Question

Mrs. Jones is a 68-year-old patient who presents to your office with a complaint of abdominal pain. Her husband died 1 year ago and she reports that she is not sexually active. Which finding would be of concern?

A. Palpable ovaries
B. Small and pale cervix
C. Constriction of the vaginal introitus
D. Absence of vaginal rugation

Answer 1

A palpable ovary is a concern in a postmenopausal 68-year-old patient like Mrs. Jones, as ovaries are typically not palpable due to atrophy at this stage, and could indicate a potential pathology such as a cyst or a tumor.

Step-by-step explanation:

In the context of a 68-year-old patient who is not sexually active and presents with abdominal pain, a palpable ovary would be a finding of concern. As women age, particularly after menopause, their ovaries typically decrease in size and are often not palpable on physical exam due to atrophy. If an ovary is palpable in a postmenopausal woman like Mrs. Jones, it raises concerns for potential pathologies such as ovarian tumors or cysts.

A small and pale cervix often reflects the normal physiological changes following menopause, as does constriction of the vaginal introitus and the absence of vaginal rugation due to decreased estrogen levels. However, the presence of such changes should still be noted and taken into account during diagnosis, particularly in the context of abdominal pain.