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Answers 2025
The fundus is at the umbilicus at approximately how many weeks? - CORRECT ANSWER ✅ 20 At how many weeks is the test for gestational diabetes performed - CORRECT ANSWER ✅ 24- At what point during a normal pregnancy should exams go from every 4 weeks to every 3 weeks? - CORRECT ANSWER ✅ 28 weeks A women whose LMP was on June 6th will have what estimated due date according to Nägele's rule - CORRECT ANSWER ✅ 3/ A blueish cervix seen at early pregnancy is known as whose sign? - CORRECT ANSWER ✅ Chadwick's When can chronic villus sampling be performed? - CORRECT ANSWER ✅ 10-12 weeks What is quickening and when does it occur? - CORRECT ANSWER ✅ When mother first starts feeling movement for first time. Typically around 20 weeks, may be earlier for multiparous women.
Answers 2025
abnormal placenta development covering the cervix? - CORRECT ANSWER ✅ Placenta Previa The umbilical vein carries _____ blood? - CORRECT ANSWER ✅ Oxygenated Which of the following Lab studies would be seen in menopause- a. high estradiol, low fsh and LH b. low estradiol, high fsh and lh c. high estradiol, high fsh and lh d. low estradiol, low fsh and lh - CORRECT ANSWER ✅ b. low estradiol, high fsh and lh 36 year old woman presents with noted mass in right breast that has remained unchanged through three menstrual cycles. She has a history of smaller benign cystic disease. What is the best diagnostic step after an initial ultrasound? - CORRECT ANSWER ✅ Aspiration of dominant mass 24 year old female presents with complaint of inability to get pregnant over the last year and is concerened about the growth of dark hair along her chin and jawline. Her last menstrual period was 6 months ago, she is overweight. From the description what is the most likely etiology of the patient's complaint- - CORRECT ANSWER ✅ PCOS
Answers 2025
A. Magnetic resonance imaging (MRI) B. Excisional biopsy C. Ultrasound D. Mammography - CORRECT ANSWER ✅ (u) A. MRI's of the breast are done in patients with prior breast cancer or who have BRCA 1 or 2 positivity. (u) B. Excisional biopsy is not indicated without differentiation of lesion by ultrasound. CORRECT: C. In a 25 year-old an ultrasound is the best choice because of the density of the breast tissue in young women. (u) D. Mammographies are not recommended in women prior to the age of 35 without family history of breast cancer or BRCA positive. A 26 year-old woman requests screening after her boyfriend was treated for a sexually transmitted infection recently. On examination you find a painless vulvar ulcer. Which of the following is the most likely diagnosis? A. Herpes B. Syphilis C. Chancroid
Answers 2025
D. Granuloma inguinale - CORRECT ANSWER ✅ (u) A. The classic presentation of herpes is a painful vesicle. CORRECT: B. The primary lesion of syphilis presents as a painless ulcer or chancre. Secondary syphilis presents with a skin rash lymphadenopathy and mucocutaneous lesions. (u) C. Chancroid presents with a painful genital ulcer and tender suppurative inguinal adenopathy. (u) D. Granuloma inguinale presents with raised, red lesions that bleed easily. A 16 year-old nulliparous acutely ill female presents with bilateral lower abdominal pain. She has a temperature of 100.4 degrees F and on examination has a tender, enlarged left adnexa. Cervical culture is positive for Chlamydia. Ultrasound reveals a complex tubular structure in the left adnexal area. What is the recommended treatment? A. Outpatient treatment with IM ceftriaxone and oral doxycycline B. Oral doxycycline C. IM procaine penicillin D. Hospitalization with parenteral doxycycline and cefoxitin - CORRECT ANSWER ✅ D. This patient has pelvic inflammatory disease and most likely a tubo-ovarian abscess. It is recommended that the patient be hospitalized and treated with high-dose IV antibiotic therapy. For patients with tubo-ovarian
Answers 2025
A 25 year-old female, G2 P1001, presents to your office at 11-weeks gestation with vaginal bleeding, mild lower abdominal cramping, and bilateral lower pelvic discomfort. On examination, blood is noted at the dilated cervical os. No tissue is protruding from the cervical os. The uterus by palpation is 8-9 weeks gestation. No other abnormalities are found. Which of the following is the most likely diagnosis? A. Threatened abortion B. Inevitable abortion C. Incomplete abortion D. Complete abortion - CORRECT ANSWER ✅ (u) A. Threatened abortion is characterized by bleeding in the first trimester without loss of fluid or tissue. CORRECT: B. Inevitable abortion is the gross rupture of membranes in the presence of cervical dilation. (u) C. Incomplete abortion is when the cervical os is open and allows passage of blood. The products of conception may remain in utero or may partially extrude through the open os. (u) D. Complete abortion refers to a documented pregnancy that spontaneously passes all of the products of conception.
