COMLEX-USA Obstetrics and Gynecology 3

Question 1

A 21-year-old woman presents with vaginal itching, dysuria, and a frothy, malodorous yellow-green discharge. Wet prep shows motile pear-shaped organisms. What is the treatment of choice?

Accepted Answer

Metronidazole 2 g orally single dose

Answer

Trichomonas vaginalis infection is treated with single-dose oral metronidazole 2g, with concurrent partner treatment required.

Question 2

Electronic fetal monitoring at 38 weeks shows late decelerations after each contraction with absent variability and baseline FHR of 140 bpm. What is the most appropriate management?

Accepted Answer

Immediate cesarean delivery

Answer

Late decelerations with absent variability represent a Category III (ominous) fetal heart rate pattern requiring immediate delivery.

Question 3

A 19-year-old woman at 18 weeks gestation presents with painless cervical dilation to 4 cm and no uterine contractions. Membranes are intact. Which diagnosis is most likely?

Accepted Answer

Cervical insufficiency

Answer

Cervical insufficiency (incompetent cervix) presents with painless cervical dilation in the second trimester without uterine contractions.

Question 4

A 27-year-old woman at 10 weeks gestation has beta-hCG of 185,000 mIU/mL, vaginal bleeding, and a uterine ultrasound showing a 'snowstorm' appearance with no fetal parts. After uterine evacuation, what must be closely monitored?

Accepted Answer

Serial beta-hCG for gestational trophoblastic neoplasia

Answer

Complete hydatidiform moles require serial beta-hCG surveillance after evacuation because 15–20% progress to gestational trophoblastic neoplasia.

Question 5

A 55-year-old woman presents with abdominal bloating, early satiety, and increased girth for 3 months. CA-125 is 480 U/mL. CT shows bilateral adnexal masses with peritoneal implants. Which histological subtype of ovarian cancer is most common?

Accepted Answer

High-grade serous adenocarcinoma

Answer

High-grade serous adenocarcinoma accounts for approximately 70% of epithelial ovarian cancers and is the most common and deadly subtype.

COMLEX-USA Practice Test

COMLEX-USA Practice Test

COMLEX-USA Obstetrics and Gynecology 3