Ob/Gyn PA Easy(All correctly answered)
A patient presents to the office at 5 weeks gestation. She has been spotting for several days, and
the flow is increasing slightly. She has mild, crampy pain; no fetal heart tones are auscultated.
Ultrasound reveals an intrauterine gestational sac with a fetal pole. What is the most likely
diagnosis?
A
Threatened abortion
B
Spontaneous abortion
C
Incomplete abortion
D
Septic abortion
E
Ectopic pregnancy correct answers A
Threatened abortion
While she is at risk for a spontaneous abortion, one cannot determine fetal viability with one
exam. Serial exams are necessary. Fetal heart tones are not always present at 5 weeks.
An 18-year-old G1P0 presents for evaluation of her amenorrhea. Her LMP was 2 months ago.
Her HCG is positive, and she has been having vaginal spotting x 2 weeks. Her ultrasound reveals
an intrauterine heterogeneous echogenic mass, without fetus or placenta. What is the most likely
diagnosis?
A
Threatened abortion
B
Missed abortion
C
Ectopic pregnancy
D
Hydatidiform mole
E
Early intrauterine pregnancy correct answers The Correct Answer is: D
The classic signs for a mole are a heterogenous mass without the placenta or fetus, and vaginal
spotting is present all of the time. The presence of the mass intrauterine without fetus or placenta
rules out ectopic and IUP, and therefore threatened abortion. Missed abortion is not echogenic
How many types of primary osteoporosis are there? correct answers The Correct Answer is: B
Osteoporosis is a condition characterized by low bone mass, which increases the fragility of
bones and leads to an increased risk of fracture. Osteoporosis is defined as being either primary
or secondary and primary osteoporosis is further broken down into Type 1 and Type 2. Type 1 is
related to decreased hormone levels - estrogen in women and testosterone in men, and is
sometimes referred to as "postmenopausal osteoporosis." It is six times more common in women
and results in loss of trabecular bone. Type 1 primary osteoporosis often presents with vertebral
,compression fractures or fractures of the distal radius after a fall. Type 2 primary osteoporosis is
sometimes referred to as "senile osteoporosis" and generally occurs in patients over 70 years of
age. It is twice as common in women as men and occurs due to a diminished capacity to make
new bone. The most common types of fractures found in this type of osteoarthritis are hip and
pelvic fractures. Secondary osteoporosis occurs at a somewhat higher rate in men versus women
and is caused by some other medical condition that produces bone loss. Common causes include
long-term steroid use, various endocrine abnormalities, and neoplastic diseases such as multiple
myeloma.
You are providing care for a 21-year-old G1P1 who delivered a 3990 gram infant by normal
spontaneous vaginal delivery. After delivery, she continues to bleed vaginally, more than is
expected for routine delivery. What is the most likely cause of her hemorrhage?
A
cervical laceration
B
lateral vaginal wall laceration
C
retained placenta
D
uterine atony
E
placenta acreata correct answers The Correct Answer is: D
Uterine atony continues to be the most common cause of postpartum hemorrhage, even though
all of the answer choices may cause it.
A 22-year-old sexually active woman presents for her annual gynecologic evaluation. She
reports one partner for the past 6 months and takes oral contraceptive pills as directed. Her
periods have been regular. Her examination is unremarkable and her Pap smear returns with
atypical squamous cells of undetermined significance and positive for human papillomavirus-16.
The next most appropriate step for this patient is to
A
proceed with colposcopy
B
repeat Pap smear in 12 months
C
repeat Pap smear in 24 months
D
schedule her for a loop electrosurgical excision procedure (LEEP) correct answers The Correct
Answer is: A
Human papillomavirus subtypes 6, 11, 16, and 18 increase risk for the development of cervical
cancer. In a young woman over 21 years old with atypical squamous cells of undetermined
significance and positive HPV 16 subtype, the next step in evaluation is the colposcopic
evaluation. Alternatively, she could be followed with Pap smears at 6 and 12 months. The LEEP
,procedure is indicated for those with recurrent histologic finding of cervical intraepithelial
neoplasm grade 2 or 3.
