23-year-old woman comes to the office due to 3 days of fever and dysuria


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23-year-old woman comes to the office due to 3 days of fever and dysuria The patient also has had a pruritic, erythematous vulvar

rash that is particularly painful during urination. She is sexually active with one partner, and they use condoms inconsistently

Temperature is 38.7 C (101.7 F), blood pressure is 120/80 mm Hg, and pulse is 84/min. T here is suprapubic fullness on abdominal

examination. Pelvic examination shows several tender, ulcerated lesions with circular borders on the inside of the left labia minora.

Speculum examination shows no cervical friability or mucopurulent discharge The left inguinal lymph nodes are enlarged and tender.

Urethral catheterization is performed due to difficultly with spontaneous voiding Urinalysis results are as follows:

Leukocyte esterase positive

Nit rites negative

Bacteria none

White blood cells 15/hpf

Urine pregnancy test is negative Which of the following tests would most likely establish this patient’s diagnosis?

  • Q A Gram stain and culture of lesion for Haemophi/us ducreyi
  • Q B. KOH wet mount microscopy for Candida albicans
  • Q C. Nucleic acid amplification testing for Chlamydia trachomatis
  • Q D. Rapid plasma reagin testing for Treponema pal/idum
  • Q E. Viral culture of lesion for herpes simplex virus

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stillborn male fetus is brought to autopsy for evaluation. The fetus was delivered at approximately 36 weeks gestation to a 26-yearold

woman, gravida 5 para 1 aborta 3, who received no prenatal care. The mother came to the hospital in active labor; an ultrasound

on admission revealed no fetal cardiac activity She had an uncomplicated vaginal delivery of the stillborn fetus, weight 2.2 kg (4.9

lb). The mother had a prior healthy female infant via normal vaginal delivery at 39 weeks gestation and 3 subsequent elective

terminations of pregnancy. She does not use tobacco, alcohol, or illicit drugs The fetus has short, bent extremities. X-ray reveals

multiple limb fractures and a hypoplastic thoracic cavity Which of the following is the most likely cause of these fetal abnormalities?

  • QA Achondroplasia
  • 0 B. Amniotic band sequence
  • 0 C. Birth trauma
  • 0 D. Osteogenesis imperfecta
  • 0 E. Paget disease
  • 0 F. Potter sequence
  • 0 G. Vitamin D deficiency

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