AANP Women's Health 2 — Questions and Answers
Question 1: Which contraceptive method has the highest typical-use failure rate?
- Intrauterine device (IUD)
- Depot medroxyprogesterone acetate (DMPA)
- Male condoms (Correct answer)
- Combined oral contraceptive pills
Correct answer: Male condoms
Male condoms have a typical-use failure rate of approximately 13–18% due to inconsistent or incorrect use, compared to less than 1% for IUDs.
Question 2: A 35-year-old woman who smokes more than 15 cigarettes per day asks about oral contraceptives. What is the appropriate response?
- Prescribe combined oral contraceptives with close monitoring
- Prescribe progestin-only pills as a safer alternative (Correct answer)
- Combined OCP is safe in smokers under age 40
- No contraception is needed as risk is minimal
Correct answer: Prescribe progestin-only pills as a safer alternative
Women over 35 who smoke have a significantly increased risk of thromboembolic events with estrogen-containing contraceptives; progestin-only methods are a safer alternative.
Question 3: A pregnant woman at 28 weeks with no blood type antibodies has Rh-negative blood. What intervention is indicated?
- No treatment needed until delivery
- Rh immunoglobulin (RhoGAM) injection now and after delivery (Correct answer)
- Transfusion of Rh-positive blood to induce tolerance
- Amniocentesis to determine fetal blood type
Correct answer: Rh immunoglobulin (RhoGAM) injection now and after delivery
Rh-negative women receive RhoGAM at 28 weeks and again within 72 hours of delivery to prevent sensitization that could cause hemolytic disease in future Rh-positive fetuses.
Question 4: Which diagnostic test is the gold standard for diagnosing endometriosis?
- Transvaginal ultrasound
- MRI of the pelvis
- Serum CA-125 level
- Laparoscopy with biopsy (Correct answer)
Correct answer: Laparoscopy with biopsy
Laparoscopy with direct visualization and biopsy of ectopic endometrial implants remains the gold standard for definitive diagnosis of endometriosis.
Question 5: A woman reports galactorrhea and amenorrhea. What is the most important initial laboratory test?
- FSH and LH levels
- Serum prolactin level (Correct answer)
- TSH and free T4
- Beta-hCG
Correct answer: Serum prolactin level
Galactorrhea with amenorrhea strongly suggests hyperprolactinemia; serum prolactin is the initial test, and an elevated level warrants pituitary imaging to rule out prolactinoma.
Question 6: Which USPSTF-recommended screening is appropriate for a 40-year-old average-risk woman with no family history of breast cancer?
- Annual mammogram starting at age 40
- Biennial mammogram starting at age 40 (Correct answer)
- Mammogram starting at age 50 only
- No screening until age 50 per USPSTF 2024 guidelines
Correct answer: Biennial mammogram starting at age 40
The 2024 USPSTF guidelines recommend that average-risk women begin biennial mammography screening at age 40, updated from the prior recommendation of age 50.
AANP Women's Health 2
Which contraceptive method has the highest typical-use failure rate?