NCCPA Obstetrics and Gynecology 2

Question 1

A 38-year-old woman presents with irregular periods, hirsutism, acne, and difficulty conceiving.
Transvaginal ultrasound shows bilateral enlarged ovaries with 12 or more peripheral follicles each.
LH:FSH ratio is elevated.
What is the most likely diagnosis?

Accepted Answer

Polycystic ovary syndrome (PCOS)

Answer

Hypothyroidism

Answer

Hyperprolactinemia

Answer

Premature ovarian insufficiency

Question 2

A 29-year-old woman presents with cyclic pelvic pain that worsens just before and during menstruation, dyspareunia, and dyschezia. She has been trying to conceive for 18 months. The most appropriate initial diagnostic tool is:

Accepted Answer

Diagnostic laparoscopy

Answer

MRI of the pelvis

Answer

Transvaginal ultrasound

Answer

CA-125 level

Question 3

According to USPSTF guidelines, at what age should average-risk women begin cervical cancer screening with Pap smear alone?

Accepted Answer

21 years

Answer

18 years

Answer

25 years

Answer

30 years

Question 4

A 55-year-old postmenopausal woman presents with hot flashes, vaginal dryness, and mood changes. She has no personal or family history of breast cancer or VTE. What is the most appropriate management for her vasomotor symptoms?

Accepted Answer

Systemic hormone replacement therapy (HRT)

Answer

Selective serotonin reuptake inhibitor (SSRI)

Answer

Ospemifene

Answer

Medroxyprogesterone acetate alone

Question 5

A 22-year-old woman presents with lower abdominal pain, fever (38.4°C), cervical motion tenderness, and mucopurulent cervical discharge. The most appropriate treatment regimen for outpatient management is:

Accepted Answer

IM ceftriaxone 500 mg once plus oral doxycycline 100 mg BID × 14 days with metronidazole 500 mg BID × 14 days

Answer

Oral doxycycline 100 mg BID × 14 days alone

Answer

IV clindamycin and gentamicin

Answer

Oral azithromycin 1 g once plus levofloxacin

Question 6

A 45-year-old woman presents with menorrhagia and pelvic pressure. Pelvic exam reveals an enlarged, irregularly shaped uterus. Transvaginal ultrasound shows multiple well-defined hypoechoic masses within the myometrium. What is the most likely diagnosis?

Accepted Answer

Uterine leiomyomas (fibroids)

Answer

Endometrial polyps

Answer

Ovarian fibromas

Answer

Adenomyosis

Question 7

A 34-year-old G3P2 woman is found on routine prenatal ultrasound at 20 weeks to have a placenta that overlies the internal cervical os. She is asymptomatic. What is the recommended management?

Accepted Answer

Repeat transvaginal ultrasound at 28–32 weeks

Answer

Immediate cesarean delivery

Answer

Vaginal delivery with continuous fetal monitoring

Answer

Cervical cerclage placement