PANCE Blueprint Obstetrics and Gynecology EXAM
2026-2027 LATEST UPDATED VERSION QUESTIONS
AND ANSWERS JUST RELEASED
What is the most common clinical symptom associated with vulvar cancer? - answer>>*Pruritis*
with red/white ulcerative/crusted lesions
Vulvovaginal atrophy is best treated with what 2 medications? - answer>>topical/vaginal
estrogen;
Ospemifene (estrogen agonist)
Recurrent vaginal infections and UTIs in a postmenopausal woman should make me suspicious
for what condition? - answer>>Vaginal atrophy
DES (Diethylstilbestrol) exposure is linked to what type of specific cancer - answer>>Clear cell
carcinoma
What does co-testing refer to for cervical cancer screening - answer>>A test for HPV
How often should females with no history of abnormal pap smears have one done? -
answer>>Every 3 years
Atypical squamous cells on a pap smear indicate what next step depending on age and HPV
testing? - answer>>Age 21-24: Repeat pap in 12 months;
Age 25+: HPV test, if negative retest in 3 yrs;
Age 30+ with HPV: Colposcopy
High grade squamous intraepithelial lesion (HSIL) on a pap smear indicate what next step
depending on age and HPV testing? - answer>>Colposcopy or immediate excisional treatment
,Low grade squamous intraepithelial lesion (LSIL) on a pap smear indicate what next step
depending on age and HPV testing? - answer>>21-24: Repeat pap in 12 months;
Ages 25+: Colposocopy (if HPV negative, it is acceptable to repeat pap)
Vaginal and Vulvar cancer are most likely which type? - answer>>Squamous Cell Carcinoma
Vaginal atrophy is best treated with... - answer>>Topical estrogen and moisturizers
What is the name of the syndrome that is often comorbid with Pelvic Inflammatory Disease and
involves RUQ pain due to liver involvement - answer>>Fitz-hugh-curtis syndrome
The lost tampon, diaphragm or other foreign object (>24 hours) amidst high fever and rash
makes me think of what diagnosis? - answer>>Toxic Shock Syndrome
Pelvic inflammatory disease should be treated with... - answer>>Ceftriaxone and
doxycycline/azithromycin
Stippled epithelial cells on vaginal fluid microscopy should make me think of what diagnosis? -
answer>>Bacterial Vaginosis (stippled epithelial cells = clue cells)
What do I use to treat vaginal trichomoniasis? - answer>>Metronidazole or tinadazole, also treat
partners!
What do I use to treat bacterial vaginosis? - answer>>Metronidazole, tinadazole, or clindamycin
When taking flagyl what must we advise our patients - answer>>Do not take with alcohol
What do I use to treat vaginal candidiasis? - answer>>Fluconazole or Itraconazole
What is the definitive diagnosis for vaginal infection? - answer>>DNA swab (Affirm test)
, A patient with PCOS has what 3 lab imbalances expected? - answer>>*LH:FSH ratio of 2:1 or
greater;*
Elevated Free Testosterone;
Insulin resistance
What 3 medications are indicated with a diagnosis PCOS - answer>>Combination OCPs;
Spironolactone;
Metformin
My PCOS patient wants to get pregnant; what medication is indicated now? -
answer>>Clomiphene
What is the most common tumor marker for ovarian cancer - answer>>CA-125
A "ring of fire" on ultrasound of the pelvis should make me think of... - answer>>Increased
vascularity associated with functional ovarian cysts
How do we treat ruptured ovarian cyst? - answer>>Pain control;
Biopsy of an ovarian cancer is most likely to show what type? - answer>>Epithelial
Upon exam of my asymptomatic post menopausal patient I find a sister mary joseph's node.
