Items 523 through 524

A 19-year-old primigravid woman is expecting her first child; she is 12 wk pregnant by dates. She has vaginal bleeding and an enlarged-for-dates uterus. In addition, no fetal heart sounds are heard. The ultrasound below is obtained.

5-23. The most likely diagnosis of this woman's condition is a. Sarcoma botryoides b. Tuberculous endometritis c. Adenocarcinoma of the uterus d. Hydatidiform mole e. Normal pregnancy

Reprinted, with permission, from Evans MD, Ginsburg KA: Obstetrics and Gynecology: PreTest Self-Assessment and Review, 9th ed. New York, McGraw-Hill, 2001.

5-24. After uterine evacuation, management of the woman described above, who has no clinical or radiographic evidence of meta-static disease, should include a. Weekly hCG titers b. Hysterectomy c. Single-agent chemotherapy d. Combination chemotherapy e. Radiation therapy

5-25. The medical evaluation of a 25-year-old intravenous drug user reveals elevated liver enzymes and a positive anti-HBsAg. The most likely cause of the abnormal liver profile is hepatitis a. A

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