Women's Health and Genetics Questions With Complete
Solutions
24y/o patient with a new sexual partner presents with yellowish
discharge from cervical os. Cervix is erythematous and friable.
Wet mount of discharge reveals squamous cells and scattered
leukocytes. Dx/Tx? Correct Answer Cervicitis
(most commonly caused by chlamydia/gonorrhea)
Tx: Azithromycin 1 g PO plus Ceftriaxone 125mg IM
A 22 year-old G0P0 pt, who denies any family history of breast
or gynecologic cancers, presents with a solitary 1 cm rubbery,
firm, well-circumscribed, non-tender left breast mass. Similar
findings were noted on last year's examination. What is the most
likely diagnosis? Correct Answer Fibroadenoma
A 25 year-old female presents with constant premenstrual pelvic
pain. She also notes dysmenorrhea and dyspareunia. Which of
the following is the most likely diagnosis? Correct Answer
Endometriosis
A 25 year-old presents with pelvic pain and uterine bleeding.
Her Beta-HCG was 1200 mIU/L six days ago. Her current Beta-
HCG is 1600 mIU/L.
What is the next best test in the evaluation of this patient?
Correct Answer Transvaginal U/S
A 26 year-old monogamous female presents with cyclic pelvic
pain, increasing over the last 6 months with dysmenorrhea and
dyspareunia. She uses condoms for BC. On PE her uterus is
retroverted and non-mobile, and she has a palpable adnexal mass
,on the left side. Her serum pregnancy test is negative. What is
the most likely diagnosis? Correct Answer Endometriosis
A 27 year-old G1P0 female presents complaining of painless
spotting since this morning. She is known to be 12 weeks
pregnant. Pelvic examination reveals the presence of blood
within the vagina with a closed cervical os. The uterus is
consistent with a 10-12 week gestation and non-tender to
palpation. what is the most likely diagnosis? Correct Answer
Threatened abortion
A 28 year-old woman is complaining of heavy uterine bleeding
and pelvic pressure that has progressively worsened over the
past year. Evaluation reveals multiple moderate-sized uterine
fibroids. The patient desires to have more children. What is the
best treatment? Correct Answer Myomectomy
A 30 year-old female presents to the emergency department with
a syncopal episode. She has a history of irregular menstrual
cycles and infertility. She has scanty, persistent vaginal bleeding
and sharp pelvic pain. A left adnexal mass is palpated. The most
likely diagnosis is Correct Answer Ectopic
A 30 year-old presents with persistent vaginal discharge and
vulvar pruritus. The discharge is profuse, frothy, greenish, and
foul smelling. pH of the vagina is 6.0. What is the most likely
diagnosis? Correct Answer Trichomoniasis
A 30-week pregnant patient presents with sudden onset of
profuse, painless vaginal bleeding. What is the most likely
diagnosis? Correct Answer Placenta previa
,A 32 year-old female G4P4 with a history of multiple sexual
partners is seen in follow-up for recent findings of high grade
squamous intraepithelial lesions (HSIL) on a Pap smear. What is
the most appropriate next step? Correct Answer Colposcopy
with endocervical curettage
A 33 year-old female presents for follow-up of her Pap smear
that showed cervical dysplasia. What is the next step in
diagnosis? Correct Answer Colposcopy with biopsy
A 35 year-old female presents with a solitary breast mass. Fine
needle aspiration reveals bloody fluid with no malignant cells.
What is the next best step in the care of this patient? Correct
Answer Excisional biopsy
(Excisional biopsy is the next step in cases of bloody fluid,
residual mass or thickening)
A 36-week pregnant patient presents to the ED with
hypertension. Physical examination reveals 2+/4+ edema in the
lower extremities with hyperreflexia and clonus bilaterally. A
urinalysis reveals 3+ protein.
Dx?Tx? Correct Answer Eclampsia, magnesium sulfate
A 47 year-old female presents to the clinic with complaints of
prolonged, heavy menses that have been getting progressively
worse for 3 years. She denies any pain. On physical
examination, enlargement of the uterus with multiple smooth,
spherical, firm masses is noted. A CBC is consistent with a mild
, anemia. Which of the following is the most likely diagnosis?
Correct Answer Leiomyoma
Abnormal uterine bleeding and irregular enlargement of the
uterus are most consistent with leiomyoma. Usually initially
painless, but may present with dysmenorrhea, dyspareunia,
pelvic pain or pressure or feeling of fullness.
A 49 year-old female has had heavier periods for the last 6
month which last for seven days duration. She has been
experiencing urinary frequency and constipation. Abdominal
exam is unremarkable. On Pelvic exam a slightly enlarged
uterus and a left adnexal mass that moves with the uterine
fundus is noted. What is the most likely diagnosis? Correct
Answer Ovarian fibroids
A 52 year-old obese patient with persistent heavy menses
undergoes an endometrial biopsy and is diagnosed with atypical
adenomatous hyperplasia. What is the next step in the
management of this patient? Correct Answer Total abdominal
hysterectomy
A 65 year-old postmenopausal female presents with complaints
of new onset of vaginal bleeding. She relates a history of two
episodes of vaginal bleeding during the past month, each lasting
about four days. What diagnostic evaluation is the most reliable
to evaluate the suspected diagnosis? Correct Answer
Endometrial biopsy for endometrial cancer
A couple presents having not been able to conceive over the past
12 months. Evaluation of the male has been normal. The female
Solutions
24y/o patient with a new sexual partner presents with yellowish
discharge from cervical os. Cervix is erythematous and friable.
