A 30-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and infertility. On pelvic ultrasound, a chocolate cyst is visualized within the ovary. Which of the following conditions is most likely to be responsible for these findings?

Correct Answer: B

Rationale: The scenario described in the question is most indicative of endometriosis. Endometriosis is a gynecological condition in which tissue similar to the lining of the uterus grows outside of the uterus. Classic symptoms of endometriosis include cyclic pelvic pain, dysmenorrhea (painful periods), and infertility. The presence of a "chocolate cyst" (also known as an endometrioma) within the ovary on pelvic ultrasound is a characteristic finding in endometriosis. These cysts are filled with old blood, giving them a dark, chocolate-like appearance on imaging. Polycystic ovary syndrome (PCOS) typically presents with irregular periods, signs of hyperandrogenism, and multiple small follicles on ultrasound. Ovarian torsion and ovarian cyst rupture would present with acute-onset symptoms and may not necessarily be associated with cyclic pelvic pain and dysmenorrhea as described in the

Correct Answer: C

Rationale: Mast cells are primarily responsible for mediating allergic responses such as severe allergies. When an allergen triggers the immune response, mast cells release histamine, leukotrienes, and other inflammatory mediators. These substances cause symptoms such as difficulty breathing, hives, and swelling. Basophils also release histamine, but mast cells are more abundant in tissues and play a significant role in allergic reactions. Eosinophils are involved in allergic reactions but are more focused on combating parasitic infections. Neutrophils are not typically involved in allergic responses but play a key role in combating bacterial infections.

Correct Answer: A

Rationale: Somatic hypermutation is the mechanism responsible for generating diversity in the antigen-binding sites of immunoglobulins. During somatic hypermutation, point mutations are introduced into the variable regions of immunoglobulin genes in B cells. These mutations occur randomly and lead to a wide range of amino acid changes in the antigen-binding sites of antibodies. As a result, a diverse repertoire of antibodies with varying specificities for different antigens is created. Gene rearrangement and isotype switching are other mechanisms that contribute to antibody diversity but do not specifically target the antigen-binding sites. Clonal expansion, on the other hand, refers to the proliferation of specific B cell clones after activation by antigens, which amplifies the immune response but does not directly impact the diversity of antigen-binding sites.

Correct Answer: A

Rationale: Fluticasone/salmeterol (Advair) is a combination medication consisting of an inhaled corticosteroid (fluticasone) and a long-acting beta-agonist (salmeterol). This combination medication is recommended for long-term control of asthma symptoms and for the prevention of exacerbations. Fluticasone reduces airway inflammation, while salmeterol helps to relax the muscles of the airways, improving breathing. Using this combination medication regularly can help manage asthma symptoms and reduce the risk of asthma attacks. It is not appropriate to use short-acting beta-agonists like albuterol (salbutamol) on a long-term basis for asthma control. Ipratropium bromide (Atrovent) is an anticholinergic bronchodilator that is more commonly used for chronic obstructive pulmonary disease (COPD

Correct Answer: B

Rationale: CPAP therapy is considered the gold standard treatment for obstructive sleep apnea (OSA) and is the most appropriate intervention for managing OSA and improving symptoms. CPAP therapy involves using a machine that delivers a continuous flow of air through a mask worn over the nose or mouth during sleep. This air pressure helps keep the airway open, preventing the collapse that causes apneas and snoring during sleep.