Deck 1: Womens Health and Reproductive Medicine

Question 1

What are the criteria used to make a diagnosis of bacterial vaginosis?

A)Clue cells on microscopic examination of wet mount, the presence of an amine odor when vaginal discharge is mixed with KOH 10%, an increased amount of white, homogeneous vaginal discharge and a vaginal pH of >4.5
B)Clue cells on microscopic examination of wet mount, the presence of an amine odor when vaginal discharge is mixed with KOH 10%, an increased amount of white, homogeneous vaginal discharge and a vaginal pH of <4.5
C)Hyphae on microscopic examination of wet mount, the absence of an amine odor when vaginal discharge is mixed with KOH 10%, an increased amount of white, clumpy vaginal discharge, and a vaginal pH of <4.5

Answer 1

Clue cells on microscopic examination of wet mount, the presence of an amine odor when vaginal discharge is mixed with KOH 10%, an increased amount of white, homogeneous vaginal discharge and a vaginal pH of >4.5

Question 2

Maternal emotional lability at five days postpartum, without other psychological symptoms, is most indicative of:

A)Postpartum blues
B)Postpartum depression
C)Postpartum psychosis

Answer 2

Postpartum blues

Question 3

What is the ASCCP recommended management for an ASCUS (atypical squamous cells of undetermined significance) pap result with a positive high risk HPV 16 cotest in a 26 year old woman without a history of abnormal pap smears?

A)Colposcopy
B)LEEP (loop electrosurgical excision procedure)
C)Repeat pap and HPV cotesting in one year

Answer 3

Colposcopy

Question 4

On clinical exam, you detect a 2cm x 1cm non-tender, smooth, round, rubbery, mobile mass in the upper outer quadrant of your 32 year-old nulligravid patient's right breast. This mass is most likely:

A)Cancer
B)Clogged duct
C)Fibroadenoma

Question 5

Which of the following HPV protocols is correct?

A)Boys and girls age 9-14 should receive three doses of 9-valent HPV vaccine (Gardasil 9) six to twelve months apart
B)Boys and girls age 9-14 should receive two doses of 9-valent HPV vaccine (Gardasil 9) six to twelve months apart
C)Boys and girls should not receive 9-valent HPV vaccine (Gardasil 9) until age 15

Question 6

The most significant risk factor for postpartum depression is:

A)Cesarean delivery
B)History of depression or anxiety
C)Unplanned pregnancy

Question 7

According to the WHO Medical Eligibility Criteria for Contraceptive Use, which of the following contraceptive methods should not be used by a patient with an acute DVT?

A)Combined oral contraceptives
B)Copper IUD (Paragard)
C)Implant (Nexplanon)

Question 8

Which class of anti-hypertensive medications is least likely to be effective for a 53 year old African American woman with chronic hypertension?

A)ACE inhibitors
B)Beta-blockers
C)Calcium channel blockers

Question 9

Which of the following is not a risk factor for gestational diabetes (GDM)?

A)Age < 25 years
B)American Indian race
C)Family history of diabetes

Question 10

A pregnant patient with sickle cell trait is at increased risk for:

A)Asymptomatic bacteriuria
B)Postpartum hemorrhage
C)Sickle cell crisis

Question 11

When hormone therapy is prescribed for menopausal symptoms:

A)It must be used for at least three months before effectiveness can be determined
B)It should be prescribed at the lowest effective dose for the shortest period of time necessary
C)It should be prescribed for no more than five years

Question 12

Poor dental hygiene in pregnancy is correlated with:

A)Bulimia
B)Increased risk for gestational diabetes
C)Increased risk for pre-term delivery

Question 13

The HPV vaccine (Gardasil 9) is indicated for:

A)All children and adults aged 9-26
B)Boys and men aged 9-26
C)Girls and women aged 9-26

Question 14

The risks of dilantin use in pregnancy include:

A)Fetal craniofacial anomalies
B)Fetal neural tube defects
C)Fetal skeletal defects

Question 15

Which ethnic groups have an increased risk for Tay-Sach's disease?

A)Ashkenazi Jewish, French Canadian and Cajun
B)Ashkenazi Jewish, Sephardic Jewish and French Canadian
C)Sephardic Jewish, French Canadian and Cajun

Question 16

Which procedure is initially indicated for a woman over age 35 with intermenstrual bleeding?

A)Dilation and curettage (D&C)
B)Endometrial biopsy
C)MRI

Question 17

What is the recommended daily calcium intake for a postmenopausal woman?

A)1000mg
B)1200mg
C)1300mg

Question 18

Which sexually transmitted infection is most likely with the finding of a single, painless, indurated lesion on the labia?

A)HPV (human papilloma virus)
B)HSV (herpes simplex virus)
C)Syphilis

Question 19

At what point can a woman discontinue routine cervical cancer screening?