A 21-year-old female presents to clinic complaining of mild, low abdominal ache and
intermittent dysuria. She denies N/V/D, and she is sexually active and uses condoms some of the
time. Her LMP was 10 days ago, and she is a G0P0. Physical exam reveals a healthy female in
no acute distress. Vitals are as follows: P 70, BP 120/80, T 99.9°F. Lungs are clear, CV RRR,
abd soft non-tender, + BS. Pelvic exam reveals normal external genitalia, scant discharge,
moderate cervical motion tenderness, and no adnexal masses. What is her most likely diagnosis?
A
Tubo-ovarian abscess
B
Gastroenteritis
C
Ectopic pregnancy
D
Cervicitis
E
Pelvic inflammatory disease correct answers Suspicion for PID should be very high in a young,
healthy, and sexually active woman with cervical motion tenderness. She is not spotting and just
menstruated, making ectopic pregnancy much less likely.
A woman who is pregnant suffered a spontaneous abortion at 12 weeks gestation. She is now a
G2P1Ab1 and is Rh negative. When should she receive her next Rhogam (Rho D immune
globulin) shot?
A
Now
B
In one month
C
At conception of her next pregnancy
D
28 weeks gestation of next pregnancy
E
After delivery of her next viable infant correct answers The Correct Answer is: A
Placental implantation occurred and separated with the spontaneous miscarriage. Therefore, there
is a slight chance of isoimmunization, so Rhogam should be given now so that the mother does
not develop antigens that can cross the placenta during the first half of the next pregnancy.
A 48-year-old woman presents complaining of vaginal fullness and difficulty passing stool.
Upon exam she is found to have a stage 3 rectocele by the Baden Walker System. What is the
most common cause for this?
A
Increasing age
B
Genetic disposition
, C
Obesity
D
Pelvic floor injury
E
Constipation correct answers The Correct Answer is: D
While all of the answer choices are risk factors, the most common cause of pelvic organ prolapse
remains pelvic floor injury, usually related to child birth or trauma.
A 25-year-old woman and her husband have been using condoms and spermicidal foam for the 8
months since the birth of their baby. She plans to wean the baby from the breast sometime
between a year and 18 months of age, but would like to begin a "less messy" method of
contraception. Prior to her pregnancy she took combination oral contraceptives for several years
without any difficulties. Which of the following is an appropriate recommendation for this
woman? correct answers he Correct Answer is: C
The progestin-only pill is ideal for breast feeding mothers because this pill does not interfere
with lactation the way combination pills do
You are caring for a pregnant woman who is Rh-negative. The father of the child is Rh-positive
and heterozygous. What percent chance will the fetus have of being Rh-positive? correct answers
The Correct Answer is: C
The mother is negative and has no genetically positive material to pass to the child; the father is
heterozygous, so only half of his genetics contain the positive antigens.
A 53-year-old woman presents to clinic complaining of amenorrhea, irritability, and hot flashes
for 6 months. She would like to try hormone replacement therapy. You are counseling her about
possible risks versus benefits. Which of the following is a benefit of combined estrogen
progestin therapy? correct answers The Correct Answer is: D
The WHI study showed increase chance of cardiovascular risks and breast cancer, and showed
no improvement in prevention of cognitive decline
A 37-year-old G3P2 female at 39 weeks gestation presents to the labor and delivery unit
complaining of abdominal pain. Laboratory evaluation reveals anemia coagulopathy that is felt
to be consumptive. What is the most likely diagnosis to have caused this? correct answers
Reproductive placental abruption is the most common cause of coagulopathy in pregnancy; the
hemorrhage may be concealed and is not always evident. In the presence of pain, anemia, and
coagulopathy, abruption should be assumed until proved otherwise
You are caring for a 33-year-old G3P2 women. Her PMH is significant for obesity and allergies.
She receives routine obstetrical care. When is she due for her glucose challenge testing to rule
out gestational diabetes? correct answers Routine surveillance for gestational diabetes of a
pregnant women is between 24 and 28 weeks
A 27-year-old G3P2 at 39 weeks gestation has been in labor for 6 hours. Her membranes
ruptured 3 hours ago and revealed a large amount of clear fluid. She has previously delivered a 7
pound 2 ounce infant. She is having good quality contractions, and has been completely dilated
A patient presents to the office at 5 weeks gestation. She has been spotting for several days, and
the flow is increasing slightly. She has mild, crampy pain; no fetal heart tones are auscultated.
