A 24 year old presents to the office with a painful lump on…

A 24 year old presents to the office with a painful lump on her right vulva. She can barely walk because of the pain. She is currently sexually active and has had a total of 6 partners in life. She is otherwise healthy. What do you expect to see on exam?

A 70 year-old woman, gravida 2, para 2, presents with a wors…

A 70 year-old woman, gravida 2, para 2, presents with a worsening bulge in her vagina over the last several months. The bulging is less noticeable in the morning, but becomes more pronounced with accompanying low back pain throughout the day. Her medical history is significant for hypertension and diet controlled diabetes. She has never had surgery. She delivered two term infants vaginally, with the largest weighing 8 pounds 10 ounces. On examination, she is 6’3” and 106 pounds. She has a soft mass protruding through the vagina with bearing down. What is the most definitive  treatment for her condition?

A 17 year-old adolescent presents with a one day history of…

A 17 year-old adolescent presents with a one day history of abdominal pain. Her pain is severe, intermittent and localizes to the right side. She has not eaten in nearly one day. Her last menstrual cycle was about 3 weeks ago. On examination, her temperature is 98.7F and her pulse is 92 beats per minute. Her abdominal examination show rebound, guarding on the right side. Bimanual examination demonstrates moderate tenderness in the right lower quadrant. A  pelvic ultrasonogram show a  6cm right adnexal mass with diminished flow. Her urine pregnancy test is negative. What is her most likely diagnosis?

68-year-old woman, gravida 3, para 3, presents with loss of…

68-year-old woman, gravida 3, para 3, presents with loss of urine with coughing and sneezing. Her symptoms are worse when she exercises. She denies urinary urgency. She underwent an abdominal hysterectomy with bilateral salpingo-oophorectomy 20 years ago for abnormal bleeding. On examination, she is 62″ and weighs 180 pounds. Her abdomen is obese without masses or tenderness. On pelvic examination, her vagina is atrophic and she has slight descent of the vaginal vault. There are no palpable masses. What is her likely diagnosis?