PANRE Obstetrics and Gynecology 4

Question 1

A 25-year-old woman presents with 7 weeks of amenorrhea, left lower quadrant pain, and vaginal spotting. Serum hCG is 2,200 mIU/mL and transvaginal ultrasound shows no intrauterine gestational sac. She is hemodynamically stable. What is the most appropriate management?

Accepted Answer

Methotrexate 50 mg/m² IM

Answer

A hemodynamically stable patient with a presumed unruptured ectopic pregnancy, hCG <5,000, and no contraindications is a candidate for medical management with methotrexate.

Question 2

Which maternal serum marker is characteristically low in trisomy 21 on second-trimester quad screening?

Accepted Answer

Unconjugated estriol

Answer

In Down syndrome, unconjugated estriol (uE3) is low, while hCG and inhibin A are elevated and AFP is low on quad screen.

Question 3

A 32-year-old G1P0 at 34 weeks is diagnosed with preterm premature rupture of membranes (PPROM). She is GBS-negative and has no signs of infection. What is the standard of care?

Accepted Answer

Expectant management with latency antibiotics and antenatal corticosteroids

Answer

PPROM between 34 and 36+6 weeks is managed expectantly with latency antibiotics and corticosteroids until delivery is indicated or spontaneous labor occurs.

Question 4

A 40-year-old woman has menorrhagia and a uterus enlarged to 12 weeks size with multiple fibroids. She has completed childbearing. She wants a definitive solution. What is the most appropriate option?

Accepted Answer

Hysterectomy

Answer

Hysterectomy is the definitive treatment for symptomatic uterine fibroids in a woman who has completed childbearing and wants no further pregnancies.

Question 5

A 19-year-old sexually active woman presents for her first gynecologic visit. According to current USPSTF guidelines, at what age should cervical cancer screening (Pap smear) begin?

Accepted Answer

Age 21

Answer

Current guidelines recommend beginning cervical cancer screening with cytology alone at age 21, regardless of sexual activity onset.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Obstetrics and Gynecology 4