SPEX Obstetrics and Gynecology 3

Question 1

A 24-year-old presents with secondary amenorrhea, galactorrhea, and headaches. Serum prolactin is 180 ng/mL. What is the most likely diagnosis?

Accepted Answer

Prolactinoma

Answer

Markedly elevated prolactin with galactorrhea, amenorrhea, and headaches (from mass effect) is classic for a prolactin-secreting pituitary adenoma (prolactinoma).

Question 2

During a routine gynecologic exam, a 45-year-old woman is found to have a vulvar lesion. Biopsy shows lichen sclerosus. Which is the first-line treatment?

Accepted Answer

High-potency topical corticosteroids

Answer

High-potency topical corticosteroids such as clobetasol propionate are the first-line treatment for lichen sclerosus, providing symptom relief and preventing disease progression.

Question 3

A 30-year-old woman with recurrent implantation failure is found to have a submucosal fibroid. What is the recommended treatment?

Accepted Answer

Hysteroscopic myomectomy

Answer

Hysteroscopic myomectomy is the preferred minimally invasive approach to remove submucosal fibroids that distort the uterine cavity and impair implantation.

Question 4

Which laboratory finding is most consistent with a diagnosis of HELLP syndrome?

Accepted Answer

Low platelets, elevated LDH, elevated liver enzymes

Answer

HELLP syndrome is defined by Hemolysis (elevated LDH), Elevated Liver enzymes (AST/ALT), and Low Platelets — a life-threatening complication of severe preeclampsia.

Question 5

A 22-year-old presents with acute pelvic pain, fever, cervical motion tenderness, and mucopurulent cervical discharge. What is the recommended outpatient antibiotic regimen?

Accepted Answer

Ceftriaxone IM plus doxycycline and metronidazole

Answer

CDC guidelines recommend ceftriaxone IM plus doxycycline with metronidazole for outpatient treatment of PID to cover gonorrhea, chlamydia, and anaerobes.

SPEX Exam Practice Test

SPEX Exam Practice Test

SPEX Obstetrics and Gynecology 3