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

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

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

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

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

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

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

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.

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

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.

APEA - Advanced Practice Education Associates Practice Test

APEA - Advanced Practice Education Associates Practice Test

APEA Women's Health and Reproductive Medicine