race
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9. A healthy 60-year-old woman comes to the physician for a routine examination. She has no history of illness over the past year and has never had an operation. She takes no medications. Menopause occurred 6 years ago. She weighs 57 kg (125 lb) and is 160 cm (63 in) tall. Pelvic examination shows atrophic external genitalia and a small, midpositioned uterus. The left ovary is 3 x 3 cm, the right ovary is not palpable. Which of the following is the most appropriate next step in management?
O A) Reexamination in 1 month
O B) Reexamination in 1 year
O C) Obtain patient's medical records
O D) Measurement of serum progesterone level
O E) Pelvic ultrasonography
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Chance favors only the prepared mind. - Louis Pasteur.
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| liliaeliz
Forum Guru
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E
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sos el sol de mis dias
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| Tuscani
Forum Guru
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hmmm confused...... 
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| GOGETA
Trying to get in PGY1
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I was between US and look for past medical records.
I eneded choosing US might be wrong I did TERRIBLE on OBGYN
Why are women giving me trouble? please dont answer is a rethorical question
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As a general rule, the better it felt when you said it, the more trouble it's going to get you into.
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| nightflight1945
banned
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E) Pelvic ultrasonography
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| Dragonfly
Forum Elite
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US! any adnexal mass postmenop. is cancer or to prove otherwise! with the grave prognosis of ovarian CA usually detected at stage III. and the number 1 killer, i would want to take a look regardless of the history!!
it would tell us whether the lesion is cyctic (less likely postmen.) or complex mass in which case we should do the preop workup (GI series, IVP, Abd CT, markers) and then proceed to exp. lap., staging (surgically: USO+forzen section) and then proceed accordingly. usually stage III. --> TAH-BSO, omentectomy, bowel resection and then chemo (carbaplatin+ taxol) . and F/U with CA-125 for 2 years q3m and then q6m for another 2 years.
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