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

Delivery of the fetus and placenta is the only definitive treatment for preeclampsia, as the placenta is the underlying cause.

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

Methotrexate is indicated for hemodynamically stable ectopic pregnancy with beta-hCG <5,000 mIU/mL and no fetal cardiac activity on ultrasound.

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

Uterine atony accounts for approximately 80% of postpartum hemorrhage cases and is the most common cause.

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

Diagnostic laparoscopy with histological confirmation of ectopic endometrial tissue is the gold standard for diagnosing endometriosis.

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

IV penicillin G is first-line intrapartum GBS prophylaxis, with ampicillin as an acceptable alternative.

COMLEX-USA Practice Test

COMLEX-USA Practice Test

COMLEX-USA Obstetrics and Gynecology