Women's Health and Reproductive Medicine Flashcards

A 28-year-old woman presents with dysmenorrhea, dyspareunia, and infertility of 2 years. Pelvic exam reveals fixed, tender uterus with nodularity along the uterosacral ligaments. What is the most likely diagnosis?

Answer: Endometriosis

Endometriosis classically presents with the triad of dysmenorrhea, dyspareunia, and infertility, along with uterosacral nodularity and a fixed, retroverted uterus on exam.

Which medication is first-line for treatment of bacterial vaginosis in non-pregnant women?

Answer: Metronidazole 500 mg orally twice daily for 7 days

CDC guidelines recommend metronidazole 500 mg PO BID for 7 days or metronidazole gel 0.75% intravaginally as first-line treatment for bacterial vaginosis.

Which finding on pelvic exam and wet prep is most characteristic of Trichomonas vaginalis infection?

Answer: Frothy, yellow-green discharge with motile trichomonads on wet mount

Trichomonas vaginalis produces frothy, malodorous, yellow-green discharge and the classic 'strawberry cervix'; wet mount reveals motile pear-shaped trichomonads.

A 42-year-old woman presents with hot flashes, night sweats, and irregular periods over the past 8 months. FSH is 48 mIU/mL and estradiol is 28 pg/mL. What is the most appropriate diagnosis?

Answer: Perimenopause

Perimenopause is diagnosed clinically in women over 40 with vasomotor symptoms and irregular periods; elevated FSH confirms the hormonal transition but is not required for diagnosis.

Which contraceptive method is most strongly contraindicated in a woman with a history of deep vein thrombosis (DVT)?

Answer: Combined oral contraceptives containing estrogen

Estrogen-containing contraceptives increase the risk of thromboembolic events by activating clotting factors; combined oral contraceptives are a WHO MEC category 4 (unacceptable risk) in women with history of DVT.

A 25-year-old woman presents with acute severe pelvic pain, vaginal spotting, and nausea. Her last menstrual period was 7 weeks ago. Urine pregnancy test is positive and transvaginal ultrasound shows no intrauterine gestational sac. What is the priority diagnosis to rule out?

Answer: Ectopic pregnancy

A positive pregnancy test with no intrauterine gestational sac on ultrasound is an ectopic pregnancy until proven otherwise, as it is a life-threatening emergency if the tube ruptures.

According to the 2024 USPSTF updated recommendations, at what age should routine screening mammography begin for average-risk women?

Answer: 40 years

The 2024 USPSTF update changed the recommendation to begin biennial mammography screening at age 40 for all women at average risk, lowering from the previous 50-year threshold.