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1. A 28-year-old woman presents with abnormal uterine
bleeding. Which of the following is the most appropriate first-
line evaluation?
A) Endometrial biopsy
B) Transvaginal ultrasound
C) Pregnancy test
D) Hysteroscopy
Answer: C) Pregnancy test
Rationale: Pregnancy must be ruled out in any woman of
reproductive age presenting with abnormal uterine bleeding
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,before other investigations are pursued. This is a fundamental
safety principle in women's health .
2. Which contraceptive method has the highest efficacy in
typical use?
A) Condoms
B) Oral contraceptives
C) Intrauterine device (IUD)
D) Diaphragm
Answer: C) Intrauterine device (IUD)
Rationale: IUDs are among the most effective reversible
contraceptive methods with less than 1% failure rate in typical
use. Long-acting reversible contraceptives (LARCs) have the
highest efficacy because they eliminate user error .
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,3. A woman requests emergency contraception 48 hours after
unprotected intercourse. Which of the following is the most
effective option within 72 hours?
A) Copper IUD
B) Levonorgestrel pill
C) Combined oral contraceptive pills
D) Diaphragm
Answer: A) Copper IUD
Rationale: The copper IUD is the most effective form of
emergency contraception and can be used up to 5 days after
unprotected intercourse. It is >99% effective and provides
ongoing contraception .
4. Which of the following is a contraindication to combined
hormonal contraception?
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, A) Migraines without aura
B) History of DVT (deep vein thrombosis)
C) Age 40 years
D) Obesity (BMI 30)
Answer: B) History of DVT (deep vein thrombosis)
Rationale: History of DVT is an absolute contraindication to
combined hormonal contraception due to increased risk of
recurrent thromboembolism. Other contraindications include
migraine with aura, uncontrolled hypertension, and active breast
cancer .
5. A 32-year-old woman with PCOS desires pregnancy. She
has not had a period in 4 months. What is the most
appropriate first step?
A) Prescribe metformin
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