Page 1 of 58
WOMEN’S HEALTH FINAL EXAM
|ACTUAL 110Qs&As|GRADED
A+|SOUTH UNIVERSITY
Q1. A 28-year-old woman reports heavy menstrual bleeding
every 28 days, lasting 8 days with clots. Hemoglobin is 10.5
g/dL. What is the most appropriate next step?
a) Endometrial biopsy
b) Oral contraceptive pills
c) Transvaginal ultrasound
d) Refer for hysteroscopy
Correct Answer: b) Oral contraceptive pills
*Rationale: This patient has heavy menstrual bleeding
(menorrhagia) with no structural cause suspected (age <35,
regular cycles). First-line medical treatment includes hormonal
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contraceptives (OCPs, LNG-IUD). Endometrial biopsy is indicated
for age >45 or risk factors for endometrial cancer.*
Q2. A 16-year-old has not yet started menstruating. She has
normal secondary sexual characteristics (Tanner stage 4 breast
and pubic hair). What is the most likely diagnosis?
a) Primary ovarian insufficiency
b) Anatomic obstruction (e.g., imperforate hymen)
c) Constitutional delay
d) Hypogonadotropic hypogonadism
Correct Answer: c) Constitutional delay
*Rationale: The presence of normal secondary sexual
characteristics indicates sufficient estrogen. Menarche typically
occurs 2-3 years after breast development. Delayed menarche
beyond age 16 with normal development is often constitutional
delay.*
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Q3. A 22-year-old has cyclic pelvic pain and heavy bleeding.
Laparoscopy reveals endometrial implants on the ovaries and
peritoneum. First-line medical management is:
a) NSAIDs alone
b) Combined oral contraceptives (continuous or cyclic)
c) GnRH agonists
d) Hysterectomy
Correct Answer: b) Combined oral contraceptives
Rationale: First-line medical therapy for endometriosis includes
NSAIDs and hormonal contraceptives (OCPs, patch, ring) to
suppress ovulation and reduce pain. GnRH agonists are second-line
due to side effects.
Q4. A 45-year-old has irregular bleeding for 6 months.
Transvaginal ultrasound shows endometrial thickness of 12 mm.
What is the next best step?
a) Endometrial biopsy
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b) Observation
c) Dilation and curettage
d) Hormonal therapy
Correct Answer: a) Endometrial biopsy
Rationale: Postmenopausal bleeding (or perimenopausal with
irregular bleeding and thickened endometrium) requires tissue
sampling to rule out hyperplasia or cancer. Biopsy is office-based
first-line.
Q5. A patient with polycystic ovary syndrome (PCOS) has
oligomenorrhea and hirsutism. Which of the following is a
diagnostic criterion for PCOS (Rotterdam criteria)?
a) Elevated FSH
b) Polycystic ovaries on ultrasound
c) Low testosterone
d) Prolactin elevation
WOMEN’S HEALTH FINAL EXAM
|ACTUAL 110Qs&As|GRADED
A+|SOUTH UNIVERSITY
Q1. A 28-year-old woman reports heavy menstrual bleeding
every 28 days, lasting 8 days with clots. Hemoglobin is 10.5
g/dL. What is the most appropriate next step?
a) Endometrial biopsy
b) Oral contraceptive pills
c) Transvaginal ultrasound
d) Refer for hysteroscopy
Correct Answer: b) Oral contraceptive pills
*Rationale: This patient has heavy menstrual bleeding
(menorrhagia) with no structural cause suspected (age <35,
regular cycles). First-line medical treatment includes hormonal
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contraceptives (OCPs, LNG-IUD). Endometrial biopsy is indicated
for age >45 or risk factors for endometrial cancer.*
Q2. A 16-year-old has not yet started menstruating. She has
normal secondary sexual characteristics (Tanner stage 4 breast
and pubic hair). What is the most likely diagnosis?
a) Primary ovarian insufficiency
b) Anatomic obstruction (e.g., imperforate hymen)
c) Constitutional delay
d) Hypogonadotropic hypogonadism
Correct Answer: c) Constitutional delay
*Rationale: The presence of normal secondary sexual
characteristics indicates sufficient estrogen. Menarche typically
occurs 2-3 years after breast development. Delayed menarche
beyond age 16 with normal development is often constitutional
delay.*
,Page 3 of 58
Q3. A 22-year-old has cyclic pelvic pain and heavy bleeding.
Laparoscopy reveals endometrial implants on the ovaries and
peritoneum. First-line medical management is:
a) NSAIDs alone
b) Combined oral contraceptives (continuous or cyclic)
c) GnRH agonists
d) Hysterectomy
Correct Answer: b) Combined oral contraceptives
Rationale: First-line medical therapy for endometriosis includes
NSAIDs and hormonal contraceptives (OCPs, patch, ring) to
suppress ovulation and reduce pain. GnRH agonists are second-line
due to side effects.
Q4. A 45-year-old has irregular bleeding for 6 months.
Transvaginal ultrasound shows endometrial thickness of 12 mm.
What is the next best step?
a) Endometrial biopsy
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b) Observation
c) Dilation and curettage
d) Hormonal therapy
Correct Answer: a) Endometrial biopsy
Rationale: Postmenopausal bleeding (or perimenopausal with
irregular bleeding and thickened endometrium) requires tissue
sampling to rule out hyperplasia or cancer. Biopsy is office-based
first-line.
Q5. A patient with polycystic ovary syndrome (PCOS) has
oligomenorrhea and hirsutism. Which of the following is a
diagnostic criterion for PCOS (Rotterdam criteria)?
a) Elevated FSH
b) Polycystic ovaries on ultrasound
c) Low testosterone
d) Prolactin elevation
