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Obstetrics and Gynecology Flashcards

7 cards from real SPEX practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Obstetrics and Gynecology flashcards as text

  1. A 40-year-old woman with stage IIIC endometrial cancer (papillary serous histology) is status post-hysterectomy. What adjuvant therapy is most appropriate?

    Answer: Chemotherapy plus external beam radiation

    High-risk endometrial cancer (papillary serous, stage IIIC) requires combination chemotherapy (carboplatin/paclitaxel) and radiation therapy to address both systemic and locoregional disease.

  2. A 17-year-old presents with cyclic pelvic pain, a normal pelvic exam, and MRI showing a hematocolpos with absent vaginal lumen. What is the diagnosis?

    Answer: Transverse vaginal septum

    A transverse vaginal septum causes outflow obstruction with hematocolpos; unlike imperforate hymen, the external genitalia appear normal and the obstruction is at a higher level.

  3. A 29-year-old with known endometriosis has a right ovarian cyst measuring 5 cm with 'ground glass' echotexture on ultrasound. CA-125 is 45 U/mL. What is the most appropriate management?

    Answer: Laparoscopic cystectomy

    An endometrioma ≥4 cm in a patient planning fertility or with symptoms should be managed with laparoscopic cystectomy, which is superior to drainage or aspiration.

  4. A patient at 26 weeks is diagnosed with a cervical length of 1.8 cm on transvaginal ultrasound and has a prior preterm birth. Which intervention has the strongest evidence for reducing recurrent preterm birth?

    Answer: Vaginal progesterone

    Vaginal progesterone is recommended for asymptomatic women with a short cervix (≤25 mm) on ultrasound to reduce the risk of preterm birth.

  5. Which HPV genotype combination accounts for the majority of cervical cancer cases?

    Answer: HPV 16 and 18

    HPV 16 and 18 together cause approximately 70% of all cervical cancers, with HPV 16 being more associated with squamous cell carcinoma and HPV 18 with adenocarcinoma.

  6. A 34-year-old presents 6 weeks postpartum with persistent sadness, inability to care for her newborn, insomnia, and thoughts of harming herself. What is the diagnosis?

    Answer: Postpartum depression

    Postpartum depression presents beyond 2 weeks postpartum with depressive symptoms impacting function; suicidal ideation requires urgent evaluation and treatment with SSRIs ± therapy.

  7. A 62-year-old with vulvar squamous cell carcinoma has a 2.5 cm lesion confined to the vulva with 6 mm stromal invasion and no groin lymphadenopathy. What is the appropriate surgical management?

    Answer: Radical wide local excision with ipsilateral sentinel lymph node biopsy

    For vulvar cancers with >1 mm invasion, radical excision is required; sentinel lymph node biopsy (ipsilateral for lateralized lesions) has replaced full groin dissection to reduce morbidity.