Comprehensive Women’s Health Clinical Mastery
Exam 2025/2026
150Questions,Answers And Rationales
1. A 32-year-old woman presents for routine well-woman care. She
has no history of abnormal Pap smears. According to current
guidelines, how often should she undergo cervical cancer
screening with cytology alone?
A. Every year
B. Every 2 years
C. Every 3 years
D. Every 5 years
Rationale: For women aged 21–29 with no history of abnormal
Pap smears, cytology alone is recommended every 3 years.
2. A 28-year-old woman wants contraception. She has a history of
migraines with aura. Which contraceptive method is safest for
her?
A. Combined oral contraceptives
B. Vaginal ring
C. Progestin-only methods
D. Combined patch
Rationale: Estrogen-containing contraceptives are
contraindicated in women with migraines with aura due to
increased risk of stroke. Progestin-only methods are safe.
3. A 45-year-old woman presents with hot flashes and night sweats.
She is otherwise healthy. Which is the first-line therapy for
symptomatic management?
, A. SSRIs
B. Gabapentin
C. Hormone replacement therapy (HRT)
D. Clonidine
Rationale: For healthy women with moderate-to-severe
menopausal symptoms, hormone replacement therapy is
considered first-line.
4. Which of the following is a common adverse effect of tamoxifen?
A. Osteoporosis
B. Endometrial hyperplasia
C. Vaginal dryness
D. Hot flashes only
Rationale: Tamoxifen acts as an estrogen agonist in the
endometrium, which can increase the risk of hyperplasia and
cancer.
5. A 25-year-old woman presents with irregular menses and
hirsutism. Labs reveal elevated testosterone and LH:FSH ratio
>2.5. Most likely diagnosis?
A. Cushing syndrome
B. Polycystic ovary syndrome (PCOS)
C. Hypothyroidism
D. Hyperprolactinemia
Rationale: Hyperandrogenism, menstrual irregularity, and
LH:FSH ratio >2 are characteristic of PCOS.
6. Which STI is most strongly associated with pelvic inflammatory
disease (PID)?
A. Trichomoniasis
B. Chlamydia trachomatis
C. HSV-2
, D. HPV
Rationale: Chlamydia trachomatis is a leading cause of PID,
often asymptomatic but can lead to infertility.
7. A 30-year-old woman is planning pregnancy. Which prenatal
vitamin is recommended before conception?
A. Calcium 1000 mg daily
B. Vitamin D 600 IU daily
C. Folic acid 400–800 mcg daily
D. Iron 18 mg daily
Rationale: Folic acid supplementation before conception reduces
the risk of neural tube defects.
8. Which contraceptive method also provides protection against
sexually transmitted infections?
A. IUD
B. Oral contraceptives
C. Hormonal implant
D. Condoms
Rationale: Only barrier methods, such as condoms, provide
protection against STIs.
9. A 38-year-old woman presents with abnormal uterine bleeding.
Transvaginal ultrasound reveals a 3-cm endometrial polyp. Next
best step?
A. Observation only
B. Hysteroscopic polypectomy
C. Endometrial biopsy
D. Start combined oral contraceptives
Rationale: Symptomatic endometrial polyps should be removed
via hysteroscopic polypectomy.
, 10. A woman presents with recurrent yeast infections. Which
condition should be ruled out?
A. Hypothyroidism
B. Diabetes mellitus
C. Hypertension
D. Hyperlipidemia
Rationale: Recurrent vulvovaginal candidiasis is commonly
associated with uncontrolled diabetes.
11. During pregnancy, which vaccine is contraindicated?
A. Influenza inactivated
B. Tdap
C. MMR (live attenuated)
D. COVID-19 mRNA vaccine
Rationale: Live vaccines like MMR are contraindicated during
pregnancy due to risk of fetal infection.
12. A 29-year-old presents with a breast lump. Ultrasound
shows a well-circumscribed solid mass. Most likely diagnosis?
A. Breast carcinoma
B. Fibroadenoma
C. Phyllodes tumor
D. Mastitis
Rationale: Fibroadenomas are the most common benign breast
tumors in women <30, usually well-circumscribed and mobile.
13. A 50-year-old woman presents for osteoporosis screening.
Which is the first-line test?
