APEA Women's Health and Reproductive Medicine 3

Question 1

According to current USPSTF guidelines, what is the recommended cervical cancer screening interval for a 32-year-old woman with a history of normal Pap smears who has never had an abnormal result?

Accepted Answer

Pap smear every 3 years OR co-testing (Pap + HPV) every 5 years

Answer

Annual Pap smear alone

Answer

Pap smear every 2 years

Answer

HPV testing alone every 3 years

Question 2

A pregnant woman at 28 weeks gestation is being evaluated for gestational diabetes. What is the standard initial screening test used in the United States?

Accepted Answer

1-hour 50 g non-fasting glucose challenge test

Answer

Fasting plasma glucose measured on 2 separate days

Answer

HbA1c level

Answer

2-hour 75 g fasting oral glucose tolerance test

Question 3

The Rotterdam criteria require at least 2 of 3 features to diagnose polycystic ovary syndrome. Which combination best reflects these diagnostic criteria?

Accepted Answer

Oligo- or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology on ultrasound

Answer

Elevated FSH, low LH, and bilateral ovarian cysts

Answer

Insulin resistance, obesity, and acne only

Answer

Normal androgens, irregular cycles, and hyperprolactinemia

Question 4

What is the most common cause of secondary amenorrhea (absence of menses for >3 months) in a reproductive-age woman who previously had regular cycles?

Accepted Answer

Pregnancy

Answer

Hypothyroidism

Answer

Hyperprolactinemia

Answer

Premature ovarian insufficiency

Question 5

A 23-year-old woman is diagnosed with chlamydial cervicitis and treated with azithromycin 1 g orally. Regarding her sexual partner, what is the most appropriate recommendation?

Accepted Answer

The partner should be treated simultaneously with the patient

Answer

The partner should be treated only if symptomatic

Answer

Partner treatment can wait until the patient completes therapy

Answer

Partner treatment is not required for chlamydia

Question 6

Which laboratory test is considered the best single marker for assessing ovarian reserve in a woman undergoing fertility evaluation?

Accepted Answer

Anti-Müllerian hormone (AMH)

Answer

Serum luteinizing hormone (LH) on day 3

Answer

Day 3 serum estradiol level

Answer

Serum testosterone level

Question 7

A 38-year-old woman presents with bilateral breast tenderness and nodularity that worsens before her period. Exam reveals diffuse fibrocystic changes without dominant mass, skin changes, or nipple discharge. What is the most appropriate initial management?

Accepted Answer

Reassurance, well-fitting supportive bra, and NSAIDs as needed for pain

Answer

Urgent bilateral breast biopsy of all palpable areas

Answer

Initiate tamoxifen prophylaxis immediately

Answer

Order bilateral mammogram and breast MRI simultaneously