Ultrasound reveals an intrauterine gestational sac with a fetal pole. What is the most likely
diagnosis?
A
Threatened abortion
B
Spontaneous abortion
C
Incomplete abortion
D
Septic abortion
E
Ectopic pregnancy correct answers A
Threatened abortion
While she is at risk for a spontaneous abortion, one cannot determine fetal viability with one
exam. Serial exams are necessary. Fetal heart tones are not always present at 5 weeks.
An 18-year-old G1P0 presents for evaluation of her amenorrhea. Her LMP was 2 months ago.
Her HCG is positive, and she has been having vaginal spotting x 2 weeks. Her ultrasound reveals
an intrauterine heterogeneous echogenic mass, without fetus or placenta. What is the most likely
diagnosis?
A
Threatened abortion
B
Missed abortion
C
Ectopic pregnancy
D
Hydatidiform mole
E
Early intrauterine pregnancy correct answers The Correct Answer is: D
The classic signs for a mole are a heterogenous mass without the placenta or fetus, and vaginal
spotting is present all of the time. The presence of the mass intrauterine without fetus or placenta
rules out ectopic and IUP, and therefore threatened abortion. Missed abortion is not echogenic
How many types of primary osteoporosis are there? correct answers The Correct Answer is: B
Osteoporosis is a condition characterized by low bone mass, which increases the fragility of
bones and leads to an increased risk of fracture. Osteoporosis is defined as being either primary
or secondary and primary osteoporosis is further broken down into Type 1 and Type 2. Type 1 is
related to decreased hormone levels - estrogen in women and testosterone in men, and is
sometimes referred to as "postmenopausal osteoporosis." It is six times more common in women
and results in loss of trabecular bone. Type 1 primary osteoporosis often presents with vertebral
,compression fractures or fractures of the distal radius after a fall. Type 2 primary osteoporosis is
sometimes referred to as "senile osteoporosis" and generally occurs in patients over 70 years of
age. It is twice as common in women as men and occurs due to a diminished capacity to make
new bone. The most common types of fractures found in this type of osteoarthritis are hip and
pelvic fractures. Secondary osteoporosis occurs at a somewhat higher rate in men versus women
and is caused by some other medical condition that produces bone loss. Common causes include
long-term steroid use, various endocrine abnormalities, and neoplastic diseases such as multiple
myeloma.
You are providing care for a 21-year-old G1P1 who delivered a 3990 gram infant by normal
spontaneous vaginal delivery. After delivery, she continues to bleed vaginally, more than is
expected for routine delivery. What is the most likely cause of her hemorrhage?
A
cervical laceration
B
lateral vaginal wall laceration
C
retained placenta
D
uterine atony
E
placenta acreata correct answers The Correct Answer is: D
Uterine atony continues to be the most common cause of postpartum hemorrhage, even though
all of the answer choices may cause it.
A 22-year-old sexually active woman presents for her annual gynecologic evaluation. She
reports one partner for the past 6 months and takes oral contraceptive pills as directed. Her
periods have been regular. Her examination is unremarkable and her Pap smear returns with
atypical squamous cells of undetermined significance and positive for human papillomavirus-16.
The next most appropriate step for this patient is to
A
proceed with colposcopy
B
repeat Pap smear in 12 months
C
repeat Pap smear in 24 months
D
schedule her for a loop electrosurgical excision procedure (LEEP) correct answers The Correct
Answer is: A
Human papillomavirus subtypes 6, 11, 16, and 18 increase risk for the development of cervical
cancer. In a young woman over 21 years old with atypical squamous cells of undetermined
significance and positive HPV 16 subtype, the next step in evaluation is the colposcopic
evaluation. Alternatively, she could be followed with Pap smears at 6 and 12 months. The LEEP
,procedure is indicated for those with recurrent histologic finding of cervical intraepithelial
neoplasm grade 2 or 3.
