Introduction to Gynecology 1 and 2
exam with correct answers all on point
A 28-year-old woman presents with a 4-month history of abnormal uterine bleeding. She
reports heavy menstrual periods lasting 10 days and spotting between periods. Her last
menstrual period was 2 weeks ago. On physical examination, the uterus is firm,
enlarged and irregular shaped. Which of the following is the most likely diagnosis?
Endometrial carcinoma
Endometrial hyperplasia
Polycystic ovary syndrome (PCOS)
Uterine fibroids
Adenomyosis - ✔️✔️correct answer-Uterine fibroids is the correct answer. Uterine
fibroids (leiomyomas) are benign smooth muscle tumors of the uterus that can cause
heavy menstrual bleeding, prolonged periods, and intermenstrual bleeding. An
enlarged, irregular uterus is characteristic of fibroids. Endometrial hyperplasia and
carcinoma typically present with postmenopausal bleeding. PCOS often presents with
irregular, infrequent periods and signs of hyperandrogenism. Adenomyosis can also
cause heavy menstrual bleeding and dysmenorrhea, but the uterus is usually uniformly
enlarged and boggy, not irregular.
Question 2
pts
A 32-year-old woman presents with acute pelvic pain, nausea, and vomiting. She has a
history of large ovarian cysts. On examination, she has tenderness in the right lower
quadrant and a palpable adnexal mass, she denies vaginal discharge. Her pregnancy
test is negative. Which of the following is the most likely diagnosis?
Pelvic inflammatory disease
Ectopic pregnancy
, Ovarian torsion
Acute appendicitis
Ruptured ovarian cyst - ✔️✔️correct answer-Ovarian torsion is the correct answer.
Ovarian torsion occurs when an ovary twists around the ligaments that support it,
cutting off its blood supply. This condition is associated with sudden, severe pelvic pain,
nausea, and vomiting. A palpable adnexal mass with these symptoms in a woman with
a history of ovarian cysts suggests ovarian torsion. Ectopic pregnancy would present
with a positive pregnancy test. Acute appendicitis would present with right lower
quadrant pain but not typically with an adnexal mass. Pelvic inflammatory disease
usually presents with bilateral pelvic pain and fever. A ruptured ovarian cyst would
present with sudden pain but without the adnexal mass and ongoing severe pain.
Question 3
pts
A 48-year-old woman presents with hot flashes, night sweats, and irregular menstrual
periods. She has no significant past medical history. Her last menstrual period was 8
months ago. Which of the following is the most appropriate next step in management?
Hormone replacement therapy
Pelvic MRI
Transvaginal ultrasound
Serum FSH level
Endometrial biopsy - ✔️✔️correct answer-Serum FSH level is the correct answer. In a
perimenopausal woman presenting with symptoms of menopause (hot flashes, night
sweats, irregular periods), measuring serum follicle-stimulating hormone (FSH) levels
can help confirm the diagnosis of menopause. Elevated FSH levels indicate decreased
ovarian function. A transvaginal ultrasound or endometrial biopsy would be indicated if
there were abnormal findings or risk factors for endometrial pathology. Hormone
replacement therapy may be considered after confirming menopause. Pelvic MRI is not
typically necessary for this clinical scenario.
Question 4
pts
A 25-year-old woman presents with vaginal discharge and itching for the past week.
She has had multiple sexual partners and does not consistently use condoms. On
examination, there is frothy, greenish-yellow vaginal discharge and a "strawberry"
cervix. Which of the following is the most likely causative organism?
Candida albicans
Chlamydia trachomatis
Trichomonas vaginalis
Neisseria gonorrhoeae
Gardnerella vaginalis - ✔️✔️correct answer-Trichomonas vaginalis is the correct
answer. Trichomoniasis, caused by the protozoan Trichomonas vaginalis, often
presents with a frothy, greenish-yellow vaginal discharge and a "strawberry" cervix,
which refers to punctate hemorrhages on the cervix. Candida albicans causes thick,
white, "cottage cheese-like" discharge with intense itching. Gardnerella vaginalis,
associated with bacterial vaginosis, causes a thin, gray, fishy-smelling discharge.
exam with correct answers all on point
A 28-year-old woman presents with a 4-month history of abnormal uterine bleeding. She
reports heavy menstrual periods lasting 10 days and spotting between periods. Her last
menstrual period was 2 weeks ago. On physical examination, the uterus is firm,
enlarged and irregular shaped. Which of the following is the most likely diagnosis?