Answers 2025
Which of the following is recommended to reduce the risk for perinatal transmission of HIV in a patient with a viral load of >1000 copies/mL? A. Vaginal delivery with female condom B. Episiotomy to shorten second stage of labor C. Use of forceps or vacuum extractor to shorten second stage of labor D. Cesarean section prior to onset of labor and rupture of membranes - CORRECT ANSWER ✅ D. Cesarean section performed prior to the onset of labor and rupture of membranes significantly reduces the risk of perinatal HIV transmission. Planned cesarean section delivery at 38 weeks of gestation to prevent perinatal transmission of HIV is recommended in women with a viral load of >1000 copies/mL. On physical examination of a pregnant patient, which can be considered a normal finding? A. Increased second heart sound split with inspiration B. Diastolic murmur C. Facial edema D. Hyperreflexia - CORRECT ANSWER ✅ CORRECT: A. Increased second heart sound split with inspiration is common in pregnancy due to the increased blood flow across the aortic and pulmonic valves.
Answers 2025
menorrhagia over the last 6 months. On physical examination her uterus feels enlarged and irregular. Which of the following is the most likely diagnosis? A. Endometritis B. Endometriosis C. Uterine leiomyomata D. Endometrial hyperplasia - CORRECT ANSWER ✅ (u) A. Endometritis is an infection of the endometrium. It occurs most commonly postpartum. (u) B. Endometriosis most commonly presents with dysmenorrhea, dyschezia, and dyspareunia. Usually the uterus is not enlarged. CORRECT: C. Uterine leiomyomata (fibroid) typically presents with severe dysmenorrhea and menorrhagia. An enlarged, irregular uterus is noted on examination. (u) D. Endometrial hyperplasia can cause menorrhagia but is not usually a cause of dysmenorrhea. Your patient has just delivered her baby vaginally without difficulty. The patient has a laceration of the vaginal mucosa including the perineal body. You repair it without difficulty. On the chart you document this as what type of tear? A. First degree
Answers 2025
B. Second degree C. Third degree D. Fourth degree - CORRECT ANSWER ✅ (u) A. A first degree tear involves the vaginal mucosa or perineal skin, but does not involve the underlying tissue. CORRECT: B. A second degree tear involves the underlying subcutaneous tissues, but not the rectal sphincter or rectal mucosa. (u) C. A third degree tear extends through the rectal sphincter, but not into the rectal mucosa. (u) D. A fourth degree tear extends into the rectal mucosa. What phase of the female menstrual cycle occurs at the time of elevated estrogen and LH/FSH surge? A. Follicular phase B. Proliferative phase C. Ovulation D. Secretory phase - CORRECT ANSWER ✅ (u) A. The follicular phase begins with the onset of menses (day 1 of the menstrual cycle) and ends on the day of the LH surge. (u) B. Progesterone causes differentiation of the endometrial components and converts proliferative endometrium
Answers 2025
B. Uterus palpable at the level of the umbilicus C. Blood pressure lower than non-pregnant state D. Hyperreflexia - CORRECT ANSWER ✅ CORRECT: A. Chadwick's sign is a bluish discoloration of the vagina early in pregnancy; it usually appears by 12 weeks of gestation. (u) B. The uterus is palpable at the level of the umbilicus at 20 weeks in a singleton pregnancy. (u) C. Blood pressure lower than non-pregnant state occurs in the second trimester. (u) D. Hyperreflexia is an uncommon finding and may occur with preeclampsia You are following a patient in labor at term. You evaluate the fetal monitoring tracing and note the presence of variable, repetitive decelerations in the heart rates. The contractions have a sharp deceleration slope. What is the recommended treatment for these decelerations? A. Change maternal position B. Administer tocolytic therapy C. Apply vibroacustic stimulation
Answers 2025
D. Perform cesarean section - CORRECT ANSWER ✅ A. Variable decelerations occur from umbilical cord compression and oligohydramnios. They are treated by changing maternal positioning to relieve pressure on the umbilical cord. Additionally, amnioinfusion may be used to relieve umbilical cord compression in cases of oligohydramnios. What is the recommended initial first trimester screening test for fetal aneuploidy? A. Amniocentesis B. Pregnancy-associated plasma protein A (PPA), beta-hCG, and ultrasound of nuchal transparency C. Maternal serum alpha feto protein, beta-hCG, estriol, and inhibin-A D. Level II ultrasound - CORRECT ANSWER ✅ (u) A. Amniocentesis is a diagnostic test not a screening test. CORRECT: B. Pregnancy-associated plasma protein A (PPA), beta-hCG, and ultrasound of nuchal transparency are screening tests done at 10-13 weeks of gestation. (u) C. Maternal serum alpha feto protein, beta hCG, estriol, and inhibin- A, are included in the quad screen which is a screening test done in the second trimester from 15-20 weeks of gestation. (u) D. Level II ultrasound is done in the second trimester.
