OB GYN ROSH REVIEW UPDATED
Actual Exam Questions and CORRECT
Answers
Which of the following combination of lab findings is most suggestive of hemolysis, elevated
liver enzymes, and low platelet count syndrome of pregnancy?
A. Decreased total bilirubin, elevated aspartate aminotransferse and alanine aminotransferase
> 500 U/L, decreased hemoglobin
B. Increased total bilirubin, elevated aspartate aminotransferase and alanine aminotransferase
levels < 500 U/L
C. Schistocytes, thrombocytopenia, and elevated aspartate aminotransferase and alanine
aminotransferase > 500 U/L
D. Schistocytes, thrombocytopenia, elevated aspartate aminotransferase and alanine
aminotransferase levels < 500 U/L - CORRECT ANSWER- ✔✔C.
The patients present with nonspecific symptoms of weight gain, right upper quadrant pain,
nausea, and vomitting. Jaundice may or may not be present.
What does the management of HELLP syndrome include? - CORRECT ANSWER- ✔✔Best
rest, blood pressure management, and mag sulfate for prevention of eclamptic seizures.
What is the definitive treatment of HELLP syndrome? - CORRECT ANSWER- ✔✔Delivery
of the fetus
What complication should be suspected in a patient with HELLP syndrome with clinically
significant bleeding and elevated prothrombin time (PT), partial thromboplastin time (PTT)
and decreased fibrinogen? - CORRECT ANSWER- ✔✔disseminated intravascular
coagulation (DIC)
A 41 year old woman suffers from heavy and irregular menses, which at time leads to fatigue,
lightheadedness and dyspnea. She had three hospitalizations in the past year for such
episodes. Her gynecological evaluation has not revealed any pathological cause. The heavy
menses continue despite hormonal therapy. Which of the following treatment options should
be considered next?
A. Colposcopy
B. Hysterectomy
,C. Hysteroscopy
D. Uterine ablation - CORRECT ANSWER- ✔✔D.
What is the most common cause of dysfunctional uterine bleeding in a post menopausal
woman? - CORRECT ANSWER- ✔✔Exogenous estrogens and or progesterone ( hormonal
replacement therapy)
A 23 year old woman presents with vulvular itching and vaginal discharge. She in not
currently sexually active, and does not use contraceptives. She works in an office, drinks 3
alcoholic beverages a week and recently took up long-distance running. Physical examination
reveals reddened vulva without surface ulcerations, the absence of lice or nits, normal
appearing vaginal secretions and an unremarkable vaginal cavity. There is no adnexal
tenderness. Which important item is missing from this patient's history?
A. Age of menarche
B. Family history of endometrial cancer
C. Prior deliveries
D. Use of local irritants - CORRECT ANSWER- ✔✔D.
Name two treatments for secondary allergic vulvitis? - CORRECT ANSWER- ✔✔Remove
offending agent
1% hydrocortisone cream
A 14 year old woman presents to clinic with some frustration over never having a menstrual
period. She is short in stature and has Tanner stage 2 breast development. As you begin a
gynecological exam, you realize that you cannot pass a speculum into the vagina. Which of
the following is the most likely diagnosis?
A. DUB
B. Primary amenorrhea
C. Secondary dysmenorrhea
D. Sheehan's syndrome - CORRECT ANSWER- ✔✔B.
What is the initial work up of a patient with primary amenorrhea? - CORRECT ANSWER-
✔✔Breast and pelvic exam, pregnancy test, pelvic ultrasound and serum follicle-stimulating
hormone
,A 39 year old woman in her third trimester presents with two days of bloody "spotting" on
her underwear. This is her third pregnancy, which thus far has been uncomplicated. Her initial
delivery was vaginal and her second delivery was via cesarean section. She is currently
sexually active, and has a history of trichomoniasis. She denies any pelvic pain. Lab
examination reveals hematocrit of 32%, white blood cell count of 10,000, platelet count of
260,000 INR of 1.1 and aPTT of 32 seconds. Pelvic examination show a nonerythematous
cervix with clear mucus. Vaginal examination is normal, and there is no discharge present.
Which of the following is the most likely diagnosis?
A. Cervicitis
B. HELLP syndrome
C. Maternal Coagulopathy
D. Placenta Previa - CORRECT ANSWER- ✔✔D.
MC cause of 3rd trimester bleeding is placenta previa
Other than peri peri partum hemorrhage, name a fetal complications of placenta previa? -
CORRECT ANSWER- ✔✔Congenital malformations doubles with placenta previa
Which of the following is the most common cause of post-partum hemorrhage?
