NCCPA Obstetrics and Gynecology 3

Question 1

A 24-year-old woman with a history of chlamydia presents with right upper quadrant pain, fever, and cervical motion tenderness. Liver function tests are mildly elevated. What is the most likely diagnosis?

Accepted Answer

Fitz-Hugh–Curtis syndrome

Answer

Fitz-Hugh–Curtis syndrome is perihepatitis secondary to PID (most commonly Chlamydia trachomatis or Neisseria gonorrhoeae) that causes right upper quadrant pain and perihepatic adhesions alongside signs of pelvic infection.

Question 2

A 30-year-old woman at 32 weeks gestation presents with painful uterine contractions every 5 minutes, back pain, and a small amount of vaginal bleeding. Cervical exam shows 2 cm dilation. She denies rupture of membranes. What is the most appropriate initial pharmacological intervention?

Accepted Answer

Administer IV magnesium sulfate for neuroprotection and betamethasone for fetal lung maturity

Answer

At 32 weeks with preterm labor, both antenatal corticosteroids (betamethasone) to accelerate fetal lung maturity and magnesium sulfate for neonatal neuroprotection are indicated; tocolytics may provide time for these agents to act.

Question 3

A 27-year-old woman at 38 weeks gestation with chronic hypertension suddenly develops severe, continuous abdominal pain and a board-like rigid uterus. Fetal heart monitoring shows late decelerations. There is dark vaginal bleeding. What is the most likely diagnosis?

Accepted Answer

Placental abruption

Answer

Placental abruption classically presents with sudden painful vaginal bleeding, a rigid tender uterus, and fetal distress; it is associated with hypertension, trauma, and cocaine use.

Question 4

A 36-year-old nulliparous woman desires long-term contraception. She has a history of migraines with aura and hypertension. Which contraceptive method is safest for her?

Accepted Answer

Levonorgestrel intrauterine device (LNG-IUD)

Answer

Estrogen-containing contraceptives are contraindicated (WHO Category 4) in women with migraines with aura due to increased stroke risk; a progestin-only LNG-IUD is safe and highly effective.

Question 5

According to USPSTF guidelines, women with average risk should begin mammography breast cancer screening at what age?

Accepted Answer

40 years

Answer

The 2024 USPSTF recommendation states that average-risk women should begin biennial mammography screening at age 40 to reduce breast cancer mortality.

(NCCPA) National Commission on Certification of Physician Assistants Practice Test

(NCCPA) National Commission on Certification of Physician Assistants Practice Test

NCCPA Obstetrics and Gynecology 3