A 21-year-old female presents to clinic complaining of mild, low abdominal ache and
intermittent dysuria. She denies N/V/D, and she is sexually active and uses condoms some of the
time. Her LMP was 10 days ago, and she is a G0P0. Physical exam reveals a healthy female in
no acute distress. Vitals are as follows: P 70, BP 120/80, T 99.9°F. Lungs are clear, CV RRR,
abd soft non-tender, + BS. Pelvic exam reveals normal external genitalia, scant discharge,
moderate cervical motion tenderness, and no adnexal masses. What is her most likely diagnosis?
A
Tubo-ovarian abscess
B
Gastroenteritis
C
Ectopic pregnancy
D
Cervicitis
E
Pelvic inflammatory disease correct answers Suspicion for PID should be very high in a young,
healthy, and sexually active woman with cervical motion tenderness. She is not spotting and just
menstruated, making ectopic pregnancy much less likely.
A woman who is pregnant suffered a spontaneous abortion at 12 weeks gestation. She is now a
G2P1Ab1 and is Rh negative. When should she receive her next Rhogam (Rho D immune
globulin) shot?
A
Now
B
In one month
C
At conception of her next pregnancy
D
28 weeks gestation of next pregnancy
E
After delivery of her next viable infant correct answers The Correct Answer is: A
Placental implantation occurred and separated with the spontaneous miscarriage. Therefore, there
is a slight chance of isoimmunization, so Rhogam should be given now so that the mother does
not develop antigens that can cross the placenta during the first half of the next pregnancy.
A 48-year-old woman presents complaining of vaginal fullness and difficulty passing stool.
Upon exam she is found to have a stage 3 rectocele by the Baden Walker System. What is the
most common cause for this?
A
Increasing age
B
Genetic disposition
, C
Obesity
D
Pelvic floor injury
E
Constipation correct answers The Correct Answer is: D
While all of the answer choices are risk factors, the most common cause of pelvic organ prolapse
remains pelvic floor injury, usually related to child birth or trauma.
A 25-year-old woman and her husband have been using condoms and spermicidal foam for the 8
months since the birth of their baby. She plans to wean the baby from the breast sometime
between a year and 18 months of age, but would like to begin a "less messy" method of
contraception. Prior to her pregnancy she took combination oral contraceptives for several years
without any difficulties. Which of the following is an appropriate recommendation for this
woman? correct answers he Correct Answer is: C
The progestin-only pill is ideal for breast feeding mothers because this pill does not interfere
with lactation the way combination pills do
You are caring for a pregnant woman who is Rh-negative. The father of the child is Rh-positive
and heterozygous. What percent chance will the fetus have of being Rh-positive? correct answers
The Correct Answer is: C
The mother is negative and has no genetically positive material to pass to the child; the father is
heterozygous, so only half of his genetics contain the positive antigens.
A 53-year-old woman presents to clinic complaining of amenorrhea, irritability, and hot flashes
for 6 months. She would like to try hormone replacement therapy. You are counseling her about
possible risks versus benefits. Which of the following is a benefit of combined estrogen
progestin therapy? correct answers The Correct Answer is: D
The WHI study showed increase chance of cardiovascular risks and breast cancer, and showed
no improvement in prevention of cognitive decline
A 37-year-old G3P2 female at 39 weeks gestation presents to the labor and delivery unit
complaining of abdominal pain. Laboratory evaluation reveals anemia coagulopathy that is felt
to be consumptive. What is the most likely diagnosis to have caused this? correct answers
Reproductive placental abruption is the most common cause of coagulopathy in pregnancy; the
hemorrhage may be concealed and is not always evident. In the presence of pain, anemia, and
coagulopathy, abruption should be assumed until proved otherwise
You are caring for a 33-year-old G3P2 women. Her PMH is significant for obesity and allergies.
She receives routine obstetrical care. When is she due for her glucose challenge testing to rule
out gestational diabetes? correct answers Routine surveillance for gestational diabetes of a
pregnant women is between 24 and 28 weeks
A 27-year-old G3P2 at 39 weeks gestation has been in labor for 6 hours. Her membranes
ruptured 3 hours ago and revealed a large amount of clear fluid. She has previously delivered a 7
pound 2 ounce infant. She is having good quality contractions, and has been completely dilated