A)At age 65 if her pap smear is normal and she has no new sexual partners
B)At age 65 if she has adequate negative cervical cancer screening and no CIN2+ within the past 20 years
C)At age 65 regardless of her sexual and cervical cancer screening histories

Question 20

Routine preconception care and counseling include all of the following except:

A)Recommendation and testing for diabetes
B)Recommendation for testing for rubella and varicella immunity
C)Recommendation to initiate or continue prenatal vitamins with folic acid and DHA

Question 21

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

A)Klonopin (clonazepam)
B)Wellbutrin (bupropion)
C)Zoloft (sertraline)

Question 22

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

A)Routine bone density testing should be started at age 50.
B)Routine bone density testing should be started at age 65.
C)Routine bone density testing should be started at the time of menopause.

Question 23

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

A)At both the first prenatal visit and at 36 weeks' gestation
B)At the first prenatal visit
C)At 36 weeks' gestation

Question 24

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

A)Having private, commercial insurance
B)Initiation of prenatal care after the first trimester
C)Single marital status

Question 25

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

A)Cardiovascular disease
B)Kidney disease
C)Liver disease

Question 26

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:

A)At least three months prior to conception
B)When it is prescribed at her first prenatal visit
C)Within a week of having a positive pregnancy test

Question 27

The increasing incidence of oropharyngeal cancers is primarily due to:

A)Environmental pollutants
B)HPV (human papilloma virus)
C)Smoking

Question 28

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

A)Aldara (imiquimod)
B)TCA (trichloroacetic acid)
C)Zovirax (acyclovir)

Question 29

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

A)Diclegis (doxylamine/pyridoxine)
B)Reglan (metoclopramide)
C)Zofran (ondansetron)

Question 30

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?

A)Colposcopy
B)Repeat pap and HPV cotesting in one year
C)Repeat pap and HPV cotesting in three years

Question 31

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

A)Bioidentical hormones would be safest since they contain no synthetic estrogen
B)Hormone therapy has risks and benefits which must be weighed in her situation
C)She is too old to take hormone therapy safely

Question 32

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

A)Combined oral contraceptives
B)Copper IUD (Paragard)
C)Depo-Provera

Question 33

Which test is the gold standard for diabetic screening?

A)FBS (fasting blood sugar)
B)HgbA1C (glycosylated hemoglobin)
C)2-hour glucose tolerance test

Question 34

What pelvic exam finding is pathognomonic for trichomonas infection?

A)Cervical motion tenderness
B)Mucopurulent cervical discharge
C)Strawberry cervix

Question 35

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

A)Alcohol use
B)Family history of GERD
C)Obesity

Question 36

Which of the following is a maternal benefit of breastfeeding?

A)Reduced risk of cardiovascular disease
B)Reduced risk of diabetes
C)Reduced risk of uterine cancer

Question 37

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

A)Dysmenorrhea
B)Irregular menses
C)Menarche after age 16

Question 38

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

A)Endometriosis
B)History of OCP (oral contraceptive pill) use
C)History of PID (pelvic inflammatory disease)

Question 39

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

A)Diabetes
B)Hypertension
C)Multiple sclerosis

Question 40

Nausea and vomiting of pregnancy most typically resolves at:

A)8-10 weeks' gestation
B)18-20 weeks' gestation
C)12-14 weeks' gestation

Question 41

Lead testing is recommended for:

A)All pregnant women
B)Pregnant women who have pica (eating non-food substances)
C)Pregnant women with a history of anemia

Question 42

Which chronic condition falsely elevates glycosylated hemoglobin (HgbA1C) levels?

A)Diabetes
B)Hypertension
C)Iron-deficiency anemia

Question 43

Intimate partner violence is:

A)Equally as common in lesbian relationships as in heterosexual relationships
B)Less common in lesbian relationships than in heterosexual relationships
C)More common in lesbian relationships than in heterosexual relationships

Question 44

Hepatitis C screening is recommended for:

A)All pregnant women regardless of risk
B)All women born between 1945 and 1965
C)All women regardless of risk and age

Question 45

The CDC recommends HIV screening for:

A)All patients aged 13 to 64 in all health care settings
B)All patients aged 13 to 64 who are at increased risk for HIV
C)All patients aged 13 to 64 who are sexually active

Question 46

The leading cause of death in women age 65 and over is:

A)Cancer
B)Heart disease
C)Pneumonia

Question 47

Which vaccine is safe for use in pregnancy?

A)Live attenuated nasal flu vaccine
B)Rubella
C)Tdap

Question 48

Which is an effective treatment for primary dysmenorrhea?

A)Aspirin
B)Copper IUD
C)NSAIDS (non-steroidal anti-inflammatory drugs)

Question 49

Which set of lab results would indicate hypothyroidism?

A)Decreased TSH, increased FT4
B)Increased TSH, decreased FT4
C)Increased TSH, increased FT4

Question 50

What is your most likely diagnosis in a postpartum patient with fever, uterine subinvolution, flu-like symptoms, pelvic pain and foul smelling lochia?

A)Endometritis
B)Trichomonas
C)UTI (urinary tract infection)