A. Serum calcium
B. Bone scan
C. DEXA scan
D. MRI of the spine
Exam 2025/2026
150Questions,Answers And Rationales
1. A 32-year-old woman presents for routine well-woman care. She
has no history of abnormal Pap smears. According to current
guidelines, how often should she undergo cervical cancer
screening with cytology alone?
A. Every year
B. Every 2 years
C. Every 3 years
D. Every 5 years
Rationale: For women aged 21–29 with no history of abnormal
Pap smears, cytology alone is recommended every 3 years.
2. A 28-year-old woman wants contraception. She has a history of
migraines with aura. Which contraceptive method is safest for
her?
A. Combined oral contraceptives
B. Vaginal ring
C. Progestin-only methods
D. Combined patch
Rationale: Estrogen-containing contraceptives are
contraindicated in women with migraines with aura due to
increased risk of stroke. Progestin-only methods are safe.
3. A 45-year-old woman presents with hot flashes and night sweats.
She is otherwise healthy. Which is the first-line therapy for
symptomatic management?
, A. SSRIs
B. Gabapentin
C. Hormone replacement therapy (HRT)
D. Clonidine
Rationale: For healthy women with moderate-to-severe
menopausal symptoms, hormone replacement therapy is
considered first-line.
4. Which of the following is a common adverse effect of tamoxifen?
A. Osteoporosis
B. Endometrial hyperplasia
C. Vaginal dryness
D. Hot flashes only
Rationale: Tamoxifen acts as an estrogen agonist in the
endometrium, which can increase the risk of hyperplasia and
cancer.
5. A 25-year-old woman presents with irregular menses and
hirsutism. Labs reveal elevated testosterone and LH:FSH ratio
>2.5. Most likely diagnosis?
A. Cushing syndrome
B. Polycystic ovary syndrome (PCOS)
C. Hypothyroidism
D. Hyperprolactinemia
Rationale: Hyperandrogenism, menstrual irregularity, and
LH:FSH ratio >2 are characteristic of PCOS.
6. Which STI is most strongly associated with pelvic inflammatory
disease (PID)?
A. Trichomoniasis
B. Chlamydia trachomatis
C. HSV-2
, D. HPV
Rationale: Chlamydia trachomatis is a leading cause of PID,
often asymptomatic but can lead to infertility.
7. A 30-year-old woman is planning pregnancy. Which prenatal
vitamin is recommended before conception?
A. Calcium 1000 mg daily
B. Vitamin D 600 IU daily
C. Folic acid 400–800 mcg daily
D. Iron 18 mg daily
Rationale: Folic acid supplementation before conception reduces
the risk of neural tube defects.
8. Which contraceptive method also provides protection against
sexually transmitted infections?
A. IUD
B. Oral contraceptives
C. Hormonal implant
D. Condoms
Rationale: Only barrier methods, such as condoms, provide
protection against STIs.
9. A 38-year-old woman presents with abnormal uterine bleeding.
Transvaginal ultrasound reveals a 3-cm endometrial polyp. Next
best step?
A. Observation only
B. Hysteroscopic polypectomy
C. Endometrial biopsy
D. Start combined oral contraceptives
Rationale: Symptomatic endometrial polyps should be removed
via hysteroscopic polypectomy.
, 10. A woman presents with recurrent yeast infections. Which
condition should be ruled out?
A. Hypothyroidism
B. Diabetes mellitus
C. Hypertension
D. Hyperlipidemia
Rationale: Recurrent vulvovaginal candidiasis is commonly
associated with uncontrolled diabetes.
11. During pregnancy, which vaccine is contraindicated?
A. Influenza inactivated
B. Tdap
C. MMR (live attenuated)
D. COVID-19 mRNA vaccine
Rationale: Live vaccines like MMR are contraindicated during
pregnancy due to risk of fetal infection.
12. A 29-year-old presents with a breast lump. Ultrasound
shows a well-circumscribed solid mass. Most likely diagnosis?
A. Breast carcinoma
B. Fibroadenoma
C. Phyllodes tumor
D. Mastitis
Rationale: Fibroadenomas are the most common benign breast
tumors in women <30, usually well-circumscribed and mobile.
13. A 50-year-old woman presents for osteoporosis screening.
Which is the first-line test?
A. Serum calcium
B. Bone scan
C. DEXA scan
D. MRI of the spine
