OBGYN APGO UWise EXAM NEWEST 2026 QUESTIONS and
CORRECT DETAILED ANSWERS ALREADY GRADED A+
A 23-year-old G0 woman reports having a solitary vulvar lesion for three days. She
had similar lesions in the past on at least two occasions, and reports that HSV1
culture done during her last outbreak was negative. She is otherwise healthy and
takes oral contraceptives and uses condoms for vaginal intercourse. She has had
four sexual partners in her lifetime. On physical examination, a cluster of three
irregular erosions with a superficial crust are noted on the posterior fourchette.
What is the most sensitive diagnostic step in the management of this patient?
A. HSV1 antibodies
B. HSV2 antibodies
C. VDRL
D. Nucleic Acid Amplification Test
E. HSV Culture - CORRECT ANSWER-D. NAAT) This patient most likely has
genital herpes. If genital lesions are present, clinical diagnosis of genital herpes
should be confirmed by type-specific virologic testing from the lesion by nucleic
acid amplification test (NAAT) or culture. Recently, HSV DNA detection based on
nucleic acid amplification, and polymerase chain reaction (PCR) in particular, has
,emerged as an alternative method because it is less dependent on collection and
transport conditions, is faster than viral culture and approximately four times
more sensitive than the culture. Type-specific serologic tests can be used to aid in
the diagnosis of HSV infection in the absence of genital lesions. The lesion is not
characteristic for syphilis and therefore a VDRL test is not indicated. Failure to
detect HSV by NAAT or culture, especially in the presence of older lesions or the
absence of active lesions, does not indicate an absence of HSV infection because
viral shedding is intermittent.
A 32-year-old G1P0 woman comes to your office for her first prenatal care visit.
She has recently read an article about the rising Cesarean section rate in the
United States and asks you about the rate in your hospital. What do you explain
as the major cause of higher Cesarean delivery rates?
A. The rate of breech presentations has increased
B. Less women are having vaginal births after Cesarean
C. Obstetricians' reluctance to perform forceps delivery
D. Increased rate of fetal macrosomia due to uncontrolled gestational diabetes
E. Rate of twins has increased - CORRECT ANSWER-B. The rate of vaginal birth
after Cesarean (VBAC) has decreased in recent years due to studies that showed
an increased risk of complications, especially uterine rupture. This is one factor
that has led to the increased Cesarean section rate. In addition, although the rate
of breech presentation is stable, there are significantly fewer obstetricians who
,are willing to perform vaginal breech deliveries. Many obstetricians do not
perform instrumental vaginal deliveries, such as forceps and vacuum extractions,
further contributing to the rising rate. Gestational diabetes is a well-known
pregnancy complication with clear clinical guidelines.
A 23-year-old G1P0 woman at 40 weeks gestation presents to labor and delivery
with contractions. At 10:00 am, her cervical exam is 2 centimeters dilated, 70%
effaced and the vertex at 0 station. Clinical pelvimetry reveals an adequate pelvis
and membranes are intact. The fetus is in a cephalic presentation and EFW is
3500 gms. Contractions are occurring every 3-4 minutes, based on the external
monitor. Her labor slowly progresses and, at 1:00 pm, the patient has
spontaneous rupture of membranes. Fetal surveillance remains reassuring. Her
cervical exam is 5 centimeters dilated, 100% effaced, and 0 station. At 4:00 pm,
the patient's cervical exam is unchanged. Contractions are occurring every 5-6
minutes. Which of the following is the most appropriate next step in the
management of this patient?
A. Perform a biophysical profile
B. Have the patient ambulate
C. Consent the patient for a Cesarean section secondary to - CORRECT
ANSWER-E.
, A 34-year-old G2P1 woman at 40 weeks gestation, with a history of one prior
vaginal delivery, strongly desires an induction of labor, as she is unable to sleep
secondary to severe back pain. Her cervical exam is closed, 20% effaced and -2
station. The cervix is firm and posterior. Which of the following is the most
appropriate next step in the management of this patient?
A. Wait until 42 weeks for induction
B. Administer cytotec
C. Insert a foley bulb in the cervix
D. Perform artificial rupture of membranes
E. Perform a Cesarean delivery - CORRECT ANSWER-B. The patient is
multiparous at term and waiting until she reaches 42 weeks may increase the risk
of perinatal mortality. Since she is uncomfortable with back pain, it is reasonable
to induce labor. Her cervix is unfavorable; therefore, cytotec administration is
appropriate prior to pitocin induction. A foley bulb or artificial rupture of
membranes cannot be achieved in a patient with a closed cervix. At this time,
there are no indications to perform a Cesarean delivery in this patient.
A 22-year-old G1P0 woman at 39-weeks gestation presents in active labor. Her
pregnancy is complicated by diet controlled gestational diabetes. She has a
history of uterine fibroids. On examination, she is found to be 4 cm dilated in
breech presentation. An ultrasound confirms the breech presentation, amniotic
fluid index is 5, and the estimated fetal weight is 3900 g. Which of the following is
the most likely cause of the breech presentation in this patient?
