COMLEX-USA Obstetrics and Gynecology 2

Question 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?

Accepted Answer

Laparoscopic detorsion

Answer

Right salpingo-oophorectomy

Answer

IV antibiotics and observation

Answer

Appendectomy

Question 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?

Accepted Answer

Prompt delivery regardless of gestational age

Answer

IV magnesium sulfate alone

Answer

Corticosteroids and delay delivery 48 hours

Answer

Plasma exchange transfusion

Question 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?

Accepted Answer

Endometrial biopsy

Answer

Repeat Pap smear

Answer

Colposcopy with biopsy

Answer

Pelvic MRI

Question 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?

Accepted Answer

Chlamydia trachomatis or Neisseria gonorrhoeae

Answer

Treponema pallidum

Answer

Gardnerella vaginalis

Answer

Trichomonas vaginalis

Question 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?

Accepted Answer

Indomethacin

Answer

Nifedipine

Answer

Magnesium sulfate

Answer

Subcutaneous terbutaline

Question 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?

Accepted Answer

Myomectomy

Answer

Total abdominal hysterectomy

Answer

Uterine artery embolization

Answer

Endometrial ablation

Question 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?

Accepted Answer

Menopause

Answer

Primary ovarian insufficiency

Answer

Hypothyroidism

Answer

Pituitary adenoma