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Obstetrics and Gynecology Flashcards

7 cards from real COMLEX-USA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 16-year-old girl has sudden onset severe right lower quadrant pain, nausea, and vomiting. Ultrasound shows an enlarged right ovary (6 cm) with absent Doppler blood flow. Which intervention is most appropriate?

    Answer: Laparoscopic detorsion

    Ovarian torsion requires urgent laparoscopic detorsion to restore blood flow; oophorectomy is reserved for clearly non-viable ovaries.

  2. A woman at 34 weeks gestation has platelet count 68,000/μL, AST 210 U/L, elevated LDH, and severe headache. HELLP syndrome is diagnosed. What is the most critical next step?

    Answer: Prompt delivery regardless of gestational age

    HELLP syndrome is a life-threatening variant of severe preeclampsia; delivery is the definitive and required treatment regardless of gestational age.

  3. A 50-year-old postmenopausal woman presents with vaginal bleeding. Transvaginal ultrasound shows an endometrial stripe of 6 mm. What is the next step in evaluation?

    Answer: Endometrial biopsy

    Postmenopausal bleeding with endometrial stripe ≥5 mm requires endometrial biopsy to exclude endometrial carcinoma.

  4. A 22-year-old sexually active woman has lower abdominal pain, cervical motion tenderness, uterine tenderness, and mucopurulent cervical discharge with temperature of 38.3°C. Which organism is most likely responsible?

    Answer: Chlamydia trachomatis or Neisseria gonorrhoeae

    Pelvic inflammatory disease is most commonly caused by ascending infection from Chlamydia trachomatis and/or Neisseria gonorrhoeae.

  5. A 29-year-old woman at 33 weeks gestation has regular uterine contractions with cervical dilation of 2 cm. Which tocolytic agent is CONTRAINDICATED at this gestational age?

    Answer: Indomethacin

    Indomethacin is contraindicated after 32 weeks gestation due to risk of premature closure of the ductus arteriosus and fetal renal impairment.

  6. A 45-year-old woman has heavy menstrual bleeding, urinary frequency, and a 14-week-size uterus on exam. Ultrasound confirms multiple intramural fibroids. She wishes to maintain fertility. What is the most appropriate surgical treatment?

    Answer: Myomectomy

    Myomectomy removes fibroids while preserving the uterus and is the preferred surgical option for women who desire future fertility.

  7. A 50-year-old woman reports 9 months of hot flashes, night sweats, and vaginal dryness. FSH is 58 mIU/mL and estradiol is 12 pg/mL. She has had no menses for 13 months. What is the diagnosis?

    Answer: Menopause

    Menopause is defined as 12 consecutive months of amenorrhea with elevated FSH (>40 mIU/mL) and low estradiol in a woman typically over 45 years.