A 17-year-old female with spina bifida and limited mobility who is a wheelchair user is considering depot medroxyprogesterone acetate for menstrual suppression. What is a key counseling point regarding this medication that is particularly relevant to her underlying condition?
A 1-week-old female infant has palpable breast buds and a small amount of milky nipple discharge. The parents are concerned and have been repeatedly manipulating the breast. What is the most likely cause of these findings?
A 2-year-old girl presents with a small amount of blood-tinged vaginal spotting and is found to have a soft, pedunculated, mobile mass protruding from the vaginal introitus. Examination under anesthesia with excisional biopsy is performed. The mass is well-circumscribed, covered by benign epithelium, and shows mature fibrovascular stroma without cytologic atypia or invasive growth on histology. What is the most likely diagnosis?
A 5-year-old girl presents with vulvar pruritus, redness, and a scant yellow-green vaginal discharge. Her mother reports that she has been applying an over-the-counter antifungal cream for a week without any improvement. What is the most likely cause of her symptoms?
A 17-year-old female with known polycystic ovary syndrome is being managed with metformin for insulin resistance. What is the primary mechanism of action of this medication in the context of her condition?
According to the American College of Obstetricians and Gynecologists (ACOG), at what age should routine cervical cancer screening with a Papanicolaou (Pap) test begin for an immunocompetent, sexually active adolescent?
A 16-year-old female is diagnosed with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. On physical examination, she has normal female secondary sexual characteristics (Tanner stage 5 breast and pubic hair development). A pelvic ultrasound confirms the absence of a uterus and the presence of normal-appearing ovaries. What is the most likely karyotype for this patient?
A 3-week-old female infant is brought to the clinic for a well-child check. The mother mentions that she noticed a small amount of vaginal bleeding in the baby’s diaper for a few days during the first week of life, which has since resolved. The physical exam is otherwise normal. What is the most likely explanation for this bleeding?
A 14-year-old female presents with excessive terminal hair growth on her upper lip and chin. Her menstrual cycles are regular. A workup for polycystic ovary syndrome is negative, and her serum testosterone and dehydroepiandrosterone sulfate (DHEAS) levels are normal. What is the most likely diagnosis?
A 16-year-old female is diagnosed with polycystic ovary syndrome and is treated with a combined oral contraceptive pill. Which component of this medication is primarily responsible for increasing the hepatic production of sex hormone-binding globulin, thereby reducing bioavailable testosterone?
