APEA Women's Health and Reproductive Medicine

Question 1

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?

Accepted Answer

Endometriosis

Answer

Polycystic ovary syndrome

Answer

Uterine fibroids

Answer

Ovarian torsion

Question 2

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

Accepted Answer

Metronidazole 500 mg orally twice daily for 7 days

Answer

Fluconazole 150 mg orally once

Answer

Azithromycin 1 g orally once

Answer

Doxycycline 100 mg twice daily for 7 days

Question 3

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

Accepted Answer

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

Answer

Thin, gray, homogeneous discharge with positive whiff test

Answer

Thick, white, cottage cheese-like discharge with pseudohyphae

Answer

Mucopurulent cervical discharge with polymorphonuclear cells

Question 4

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?

Accepted Answer

Perimenopause

Answer

Primary hypothyroidism

Answer

Premature ovarian insufficiency

Answer

Hyperprolactinemia

Question 5

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

Accepted Answer

Combined oral contraceptives containing estrogen

Answer

Progestin-only pills (mini-pill)

Answer

Levonorgestrel-releasing IUD

Answer

Copper intrauterine device

Question 6

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?

Accepted Answer

Ectopic pregnancy

Answer

Ovarian torsion

Answer

Ruptured hemorrhagic cyst

Answer

Appendicitis

Question 7

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

Accepted Answer

40 years

Answer

45 years

Answer

50 years

Answer

35 years