pediatric gynecology

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[size=20px]A 4-year-old presents with a history of recurrent brown vaginal discharge, associated with odour. It has recurred despite multiple courses of oral antibiotic therapy with amoxicillin. What is the next most appropriate step? a- Consult child protective services. b- Perform a vulvar biopsy. c- Flush or irrigate the vagina. d- Prescribe an antifungal cream. e- Prescribe a course of trimethoprim and sulfamethoxazole.[/size]

[size=20px]An 11-year old premenarchal girl presents with right lower quadrant pain and is taken to the operating room with the presumptive diagnosis of appendicitis. At laparoscopy her appendix is normal but she is found to have right adnexal torsion. The right ovary appears ischemic with a cyst. The left adnexa appears normal. In addition to reduction of the right adnexal torsion and cyst drainage this patient requires A nothing further. B appendectomy. C right oophoropexy. D bilateral oophoropexy. E right oophorectomy.[/size]

please write the answer and your justification, correct answer will be submitted after 48 hrs [size=20px]An 11-year old premenarchal female presents with nausea, vomiting and right lower quadrant pain. An abdominal ultrasound demonstrates a six cm cystic and solid mass involving the right ovary with internal hemorrhage and calcifications. At laparoscopy, a torsed, blue irregularly enlarged right ovary is found. Upon detorsion, the ovary appears slightly more pink, but no plane can be identified between the mass and any identifiable ovarian tissue. The most appropriate next step for this patient with ovarian torsion is A right oophorectomy. B right salpingo-oophor…

First one with correct answer with justification win. [size=20px]A 13-year old female presents with severe lower abdominal pain. An ultrasound reveals an enlarged right ovary with vascular flow and a seven centimeter cystic mass. What is the most appropriate next step in management of this patient with an enlarged ovary? A observation. B transvaginal ultrasound. C computerized tomography scan of abdomen and pelvis. D intravenous antibiotics. E diagnostic laparoscopy[/size]