Question 1

Which medication is the drug of choice for use by a woman with postpartum depression who is breastfeeding?

Accepted Answer

Sertraline is the drug of choice for use by a woman with postpartum depression who is breastfeeding. Klonopin is a benzodiazepine. Benzodiazepines may cause CNS depression in the breastfed infant. There is a risk of infant seizure associated with maternal use of bupropion while breastfeeding.

Question 2

Which of the following describes the recommendation for routine bone density testing in women?

Accepted Answer

Routine bone density testing should be started at age 65, as recommended by the National Osteoporosis Foundation and the United States Preventative Services Task Force.

Question 3

The CDC recommends routine GBS (group B strep) screening for pregnant women:

Accepted Answer

The CDC recommends routine GBS (group B strep) screening for pregnant women at 36 weeks' gestation. There is no indication for routine GBS screening prior to 36 weeks' gestation.

Question 4

Which factor is not associated with early cessation (by two weeks postpartum) of breastfeeding?

Accepted Answer

Having private, commercial insurance is not associated with early cessation of breastfeeding. Women who are single and women who initiate prenatal care in the second and third trimesters are more likely to discontinue breastfeeding within the first two weeks postpartum.

Question 5

Women with a history of preeclampsia in any pregnancy are at increased risk for:

Accepted Answer

Women with a history of preeclampsia are at increased risk for cardiovascular disease.

Question 6

In order to have the most significant impact on preventing neural tube defects, women who are pregnant or considering pregnancy should take a folic acid supplement starting at:

Accepted Answer

In order to have the most significant impact on preventing neural tube defects, women who are pregnant or considering pregnancy should take a folic acid supplement starting at least three months prior to conception. Waiting until pregnancy to start folic acid supplementation misses the window of neural tube development.

Question 7

The increasing incidence of oropharyngeal cancers is primarily due to:

Accepted Answer

The increasing incidence of oropharyngeal cancers is primarily due to HPV. As rates of smoking have declined, rates of oropharyngeal cancers related to smoking have declined. Environmental pollutants are not associated with oropharyngeal cancers.

Question 8

All of the following are indicated for the treatment of genital warts except:

Accepted Answer

Acyclovir is not indicated for the treatment of genital warts. The CDC recommends both Aldara and TCA for the treatment of genital warts. Acyclovir is indicated for the treatment of HSV (herpes simplex virus).

Question 9

Which of the following is the only category A drug indicated for the relief of nausea and vomiting in early pregnancy?

Accepted Answer

Diclegis is the only category A drug indicated for the relief of nausea and vomiting in early pregnancy. Zofran and reglan are both used in the treatment of nausea and vomiting in pregnancy, however, zofran and reglan are both category B drugs.

Question 10

What is the appropriate management of an ASCUS pap, negative for high risk HPV, found on cotesting in a 25 year old woman with no history of abnormal pap smears or HPV?

Accepted Answer

The appropriate management of an ASCUS pap, negative for high risk HPV, found on cotesting in a 25 year old woman with no history of abnormal pap smears or HPV is to repeat pap and HPV cotesting in three years. Women with this result have a 5-year CIN3+ risk of 0.59%.

Question 11

How would you best counsel a healthy 56 year old woman who presents with disruptive vasomotor symptoms and has questions about hormone therapy?

Accepted Answer

The best counseling for a healthy 56 year old woman who presents with disruptive vasomotor symptoms and has questions about hormone therapy is to explain that hormone therapy has risks and benefits which must be weighed in her situation. Bioidentical hormones are not standardized or regulated. As such, safety and efficacy have not been established. Her age alone does not prohibit the use of hormone therapy.

Question 12

Which is the safest contraceptive method for a woman with active breast cancer?

Accepted Answer

The Copper IUD is the safest contraceptive method for a woman with active breast cancer. According to the WHO Medical Eligibility Criteria for Contraceptive Use, neither combined oral contraceptives nor Depo-Provera should be initiated or continued in a woman with active breast cancer.

Question 13

Which test is the gold standard for diabetic screening?

Accepted Answer

The gold standard test for diabetic screening is a fasting blood sugar. HgbA1C is often used to diagnose diabetes, but it is less sensitive than a fasting blood sugar. A 2-hour glucose tolerance test has no place in the diagnosis of diabetes.

Question 14

What pelvic exam finding is pathognomonic for trichomonas infection?

Accepted Answer

A strawberry cervix is a pathognomonic pelvic exam finding for trichomonas infection. Cervical motion tenderness might indicate pelvic inflammatory disease or ectopic pregnancy. Mucopurulent cervical discharge might indicate gonorrhea, chlamydia or other cervical infection.

Question 15

Which of the following is not an established risk factor for GERD (gastroesophageal reflux disease)?

Accepted Answer

Family history of GERD is not an established risk factor for GERD. Both obesity and alcohol use are established risk factors for GERD.

Question 16

Which of the following is a maternal benefit of breastfeeding?

Accepted Answer

A maternal benefit of breastfeeding is a reduced risk of cardiovascular disease. Breastfeeding is not known to reduce the risk of diabetes or uterine cancer.

Question 17

A common finding in women with PCOS (polycystic ovarian syndrome) is:

Accepted Answer

A common finding in women with PCOS is irregular menses. Neither dysmenorrhea nor age of menarche are associated with PCOS.

Question 18

Which of the following are not associated with female factor infertility?

Accepted Answer

A history of OCP use is not associated with female factor infertility. Both a history of PID (secondary to scarring in the fallopian tubes) and endometriosis are associated with female factor infertility.

Question 19

Which of the following is a risk factor for vaginal yeast infection?

Accepted Answer

Diabetes is a risk factor for vaginal yeast infection due to increased blood sugar levels. Neither hypertension nor multiple sclerosis increase the risk of vaginal yeast infection.

Question 20

Nausea and vomiting of pregnancy most typically resolves at:

Accepted Answer

Nausea and vomiting of pregnancy most typically resolves at 12-14 weeks' gestation, as beta HCG levels decrease. Beta HCG is the cause of nausea and vomiting of pregnancy. Nausea and vomiting of pregnancy is typically most severe around 10 weeks' gestation, when beta HCG levels peak.

Quiz 1: Womens Health and Reproductive Medicine