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

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

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

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

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

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

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

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

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

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

COMLEX-USA Practice Test

COMLEX-USA Practice Test

COMLEX-USA Obstetrics and Gynecology 2