A. Laceration to the cervix
B. Retained placenta
C. Uterine Antony
D. Uterine rupture - CORRECT ANSWER- ✔✔C.
What is the most common condition associated with placental abruption? - CORRECT
ANSWER- ✔✔Maternal hypertension
You are treating a patient for primary amenorrhea. Her diagnostic evaluation has determined
that the etiology is primary ovarian failure. Which of the following disorders is this patient at
risk for?
A. Cluster headaches
B. Gastrointestinal bleeding
C. Menorrhagia
D. Osteoporosis - CORRECT ANSWER- ✔✔D.
, Which medications offer decent replacement therapy for hypoestrogenic women? -
CORRECT ANSWER- ✔✔Oral contraceptive pills
A 26 year old woman presents with abdominal cramping after a positive home pregnancy
test. Her vitals are T 98.7, HR 94, BP 110/66, RR 18, oxygen sat 97%. Her exam is
unremarkable. Labs reveal a serum beta HCG of 1000 mIU and she is Rh positive. An
ultrasound shows the gestational sack. Which of the following is an appropriate management
for this patient?
A. Administer methotrexate
B. Administer Rhogam and discharge home with repeat beta HCG in 48 hrs
C. Administer Rhogam and methotrexate
D. Discharge home with repeat beta hCG in 48 hours - CORRECT ANSWER- ✔✔D.
What is the success rate of methotrexate in the management of early ectopic pregnancy? -
CORRECT ANSWER- ✔✔85-93%
A woman presents with fever and foul-smelling vaginal discharge 3 days after delivery of a
full-term fetus. She is febrile, with uterine tenderness on pelvic exam. Which of the following
is the strongest risk factor for postpartum endometritis?
A. Cesarean section
B. Internal fetal monitoring
C. Multiple gestation
D. Premature rupture of membranes - CORRECT ANSWER- ✔✔A.
What is the most common malpresentation in fetal delivery? - CORRECT ANSWER-
✔✔Breech presentation
A 15 year old G1Po woman at 23 weeks presents with sharp, left lower quad abdominal pain
for 1 hour. She has had an ultrasound confirming the presence of a single intrauterine
pregnancy. The pain is severe and associated with nausea. Pelvic exam reveals tenderness of
the left adnexa. The patient's urinalysis is unremarkable. What test should be ordered to
diagnose the patient?
A. Abdominal x-ray
Actual Exam Questions and CORRECT
Answers
Which of the following combination of lab findings is most suggestive of hemolysis, elevated
liver enzymes, and low platelet count syndrome of pregnancy?
A. Decreased total bilirubin, elevated aspartate aminotransferse and alanine aminotransferase
> 500 U/L, decreased hemoglobin
B. Increased total bilirubin, elevated aspartate aminotransferase and alanine aminotransferase
levels < 500 U/L
C. Schistocytes, thrombocytopenia, and elevated aspartate aminotransferase and alanine
aminotransferase > 500 U/L
D. Schistocytes, thrombocytopenia, elevated aspartate aminotransferase and alanine
aminotransferase levels < 500 U/L - CORRECT ANSWER- ✔✔C.
The patients present with nonspecific symptoms of weight gain, right upper quadrant pain,
nausea, and vomitting. Jaundice may or may not be present.
What does the management of HELLP syndrome include? - CORRECT ANSWER- ✔✔Best
rest, blood pressure management, and mag sulfate for prevention of eclamptic seizures.
What is the definitive treatment of HELLP syndrome? - CORRECT ANSWER- ✔✔Delivery
of the fetus
What complication should be suspected in a patient with HELLP syndrome with clinically
significant bleeding and elevated prothrombin time (PT), partial thromboplastin time (PTT)
and decreased fibrinogen? - CORRECT ANSWER- ✔✔disseminated intravascular
coagulation (DIC)
A 41 year old woman suffers from heavy and irregular menses, which at time leads to fatigue,
lightheadedness and dyspnea. She had three hospitalizations in the past year for such
episodes. Her gynecological evaluation has not revealed any pathological cause. The heavy
menses continue despite hormonal therapy. Which of the following treatment options should
be considered next?
A. Colposcopy
B. Hysterectomy
,C. Hysteroscopy
D. Uterine ablation - CORRECT ANSWER- ✔✔D.
What is the most common cause of dysfunctional uterine bleeding in a post menopausal
woman? - CORRECT ANSWER- ✔✔Exogenous estrogens and or progesterone ( hormonal
replacement therapy)
A 23 year old woman presents with vulvular itching and vaginal discharge. She in not
currently sexually active, and does not use contraceptives. She works in an office, drinks 3
alcoholic beverages a week and recently took up long-distance running. Physical examination
reveals reddened vulva without surface ulcerations, the absence of lice or nits, normal
appearing vaginal secretions and an unremarkable vaginal cavity. There is no adnexal
tenderness. Which important item is missing from this patient's history?
