APEA Women's Health and Reproductive Medicine 2

Question 1

A 26-year-old woman presents with vaginal pruritus, thick white cottage cheese-like discharge, and vulvar erythema. KOH prep shows budding hyphae. What is the most appropriate first-line treatment?

Accepted Answer

Oral fluconazole 150 mg once or topical azole for 3–7 days

Answer

Metronidazole 500 mg PO BID for 7 days

Answer

Doxycycline 100 mg PO BID for 14 days

Answer

Clindamycin vaginal cream for 7 days

Question 2

A 29-year-old woman with PCOS who desires pregnancy has failed lifestyle modification for 6 months. Which medication is most appropriate as first-line pharmacotherapy to induce ovulation?

Accepted Answer

Clomiphene citrate

Answer

Metformin alone

Answer

Medroxyprogesterone acetate

Answer

Spironolactone

Question 3

Which histological type of cervical cancer is most commonly associated with high-risk HPV infection?

Accepted Answer

Squamous cell carcinoma

Answer

Adenocarcinoma

Answer

Small cell neuroendocrine carcinoma

Answer

Clear cell carcinoma

Question 4

A 55-year-old postmenopausal woman presents with unexpected vaginal bleeding that started 2 weeks ago. She has no prior history of hormone therapy. What is the most critical next step in management?

Accepted Answer

Order pelvic ultrasound and perform endometrial biopsy

Answer

Reassure the patient and schedule a follow-up in 6 months

Answer

Prescribe topical estrogen cream and re-evaluate in 3 months

Answer

Initiate systemic hormone replacement therapy

Question 5

Which Bethesda System classification corresponds to cervical intraepithelial neoplasia grade 1 (CIN 1) on Pap smear cytology?

Accepted Answer

Low-grade squamous intraepithelial lesion (LSIL)

Answer

Atypical squamous cells of undetermined significance (ASC-US)

Answer

High-grade squamous intraepithelial lesion (HSIL)

Answer

Atypical squamous cells, cannot exclude HSIL (ASC-H)

Question 6

A 24-year-old woman is diagnosed with an unruptured tubal ectopic pregnancy at 6 weeks. She is hemodynamically stable, hCG is 1,800 mIU/mL, and the gestational sac measures 2.5 cm. Which treatment is most appropriate?

Accepted Answer

Methotrexate 50 mg/m² intramuscularly

Answer

Expectant management only

Answer

Mifepristone 600 mg orally

Answer

Emergency salpingectomy

Question 7

A 30-year-old woman with well-controlled hypertension desires reliable contraception. She is a non-smoker with no personal history of thromboembolic disease. Which contraceptive option is most appropriate?

Accepted Answer

Levonorgestrel-releasing IUD (Mirena)

Answer

Combined oral contraceptive pill

Answer

Contraceptive patch (Xulane)

Answer

Combined hormonal vaginal ring (NuvaRing)