Answers 2025
pH of the vaginal discharge is five. Which of the following is the recommended treatment for this patient? A. Topical metronidazole (Metrogel) B. Oral fluconazole (Diflucan) C. Topical estradiol (Estrace) cream D. Oral metronidazole (Flagyl) - CORRECT ANSWER ✅ D. This is a classic description of trichomonas vulvovaginitis. This condition must be treated with oral metronidazole or tinidazole. A 28 year-old female presents with lower abdominal pain and vaginal discharge. On examination the patient is toxic appearing and her temperature is 39°C. Pelvic examination reveals cervical motion tenderness. What is the next best step in the evaluation of this patient? A. Abdominal x-ray B. Endocervical culture C. Laparoscopy D. Hysterosalpingogram - CORRECT ANSWER ✅ (u) A. Abdominal x-rays are not helpful in the diagnosis of pelvic inflammatory disease. CORRECT: B. Endocervical culture would be helpful in the diagnosis of pelvic infection.
Answers 2025
(u) C. Laparoscopy is invasive and would not be the next best step in evaluation of this patient. (u) D. Hysterosalpingogram is indicated in the evaluation of abnormal uterine bleeding and infertility A 16 year-old female G1P0Ab0 is 30 weeks pregnant. Her last two monthly prenatal exams have shown a trace to 1 plus proteinuria. The patient denies any previous history of hypertension, seizures, headache, visual disturbances or spotting. On examination, blood pressure is 150/98. The fundal height is 32 cm, the uterus is soft and nontender and fetal heart tones are 160 bpm. DTRs are 4 plus out of 4 plus in the upper and lower extremities, and there is moderate pedal edema bilaterally. The skin examination is unremarkable. Based upon these findings what is the most likely diagnosis? A. Eclampsia B. Pre-eclampsia C. Gestational hypertension D. HELLP Syndrome - CORRECT ANSWER ✅ (u) A. Eclampsia is the occurrence of seizures in a pre-eclamptic patient. CORRECT: B. Pre-eclampsia is the hypertension associated with proteinuria. This occurs in greater frequency in nulliparous,
Answers 2025
D. Corticosteroids - CORRECT ANSWER ✅ (u) A. With premature rupture of the membranes, the patient is at risk for the development of amnionitis. CORRECT: B. Since the patient is 36 weeks gestation and it has been greater than 12 hours since the leakage of fluid, labor should be induced to minimize infection. (u) C. If the patient was less than 33 weeks pregnant and amnionitis had been ruled out, then antibiotics along with corticosteroids would be advisable. Favorable outcomes utilizing both of these drugs have been demonstrated. In the treatment of endometriosis, which of the following medications has a side effect profile that includes loss of bone mineral density, vasomotor symptoms, vaginal dryness and mood changes? A. Oral contraceptives B. Dantrolene (Danazol) C. Leuprolide (Lupron) D. Progestational agents - CORRECT ANSWER ✅ (u) A. Oral contraceptives, dantrolene, and progestational agents do not have this side effect profile. (u) B. See A for explanation. CORRECT: C. Leuprolide is a gonadotropin releasing hormone analogue that results in suppression of gonadotropic
Answers 2025
secretion. This suppression leads to a hypoestrogenic state which contributes to these side effects. A 28 year-old woman is complaining of heavy uterine bleeding and pelvic pressure that has progressively worsened over the past year. Evaluation reveals multiple moderate-sized uterine fibroids. The patient desires to have more children. The most appropriate definitive treatment is A. Myomectomy. B. Hysterectomy. C. GnRH agonists. D. Oral progesterone. - CORRECT ANSWER ✅ CORRECT: A. Myomectomy is the definitive treatment of choice for moderate-sized uterine fibroids in young women who desire to maintain reproductive capability. (u) B. Hysterectomy is indicated as definitive treatment in a patient who does not desire to maintain reproductive capability. (u) C. GnRH agonists are used as an adjunct to surgery for treatment of uterine fibroids. Used alone, they would not be considered definitive treatment. (u) D. Oral progesterone may be used to suppress menorrhagia preoperatively. Used alone, it would not be considered definitive treatment.
