COMLEX-USA Obstetrics and Gynecology

Question 1

A 28-year-old woman at 38 weeks gestation presents with severe headache, visual disturbances, and blood pressure of 158/105 mmHg.
Urine dipstick shows 3+ proteinuria.
Which is the definitive treatment?

Accepted Answer

Delivery of the fetus

Answer

IV labetalol

Answer

Magnesium sulfate

Answer

Oral nifedipine

Question 2

A 24-year-old woman presents with 6 weeks of amenorrhea, vaginal bleeding, and left lower quadrant pain. Beta-hCG is 1,500 mIU/mL and transvaginal ultrasound shows no intrauterine gestational sac. She is hemodynamically stable. Which is the most appropriate management?

Accepted Answer

Methotrexate administration

Answer

Expectant management alone

Answer

Dilation and curettage

Answer

Immediate laparotomy

Question 3

A nulliparous woman delivers vaginally at term and has 700 mL of blood loss within the first hour after placental delivery. The uterus is boggy on exam. What is the most common cause of this complication?

Accepted Answer

Uterine atony

Answer

Retained placental fragments

Answer

Cervical laceration

Answer

Coagulopathy

Question 4

A 32-year-old nulliparous woman presents with cyclic pelvic pain, progressive dysmenorrhea, and dyspareunia. CA-125 is mildly elevated. What is the gold standard for diagnosis?

Accepted Answer

Diagnostic laparoscopy with biopsy

Answer

Transvaginal ultrasound

Answer

MRI of the pelvis

Answer

Endometrial biopsy

Question 5

A 36-week pregnant woman has a positive Group B Streptococcus vaginal-rectal culture. Which antibiotic should be administered intrapartum for prophylaxis?

Accepted Answer

IV penicillin G or ampicillin

Answer

Oral clindamycin

Answer

IV erythromycin

Answer

IV vancomycin

Question 6

A 26-year-old woman has irregular periods, hirsutism, and obesity. Transvaginal ultrasound shows bilateral ovaries with 14 follicles each (< 10 mm). Testosterone is mildly elevated. What is the most likely diagnosis?

Accepted Answer

Polycystic ovary syndrome

Answer

Hypothyroidism

Answer

Cushing syndrome

Answer

Congenital adrenal hyperplasia

Question 7

A 34-year-old woman at 30 weeks gestation has painless vaginal bleeding. Ultrasound shows the placenta completely covering the internal cervical os. She is currently stable. What is the most appropriate management?

Accepted Answer

Pelvic rest, hospitalization, and planned delivery at 36–37 weeks

Answer

Immediate cesarean section

Answer

Amniocentesis for fetal lung maturity

Answer

Vaginal delivery with oxytocin augmentation