Endometrial carcinoma
Endometrial hyperplasia
Polycystic ovary syndrome (PCOS)
Uterine fibroids
Adenomyosis - ✔️✔️correct answer-Uterine fibroids is the correct answer. Uterine
fibroids (leiomyomas) are benign smooth muscle tumors of the uterus that can cause
heavy menstrual bleeding, prolonged periods, and intermenstrual bleeding. An
enlarged, irregular uterus is characteristic of fibroids. Endometrial hyperplasia and
carcinoma typically present with postmenopausal bleeding. PCOS often presents with
irregular, infrequent periods and signs of hyperandrogenism. Adenomyosis can also
cause heavy menstrual bleeding and dysmenorrhea, but the uterus is usually uniformly
enlarged and boggy, not irregular.
Question 2
pts
A 32-year-old woman presents with acute pelvic pain, nausea, and vomiting. She has a
history of large ovarian cysts. On examination, she has tenderness in the right lower
quadrant and a palpable adnexal mass, she denies vaginal discharge. Her pregnancy
test is negative. Which of the following is the most likely diagnosis?
Pelvic inflammatory disease
Ectopic pregnancy
, Ovarian torsion
Acute appendicitis
Ruptured ovarian cyst - ✔️✔️correct answer-Ovarian torsion is the correct answer.
Ovarian torsion occurs when an ovary twists around the ligaments that support it,
cutting off its blood supply. This condition is associated with sudden, severe pelvic pain,
nausea, and vomiting. A palpable adnexal mass with these symptoms in a woman with
a history of ovarian cysts suggests ovarian torsion. Ectopic pregnancy would present
with a positive pregnancy test. Acute appendicitis would present with right lower
quadrant pain but not typically with an adnexal mass. Pelvic inflammatory disease
usually presents with bilateral pelvic pain and fever. A ruptured ovarian cyst would
present with sudden pain but without the adnexal mass and ongoing severe pain.
Question 3
pts
A 48-year-old woman presents with hot flashes, night sweats, and irregular menstrual
periods. She has no significant past medical history. Her last menstrual period was 8
months ago. Which of the following is the most appropriate next step in management?
Hormone replacement therapy
Pelvic MRI
Transvaginal ultrasound
Serum FSH level
Endometrial biopsy - ✔️✔️correct answer-Serum FSH level is the correct answer. In a
perimenopausal woman presenting with symptoms of menopause (hot flashes, night
sweats, irregular periods), measuring serum follicle-stimulating hormone (FSH) levels
can help confirm the diagnosis of menopause. Elevated FSH levels indicate decreased
ovarian function. A transvaginal ultrasound or endometrial biopsy would be indicated if
there were abnormal findings or risk factors for endometrial pathology. Hormone
replacement therapy may be considered after confirming menopause. Pelvic MRI is not
typically necessary for this clinical scenario.
Question 4
pts
A 25-year-old woman presents with vaginal discharge and itching for the past week.
She has had multiple sexual partners and does not consistently use condoms. On
examination, there is frothy, greenish-yellow vaginal discharge and a "strawberry"
cervix. Which of the following is the most likely causative organism?
Candida albicans
Chlamydia trachomatis
Trichomonas vaginalis
Neisseria gonorrhoeae
Gardnerella vaginalis - ✔️✔️correct answer-Trichomonas vaginalis is the correct
answer. Trichomoniasis, caused by the protozoan Trichomonas vaginalis, often
presents with a frothy, greenish-yellow vaginal discharge and a "strawberry" cervix,
which refers to punctate hemorrhages on the cervix. Candida albicans causes thick,
white, "cottage cheese-like" discharge with intense itching. Gardnerella vaginalis,
associated with bacterial vaginosis, causes a thin, gray, fishy-smelling discharge.
