PANRE Obstetrics and Gynecology 2

Question 1

A 28-year-old G2P1 at 32 weeks gestation presents with sudden painless vaginal bleeding. Her uterus is soft and nontender. What is the most likely diagnosis?

Accepted Answer

Placenta previa

Answer

Painless vaginal bleeding with a soft, nontender uterus in the third trimester is the classic presentation of placenta previa.

Question 2

A 35-year-old woman with PCOS is anovulatory and desires conception. After lifestyle modification fails, what is the first-line pharmacologic ovulation induction agent?

Accepted Answer

Letrozole

Answer

Letrozole (an aromatase inhibitor) is now preferred over clomiphene as first-line ovulation induction in PCOS due to higher live birth rates.

Question 3

A 24-year-old presents with cyclic pelvic pain, dysmenorrhea, and dyspareunia. CA-125 is mildly elevated. What is the gold standard for diagnosis?

Accepted Answer

Diagnostic laparoscopy

Answer

Diagnostic laparoscopy with biopsy is the gold standard for diagnosing endometriosis, as imaging modalities cannot detect peritoneal implants reliably.

Question 4

Which fetal heart rate pattern is most concerning for uteroplacental insufficiency during labor?

Accepted Answer

Late decelerations

Answer

Late decelerations—nadir after the peak of a contraction—reflect uteroplacental insufficiency and fetal hypoxemia.

Question 5

A postmenopausal woman on tamoxifen for breast cancer presents with abnormal uterine bleeding. What is the most appropriate next step?

Accepted Answer

Endometrial biopsy

Answer

Any postmenopausal bleeding in a tamoxifen user warrants endometrial biopsy to rule out endometrial carcinoma, given tamoxifen's uterotrophic effects.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Obstetrics and Gynecology 2