What should I be highly suspicious of? - answer>>Ovarian Cancer (also consider gastric
carcinoma)
A transvaginal ultrasound reveals an irregular mass on the ovary of my young patient. What is
the most likely result of my biopsy? - answer>>Dermoid cystic teratoma
2026-2027 LATEST UPDATED VERSION QUESTIONS
AND ANSWERS JUST RELEASED
What is the most common clinical symptom associated with vulvar cancer? - answer>>*Pruritis*
with red/white ulcerative/crusted lesions
Vulvovaginal atrophy is best treated with what 2 medications? - answer>>topical/vaginal
estrogen;
Ospemifene (estrogen agonist)
Recurrent vaginal infections and UTIs in a postmenopausal woman should make me suspicious
for what condition? - answer>>Vaginal atrophy
DES (Diethylstilbestrol) exposure is linked to what type of specific cancer - answer>>Clear cell
carcinoma
What does co-testing refer to for cervical cancer screening - answer>>A test for HPV
How often should females with no history of abnormal pap smears have one done? -
answer>>Every 3 years
Atypical squamous cells on a pap smear indicate what next step depending on age and HPV
testing? - answer>>Age 21-24: Repeat pap in 12 months;
Age 25+: HPV test, if negative retest in 3 yrs;
Age 30+ with HPV: Colposcopy
High grade squamous intraepithelial lesion (HSIL) on a pap smear indicate what next step
depending on age and HPV testing? - answer>>Colposcopy or immediate excisional treatment
,Low grade squamous intraepithelial lesion (LSIL) on a pap smear indicate what next step
depending on age and HPV testing? - answer>>21-24: Repeat pap in 12 months;
Ages 25+: Colposocopy (if HPV negative, it is acceptable to repeat pap)
Vaginal and Vulvar cancer are most likely which type? - answer>>Squamous Cell Carcinoma
Vaginal atrophy is best treated with... - answer>>Topical estrogen and moisturizers
What is the name of the syndrome that is often comorbid with Pelvic Inflammatory Disease and
involves RUQ pain due to liver involvement - answer>>Fitz-hugh-curtis syndrome
The lost tampon, diaphragm or other foreign object (>24 hours) amidst high fever and rash
makes me think of what diagnosis? - answer>>Toxic Shock Syndrome
Pelvic inflammatory disease should be treated with... - answer>>Ceftriaxone and
doxycycline/azithromycin
Stippled epithelial cells on vaginal fluid microscopy should make me think of what diagnosis? -
answer>>Bacterial Vaginosis (stippled epithelial cells = clue cells)
What do I use to treat vaginal trichomoniasis? - answer>>Metronidazole or tinadazole, also treat
partners!
What do I use to treat bacterial vaginosis? - answer>>Metronidazole, tinadazole, or clindamycin
When taking flagyl what must we advise our patients - answer>>Do not take with alcohol
What do I use to treat vaginal candidiasis? - answer>>Fluconazole or Itraconazole
What is the definitive diagnosis for vaginal infection? - answer>>DNA swab (Affirm test)
, A patient with PCOS has what 3 lab imbalances expected? - answer>>*LH:FSH ratio of 2:1 or
greater;*
Elevated Free Testosterone;
Insulin resistance
What 3 medications are indicated with a diagnosis PCOS - answer>>Combination OCPs;
Spironolactone;
Metformin
My PCOS patient wants to get pregnant; what medication is indicated now? -
answer>>Clomiphene
What is the most common tumor marker for ovarian cancer - answer>>CA-125
A "ring of fire" on ultrasound of the pelvis should make me think of... - answer>>Increased
vascularity associated with functional ovarian cysts
How do we treat ruptured ovarian cyst? - answer>>Pain control;
Biopsy of an ovarian cancer is most likely to show what type? - answer>>Epithelial
Upon exam of my asymptomatic post menopausal patient I find a sister mary joseph's node.
What should I be highly suspicious of? - answer>>Ovarian Cancer (also consider gastric
carcinoma)
A transvaginal ultrasound reveals an irregular mass on the ovary of my young patient. What is
the most likely result of my biopsy? - answer>>Dermoid cystic teratoma
