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I-HUMAN CASES GYNECOLOGY EXAM 2026 QUESTIONS
LATEST VERSION QUESTIONS AND ANSWERS
i-Human Cases Exam: Gynecology
70 Questions with Detailed Rationales
CASE 1: 24-Year-Old Female with Pelvic Pain and Vaginal Discharge – Pelvic
Inflammatory Disease (Questions 1-12)
Question 1
A 24-year-old female presents with a 3-day history of bilateral lower abdominal pain,
fever, and purulent vaginal discharge. She has a history of multiple sexual partners and
inconsistent condom use. What is the most likely diagnosis?
A) Urinary tract infection
B) Pelvic inflammatory disease (PID)
C) Ovarian cyst
D) Appendicitis
Answer: B
Rationale: The classic triad of PID includes bilateral lower abdominal pain, fever, and
purulent cervical discharge. Risk factors include multiple sexual partners, age <25, and
inconsistent condom use. Chlamydia trachomatis and Neisseria gonorrhoeae are the most
common causative organisms.
Question 2
What is the most important physical exam finding in PID?
A) Cervical motion tenderness (chandelier sign)
B) Adnexal tenderness
C) Uterine tenderness
D) All of the above
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Answer: D
Rationale: Cervical motion tenderness, adnexal tenderness, and uterine tenderness are all
classic findings of PID. These findings help distinguish PID from other causes of pelvic pain.
The presence of fever and purulent discharge supports the diagnosis.
Question 3
What is the most appropriate diagnostic test for suspected PID?
A) Nucleic acid amplification testing (NAAT) for Chlamydia and Gonorrhea
B) Endocervical culture
C) Pelvic ultrasound
D) Complete blood count
Answer: A
Rationale: NAAT is the most sensitive test for Chlamydia and Gonorrhea. Endocervical
culture may also be performed. Pelvic ultrasound is indicated to rule out tubo-ovarian abscess
or other complications. Pregnancy test is essential to rule out ectopic pregnancy.
Question 4
The patient's pregnancy test is negative. What is the most appropriate treatment for
PID?
A) Outpatient oral antibiotics (e.g., ceftriaxone + doxycycline)
B) Inpatient intravenous antibiotics
C) Surgical intervention
D) Observation only
Answer: A
Rationale: Outpatient treatment with ceftriaxone (IM) + doxycycline (oral) is appropriate for
mild to moderate PID. Inpatient treatment is indicated for severe PID, pregnancy, tubo-
ovarian abscess, or failure of outpatient therapy. Surgical intervention may be needed for
abscess drainage.
Question 5
What is the most important education for a patient with PID?
A) "Complete the full course of antibiotics."
B) "Abstain from sexual intercourse until treatment is completed."
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C) "Notify sexual partners for testing and treatment."
D) All of the above
Answer: D
Rationale: Education includes completing antibiotics, abstaining from sexual intercourse
until treatment is completed and symptoms resolve, and notifying sexual partners for testing
and treatment. PID is a sexually transmitted infection; partner treatment is essential to prevent
reinfection.
Question 6
What is the most important complication of untreated PID?
A) Tubal factor infertility
B) Ectopic pregnancy
C) Chronic pelvic pain
D) All of the above
Answer: D
Rationale: Untreated PID can lead to tubal factor infertility, ectopic pregnancy, and chronic
pelvic pain. These complications are caused by scarring and adhesions of the fallopian tubes.
Early treatment reduces the risk of these complications.
Question 7
The patient asks about the risk of infertility with PID. What is the most accurate
response?
A) "One episode of PID has no effect on fertility."
B) "PID can cause scarring of the fallopian tubes, leading to infertility."
C) "Infertility is not a complication of PID."
D) "PID only affects fertility if it is severe."
Answer: B
Rationale: PID can cause scarring and adhesions of the fallopian tubes, leading to tubal
factor infertility. The risk of infertility increases with the number of episodes of PID. Early
treatment reduces the risk.
Question 8
What is the most important prevention strategy for PID?
