Comprehension Questions

[59.11 A 6-year-old girl is noted to have breast development and vaginal spotting. No abnormal hair growth is noted. A 10-cm ovarian mass is palpated on rectal examination. Which of the following is the most likely diagnosis?

A. Benign cystic tumor (dermoid)

B. Idiopathic precocious puberty

C. Sertoli-Leydig cell tumor

D. Congenital adrenal hyperplasia

E. Granulosa-theca cell tumor

|59.2] A 15-year-old GO PO girl complains of increasing hair over her face and chest. She also has a deepening voice and clitoromegaly. There have been two neonatal deaths in the family. Which of the following is the best diagnostic test to confirm the diagnosis?

A. Testosterone level

B. Dexamethasone suppression test

C. 17-hydroxyprogesterone level

D. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels

E. Karyotype

[59.3] A 22-year-old nulliparous woman with irregular menses of 7 years' duration complains of primary infertility. She has a family history of diabetes. She has mild hirsutism on examination. Which of the following is the most appropriate therapy?

A. Cortisol and mineralocorticoid replacement

B. Excision of an adrenal tumor

C. Surgical excision of an ovarian tumor

D. Oral clomiphene citrate

E. Intrauterine insemination

[59.4] A 24-year-old woman complains of bothersome hirsutism and skipping periods. She does not have evidence of voice changes, hair loss, or clitoromegaly. Pelvic examination does not reveal adnexal masses. Serum DHEA-S. testosterone, and 17-hydroxyprogesterone levels are normal. LH/FSH ratio is 2:1. Which of the following is the most likely diagnosis?

A. Polycystic ovarian syndrome

B. Familial hirsutism

C. Ovarian tumor

D. Adrenal tumor

E. Cushing's syndrome

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