At what age should COC’s be discontinued for smokers?

What condition of the reproductive system results in pain, erythema, a perineal mass, and dyspareunia?

All the following suggest vulvar cancer except:  

A 22 year old female presents with a complaint of increased vaginal discharge, no itching, and an unpleasant odor.  On examination a grayish white discharge is noted at the introitus and adhering to the vaginal walls.  There is no erythema. She is sexually active. The most likely finding on a wet mount examination would be:

A mother and her young 12 y.o. daughter come to your office frightened and concerned over the daughter’s irregular menstrual patterns and bleeding.  You explain to them that:

A 30-year old woman with bilateral breast implants is scheduled for her yearly exam. You begin to assess her breast health. She asks if it is necessary to do monthly BSE (breast self exam) because she does not know what to feel for.  The most appropriate response would be?  AND You are preparing for her breast exam, the proper exam technique for this woman  would be:

I have no set office hours. You must contact me via email.

Your patient is a 58yo postmenopausal female who comes in for her annual examination. She reports a feeling of fullness, bloating, and anorexia for the past 5-6 months. Her pelvic exam reveals a firm, fixed left adnexal mass >8cm. What is the most appropriate next step in managing this patient?  

Your patient MC, G4P2012 comes to your office at 30 weeks gestation with complaints of contractions “on & off” for 2 days since she was gardening in the heat to get ready for her son’s birthday party. You perform a bimanual exam and note a closed thick high cervix. Her urine specific gravity is 1030 +1 ketones, without protein, nitrites, glucose, or leukocytes.  You decide to give her an IV fluid bolus in the office. You know the reason for this is:

A 26 year-old woman is newly diagnosed with early HIV infection.  She is believed to have acquired HIV approximately 4 months prior from a brief sexual relationship with a partner who frequently injects methamphetamine.  She has a new boyfriend and they have regularly had vaginal sex without using a condom during the last 3 months.  She is asking how likely it is that she has passed on HIV to her new partner.