CORRECT DETAILED ANSWERS ALREADY GRADED A+
A 23-year-old G0 woman reports having a solitary vulvar lesion for three days. She
had similar lesions in the past on at least two occasions, and reports that HSV1
culture done during her last outbreak was negative. She is otherwise healthy and
takes oral contraceptives and uses condoms for vaginal intercourse. She has had
four sexual partners in her lifetime. On physical examination, a cluster of three
irregular erosions with a superficial crust are noted on the posterior fourchette.
What is the most sensitive diagnostic step in the management of this patient?
A. HSV1 antibodies
B. HSV2 antibodies
C. VDRL
D. Nucleic Acid Amplification Test
E. HSV Culture - CORRECT ANSWER-D. NAAT) This patient most likely has
genital herpes. If genital lesions are present, clinical diagnosis of genital herpes
should be confirmed by type-specific virologic testing from the lesion by nucleic
acid amplification test (NAAT) or culture. Recently, HSV DNA detection based on
nucleic acid amplification, and polymerase chain reaction (PCR) in particular, has
,emerged as an alternative method because it is less dependent on collection and
transport conditions, is faster than viral culture and approximately four times
more sensitive than the culture. Type-specific serologic tests can be used to aid in
the diagnosis of HSV infection in the absence of genital lesions. The lesion is not
characteristic for syphilis and therefore a VDRL test is not indicated. Failure to
detect HSV by NAAT or culture, especially in the presence of older lesions or the
absence of active lesions, does not indicate an absence of HSV infection because
viral shedding is intermittent.
A 32-year-old G1P0 woman comes to your office for her first prenatal care visit.
She has recently read an article about the rising Cesarean section rate in the
United States and asks you about the rate in your hospital. What do you explain
as the major cause of higher Cesarean delivery rates?
A. The rate of breech presentations has increased
B. Less women are having vaginal births after Cesarean
C. Obstetricians' reluctance to perform forceps delivery
D. Increased rate of fetal macrosomia due to uncontrolled gestational diabetes
E. Rate of twins has increased - CORRECT ANSWER-B. The rate of vaginal birth
after Cesarean (VBAC) has decreased in recent years due to studies that showed
an increased risk of complications, especially uterine rupture. This is one factor
that has led to the increased Cesarean section rate. In addition, although the rate
of breech presentation is stable, there are significantly fewer obstetricians who
,are willing to perform vaginal breech deliveries. Many obstetricians do not
perform instrumental vaginal deliveries, such as forceps and vacuum extractions,
further contributing to the rising rate. Gestational diabetes is a well-known
pregnancy complication with clear clinical guidelines.
A 23-year-old G1P0 woman at 40 weeks gestation presents to labor and delivery
with contractions. At 10:00 am, her cervical exam is 2 centimeters dilated, 70%
effaced and the vertex at 0 station. Clinical pelvimetry reveals an adequate pelvis
and membranes are intact. The fetus is in a cephalic presentation and EFW is
3500 gms. Contractions are occurring every 3-4 minutes, based on the external
monitor. Her labor slowly progresses and, at 1:00 pm, the patient has
spontaneous rupture of membranes. Fetal surveillance remains reassuring. Her
cervical exam is 5 centimeters dilated, 100% effaced, and 0 station. At 4:00 pm,
the patient's cervical exam is unchanged. Contractions are occurring every 5-6
minutes. Which of the following is the most appropriate next step in the
management of this patient?
A. Perform a biophysical profile
B. Have the patient ambulate
C. Consent the patient for a Cesarean section secondary to - CORRECT
ANSWER-E.
, A 34-year-old G2P1 woman at 40 weeks gestation, with a history of one prior
vaginal delivery, strongly desires an induction of labor, as she is unable to sleep
secondary to severe back pain. Her cervical exam is closed, 20% effaced and -2
station. The cervix is firm and posterior. Which of the following is the most
appropriate next step in the management of this patient?
A. Wait until 42 weeks for induction
B. Administer cytotec
C. Insert a foley bulb in the cervix
D. Perform artificial rupture of membranes
E. Perform a Cesarean delivery - CORRECT ANSWER-B. The patient is
multiparous at term and waiting until she reaches 42 weeks may increase the risk
of perinatal mortality. Since she is uncomfortable with back pain, it is reasonable
to induce labor. Her cervix is unfavorable; therefore, cytotec administration is
appropriate prior to pitocin induction. A foley bulb or artificial rupture of
membranes cannot be achieved in a patient with a closed cervix. At this time,
there are no indications to perform a Cesarean delivery in this patient.
A 22-year-old G1P0 woman at 39-weeks gestation presents in active labor. Her
pregnancy is complicated by diet controlled gestational diabetes. She has a
history of uterine fibroids. On examination, she is found to be 4 cm dilated in
breech presentation. An ultrasound confirms the breech presentation, amniotic
fluid index is 5, and the estimated fetal weight is 3900 g. Which of the following is
the most likely cause of the breech presentation in this patient?