Wet mount of discharge reveals squamous cells and scattered
leukocytes. Dx/Tx? Correct Answer Cervicitis
(most commonly caused by chlamydia/gonorrhea)
Tx: Azithromycin 1 g PO plus Ceftriaxone 125mg IM
A 22 year-old G0P0 pt, who denies any family history of breast
or gynecologic cancers, presents with a solitary 1 cm rubbery,
firm, well-circumscribed, non-tender left breast mass. Similar
findings were noted on last year's examination. What is the most
likely diagnosis? Correct Answer Fibroadenoma
A 25 year-old female presents with constant premenstrual pelvic
pain. She also notes dysmenorrhea and dyspareunia. Which of
the following is the most likely diagnosis? Correct Answer
Endometriosis
A 25 year-old presents with pelvic pain and uterine bleeding.
Her Beta-HCG was 1200 mIU/L six days ago. Her current Beta-
HCG is 1600 mIU/L.
What is the next best test in the evaluation of this patient?
Correct Answer Transvaginal U/S
A 26 year-old monogamous female presents with cyclic pelvic
pain, increasing over the last 6 months with dysmenorrhea and
dyspareunia. She uses condoms for BC. On PE her uterus is
retroverted and non-mobile, and she has a palpable adnexal mass
,on the left side. Her serum pregnancy test is negative. What is
the most likely diagnosis? Correct Answer Endometriosis
A 27 year-old G1P0 female presents complaining of painless
spotting since this morning. She is known to be 12 weeks
pregnant. Pelvic examination reveals the presence of blood
within the vagina with a closed cervical os. The uterus is
consistent with a 10-12 week gestation and non-tender to
palpation. what is the most likely diagnosis? Correct Answer
Threatened abortion
A 28 year-old woman is complaining of heavy uterine bleeding
and pelvic pressure that has progressively worsened over the
past year. Evaluation reveals multiple moderate-sized uterine
fibroids. The patient desires to have more children. What is the
best treatment? Correct Answer Myomectomy
A 30 year-old female presents to the emergency department with
a syncopal episode. She has a history of irregular menstrual
cycles and infertility. She has scanty, persistent vaginal bleeding
and sharp pelvic pain. A left adnexal mass is palpated. The most
likely diagnosis is Correct Answer Ectopic
A 30 year-old presents with persistent vaginal discharge and
vulvar pruritus. The discharge is profuse, frothy, greenish, and
foul smelling. pH of the vagina is 6.0. What is the most likely
diagnosis? Correct Answer Trichomoniasis
A 30-week pregnant patient presents with sudden onset of
profuse, painless vaginal bleeding. What is the most likely
diagnosis? Correct Answer Placenta previa
,A 32 year-old female G4P4 with a history of multiple sexual
partners is seen in follow-up for recent findings of high grade
squamous intraepithelial lesions (HSIL) on a Pap smear. What is
the most appropriate next step? Correct Answer Colposcopy
with endocervical curettage
A 33 year-old female presents for follow-up of her Pap smear
that showed cervical dysplasia. What is the next step in
diagnosis? Correct Answer Colposcopy with biopsy
A 35 year-old female presents with a solitary breast mass. Fine
needle aspiration reveals bloody fluid with no malignant cells.
What is the next best step in the care of this patient? Correct
Answer Excisional biopsy
(Excisional biopsy is the next step in cases of bloody fluid,
residual mass or thickening)
A 36-week pregnant patient presents to the ED with
hypertension. Physical examination reveals 2+/4+ edema in the
lower extremities with hyperreflexia and clonus bilaterally. A
urinalysis reveals 3+ protein.
Dx?Tx? Correct Answer Eclampsia, magnesium sulfate
A 47 year-old female presents to the clinic with complaints of
prolonged, heavy menses that have been getting progressively
worse for 3 years. She denies any pain. On physical
examination, enlargement of the uterus with multiple smooth,
spherical, firm masses is noted. A CBC is consistent with a mild
, anemia. Which of the following is the most likely diagnosis?
Correct Answer Leiomyoma
Abnormal uterine bleeding and irregular enlargement of the
uterus are most consistent with leiomyoma. Usually initially
painless, but may present with dysmenorrhea, dyspareunia,
pelvic pain or pressure or feeling of fullness.
A 49 year-old female has had heavier periods for the last 6
month which last for seven days duration. She has been
experiencing urinary frequency and constipation. Abdominal
exam is unremarkable. On Pelvic exam a slightly enlarged
uterus and a left adnexal mass that moves with the uterine
fundus is noted. What is the most likely diagnosis? Correct
Answer Ovarian fibroids
A 52 year-old obese patient with persistent heavy menses
undergoes an endometrial biopsy and is diagnosed with atypical
adenomatous hyperplasia. What is the next step in the
management of this patient? Correct Answer Total abdominal
hysterectomy
A 65 year-old postmenopausal female presents with complaints
of new onset of vaginal bleeding. She relates a history of two
episodes of vaginal bleeding during the past month, each lasting
about four days. What diagnostic evaluation is the most reliable
to evaluate the suspected diagnosis? Correct Answer
Endometrial biopsy for endometrial cancer
A couple presents having not been able to conceive over the past
12 months. Evaluation of the male has been normal. The female