A) Condom use
I-HUMAN CASES GYNECOLOGY EXAM 2026 QUESTIONS
LATEST VERSION QUESTIONS AND ANSWERS
i-Human Cases Exam: Gynecology
70 Questions with Detailed Rationales
CASE 1: 24-Year-Old Female with Pelvic Pain and Vaginal Discharge – Pelvic
Inflammatory Disease (Questions 1-12)
Question 1
A 24-year-old female presents with a 3-day history of bilateral lower abdominal pain,
fever, and purulent vaginal discharge. She has a history of multiple sexual partners and
inconsistent condom use. What is the most likely diagnosis?
A) Urinary tract infection
B) Pelvic inflammatory disease (PID)
C) Ovarian cyst
D) Appendicitis
Answer: B
Rationale: The classic triad of PID includes bilateral lower abdominal pain, fever, and
purulent cervical discharge. Risk factors include multiple sexual partners, age <25, and
inconsistent condom use. Chlamydia trachomatis and Neisseria gonorrhoeae are the most
common causative organisms.
Question 2
What is the most important physical exam finding in PID?
A) Cervical motion tenderness (chandelier sign)
B) Adnexal tenderness
C) Uterine tenderness
D) All of the above
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Answer: D
Rationale: Cervical motion tenderness, adnexal tenderness, and uterine tenderness are all
classic findings of PID. These findings help distinguish PID from other causes of pelvic pain.
The presence of fever and purulent discharge supports the diagnosis.
Question 3
What is the most appropriate diagnostic test for suspected PID?
A) Nucleic acid amplification testing (NAAT) for Chlamydia and Gonorrhea
B) Endocervical culture
C) Pelvic ultrasound
D) Complete blood count
Answer: A
Rationale: NAAT is the most sensitive test for Chlamydia and Gonorrhea. Endocervical
culture may also be performed. Pelvic ultrasound is indicated to rule out tubo-ovarian abscess
or other complications. Pregnancy test is essential to rule out ectopic pregnancy.
Question 4
The patient's pregnancy test is negative. What is the most appropriate treatment for
PID?
A) Outpatient oral antibiotics (e.g., ceftriaxone + doxycycline)
B) Inpatient intravenous antibiotics
C) Surgical intervention
D) Observation only
Answer: A
Rationale: Outpatient treatment with ceftriaxone (IM) + doxycycline (oral) is appropriate for
mild to moderate PID. Inpatient treatment is indicated for severe PID, pregnancy, tubo-
ovarian abscess, or failure of outpatient therapy. Surgical intervention may be needed for
abscess drainage.
Question 5
What is the most important education for a patient with PID?
A) "Complete the full course of antibiotics."
B) "Abstain from sexual intercourse until treatment is completed."
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C) "Notify sexual partners for testing and treatment."
D) All of the above
Answer: D
Rationale: Education includes completing antibiotics, abstaining from sexual intercourse
until treatment is completed and symptoms resolve, and notifying sexual partners for testing
and treatment. PID is a sexually transmitted infection; partner treatment is essential to prevent
reinfection.
Question 6
What is the most important complication of untreated PID?
A) Tubal factor infertility
B) Ectopic pregnancy
C) Chronic pelvic pain
D) All of the above
Answer: D
Rationale: Untreated PID can lead to tubal factor infertility, ectopic pregnancy, and chronic
pelvic pain. These complications are caused by scarring and adhesions of the fallopian tubes.
Early treatment reduces the risk of these complications.
Question 7
The patient asks about the risk of infertility with PID. What is the most accurate
response?
A) "One episode of PID has no effect on fertility."
B) "PID can cause scarring of the fallopian tubes, leading to infertility."
C) "Infertility is not a complication of PID."
D) "PID only affects fertility if it is severe."
Answer: B
Rationale: PID can cause scarring and adhesions of the fallopian tubes, leading to tubal
factor infertility. The risk of infertility increases with the number of episodes of PID. Early
treatment reduces the risk.
Question 8
What is the most important prevention strategy for PID?
A) Condom use
