AANP Women's Health 1 — Questions and Answers
Question 1: A 25-year-old woman has a positive urine pregnancy test and unilateral pelvic pain with vaginal spotting. What must be ruled out first?
- Ovarian cyst
- Ectopic pregnancy (Correct answer)
- Miscarriage
- Appendicitis
Correct answer: Ectopic pregnancy
Unilateral pelvic pain with vaginal bleeding in early pregnancy is ectopic pregnancy until proven otherwise, as rupture can cause life-threatening hemorrhage.
Question 2: Which screening test is currently recommended for cervical cancer detection in average-risk women aged 21–29?
- Pap smear alone every 3 years (Correct answer)
- Co-testing (Pap + HPV) every 5 years
- HPV testing alone every 5 years
- Annual Pap smear
Correct answer: Pap smear alone every 3 years
Current USPSTF and ASCCP guidelines recommend Pap smear alone every 3 years for women aged 21–29; HPV co-testing is not recommended until age 30.
Question 3: A woman presents with cyclic pelvic pain, dysmenorrhea, and dyspareunia. Pelvic exam reveals a fixed, retroverted uterus. What is the most likely diagnosis?
- Uterine fibroids
- Endometriosis (Correct answer)
- Pelvic inflammatory disease
- Ovarian torsion
Correct answer: Endometriosis
Endometriosis classically causes cyclic pelvic pain, dysmenorrhea, dyspareunia, and can cause a fixed, retroverted uterus due to adhesions from ectopic endometrial tissue.
Question 4: Which medication is the recommended pharmacological treatment for postmenopausal osteoporosis prevention as first-line therapy?
- Calcitonin
- Bisphosphonates (e.g., alendronate) (Correct answer)
- Selective estrogen receptor modulators alone
- Teriparatide
Correct answer: Bisphosphonates (e.g., alendronate)
Bisphosphonates such as alendronate are the first-line pharmacological treatment for postmenopausal osteoporosis due to their proven efficacy in reducing fracture risk.
Question 5: The most common cause of vaginal discharge with a thin, gray, fishy-smelling discharge and clue cells on wet mount is:
- Trichomonas vaginalis
- Candida albicans
- Bacterial vaginosis (Correct answer)
- Chlamydia trachomatis
Correct answer: Bacterial vaginosis
Bacterial vaginosis is caused by an overgrowth of anaerobic bacteria, presenting with a fishy-smelling, thin gray discharge and clue cells (epithelial cells studded with bacteria).
Question 6: A woman at 10 weeks gestation reports heavy bleeding and passage of tissue. Ultrasound shows no intrauterine pregnancy. Quantitative hCG is falling. What type of miscarriage is this?
- Threatened abortion
- Inevitable abortion
- Incomplete abortion
- Complete abortion (Correct answer)
Correct answer: Complete abortion
A complete abortion is characterized by complete expulsion of all products of conception, confirmed by falling hCG and no intrauterine pregnancy on ultrasound.
AANP Women's Health 1
A 25-year-old woman has a positive urine pregnancy test and unilateral pelvic pain with vaginal spotting.
What must be ruled out first?