A. Age of menarche
B. Family history of endometrial cancer
C. Prior deliveries
D. Use of local irritants - CORRECT ANSWER- ✔✔D.
Name two treatments for secondary allergic vulvitis? - CORRECT ANSWER- ✔✔Remove
offending agent
1% hydrocortisone cream
A 14 year old woman presents to clinic with some frustration over never having a menstrual
period. She is short in stature and has Tanner stage 2 breast development. As you begin a
gynecological exam, you realize that you cannot pass a speculum into the vagina. Which of
the following is the most likely diagnosis?
A. DUB
B. Primary amenorrhea
C. Secondary dysmenorrhea
D. Sheehan's syndrome - CORRECT ANSWER- ✔✔B.
What is the initial work up of a patient with primary amenorrhea? - CORRECT ANSWER-
✔✔Breast and pelvic exam, pregnancy test, pelvic ultrasound and serum follicle-stimulating
hormone
,A 39 year old woman in her third trimester presents with two days of bloody "spotting" on
her underwear. This is her third pregnancy, which thus far has been uncomplicated. Her initial
delivery was vaginal and her second delivery was via cesarean section. She is currently
sexually active, and has a history of trichomoniasis. She denies any pelvic pain. Lab
examination reveals hematocrit of 32%, white blood cell count of 10,000, platelet count of
260,000 INR of 1.1 and aPTT of 32 seconds. Pelvic examination show a nonerythematous
cervix with clear mucus. Vaginal examination is normal, and there is no discharge present.
Which of the following is the most likely diagnosis?
A. Cervicitis
B. HELLP syndrome
C. Maternal Coagulopathy
D. Placenta Previa - CORRECT ANSWER- ✔✔D.
MC cause of 3rd trimester bleeding is placenta previa
Other than peri peri partum hemorrhage, name a fetal complications of placenta previa? -
CORRECT ANSWER- ✔✔Congenital malformations doubles with placenta previa
Which of the following is the most common cause of post-partum hemorrhage?
A. Laceration to the cervix
B. Retained placenta
C. Uterine Antony
D. Uterine rupture - CORRECT ANSWER- ✔✔C.
What is the most common condition associated with placental abruption? - CORRECT
ANSWER- ✔✔Maternal hypertension
You are treating a patient for primary amenorrhea. Her diagnostic evaluation has determined
that the etiology is primary ovarian failure. Which of the following disorders is this patient at
risk for?
A. Cluster headaches
B. Gastrointestinal bleeding
C. Menorrhagia
D. Osteoporosis - CORRECT ANSWER- ✔✔D.
, Which medications offer decent replacement therapy for hypoestrogenic women? -
CORRECT ANSWER- ✔✔Oral contraceptive pills
A 26 year old woman presents with abdominal cramping after a positive home pregnancy
test. Her vitals are T 98.7, HR 94, BP 110/66, RR 18, oxygen sat 97%. Her exam is
unremarkable. Labs reveal a serum beta HCG of 1000 mIU and she is Rh positive. An
ultrasound shows the gestational sack. Which of the following is an appropriate management
for this patient?
A. Administer methotrexate
B. Administer Rhogam and discharge home with repeat beta HCG in 48 hrs
C. Administer Rhogam and methotrexate
D. Discharge home with repeat beta hCG in 48 hours - CORRECT ANSWER- ✔✔D.
What is the success rate of methotrexate in the management of early ectopic pregnancy? -
CORRECT ANSWER- ✔✔85-93%
A woman presents with fever and foul-smelling vaginal discharge 3 days after delivery of a
full-term fetus. She is febrile, with uterine tenderness on pelvic exam. Which of the following
is the strongest risk factor for postpartum endometritis?
A. Cesarean section
B. Internal fetal monitoring
C. Multiple gestation
D. Premature rupture of membranes - CORRECT ANSWER- ✔✔A.
What is the most common malpresentation in fetal delivery? - CORRECT ANSWER-
✔✔Breech presentation
A 15 year old G1Po woman at 23 weeks presents with sharp, left lower quad abdominal pain
for 1 hour. She has had an ultrasound confirming the presence of a single intrauterine
pregnancy. The pain is severe and associated with nausea. Pelvic exam reveals tenderness of
the left adnexa. The patient's urinalysis is unremarkable. What test should be ordered to
diagnose the patient?
A. Abdominal x-ray
