Women's Health EOR Exam Questions with 100% Correct Answers

A 15-year-old sexually active female presents with non-pruritic mucopurulent cervicitis and post coital bleeding. She was given medication for the same symptoms three weeks ago but reports she did not take it. Which of the following is the best treatment? A azithromycin x 1 dose B benzathine penicillin G x 1 dose C doxycycline x 7 days D tetracycline x 14 days Correct Answer A The patient has Chlamydia trachomatis, one of the the most common bacterial STI in women. Risk factor for chlamydia include being sexually active under 20 years of age and having multiple sex partners. Azithromycin is highly effective when given as a single dose. Since this patient has a history of non-compliance, the one dose medication, taken in the office, is the treatment of choice. She must also be counseled on having her sexual partner(s) treated. A 55-year-old female presents complaining of vaginal bleeding. LMP was 3 years ago; Pap smear is normal. An endometrial biopsy is performed. Which of the following histological cells types is most likely to be found? A adenocarcinoma B adenosquamous C clear cell D secretory Correct Answer A In the US, adenocarcinoma comprises 70-80% of endometrial carcinoma. This figure is even higher in other countries. A 28-year-old female describes a one year history of weight gain, irritability and increased tension which occur 5 days before onset of menses. Which of the following dietary modifications will most likely decrease her symptoms? A decreasing snacking throughout day B decreasing sodium intake C limiting caffeine D limiting complex carbohydrates Correct Answer C The woman is suffering from premenstrual syndrome (PMS). The etiology is not known but it is thought that estrogen and progesterone may influence serotonin centrally, causing the symptoms of PMS. Limiting caffeine, alcohol, tobacco, and chocolate has been found to help with some patients. A 32-year-old G2P1001 presents at 27 weeks gestation. Glucose challenge returns at 165 mg/dl. Results of a glucose tolerance test are: fasting: 90 mg/dl 1-hour: 195 mg/dl 2-hour: 145 mg/dl 3-hour: 130 mg/dl According to the White Classification, which of the following is the best diagnosis? A no gestational diabetes B class A-1 gestational diabetes C class A-2 gestational diabetes D class B gestational diabetes Correct Answer A Gestational diabetes screening is recommended between 24-28 weeks gestation. Initially a 50-gram non fasting glucose load is performed. If the results are over 140 mg/dL, a fasting 3-hour glucose tolerance test is done. Normal values are: fasting: <95 mg/dL; 1-hour: < 180 mg/dL; 2-hour: < 155 mg/dL; 3 hour: < 140 mg/dL. To make the diagnosis of gestational diabetes, at least two values must be elevated. Only the 1-hour glucose level is high in this patient. A woman presents at 30 weeks gestation complaining of a slow constant trickle of fluid from her vagina x 3 days. Physical exam shows positive pooling in the posterior fornix and the ferning test is positive. External monitoring shows the fetal heart rate at 140 beats per minute with beat to beat variability and accelerations; biophysical profile is 10. What is the next step in management? A admit to hospital for bedrest and monitoring B induction of labor C stat Cesarean section D send home with instructions to return when contractions begin Correct Answer A The woman has experienced premature rupture of membranes (PROM). Because the fetus is preterm (under 37 weeks gestation) but shows no sign of distress (fetal heart reactivity tracing and biophysical profile are reassuring), in-hospital conservative management is warranted. In addition to the above management, prophylactic antibiotics and maternal corticosteroids (to accelerate fetal lung maturity) may be administered as well. A 22-year-old obese female presents complaining of anovulation and hirsutism. Testosterone levels are mildly elevated and LH/FSH ratio is 4. She does not wish to become pregnant at this time. Which of the following is the best treatment? A danazol B glucocorticoids C medroxyprogesterone acetate D spironolactone Correct Answer C The patient's diagnosis is polycystic ovarian syndrome (PCOS). Patients are often obese, anovulatory and often present with hirsutism. Testosterone levels are mildly elevated and the LH/FSH ratio is greater than 3. Medroxyprogesterone acetate given on the first 10 days of each month will promote regular shedding of the endometrium. If