Women's Health EOR Exam Test Questions And Answers
Verified 100% Correct
A 23-year-old female presents complaining of vaginal irritation, pruritus and a discharge
described as grayish with a "fishy" odor. LNMP was 1 week ago, urine hCG is negative
and she denies recent sexual activity. What is most likely to be found on microscopic
exam?
A clue cells
B Gram negative diplococci
C motile organisms
D spores - ANSWER A
This patient has bacterial vaginosis. It is a polymicrobial disease with overgrowth of
Gardnerella which is not sexually transmitted. The discharge is malodorous, "fishy",
sometimes frothy. On wet mount, epithelial cells appear covered with bacteria obscuring
cell borders (clue cells).
A 33-year-old G2P1 has just delivered a singleton male infant with no complications.
The umbilical cord was doubly clamped and cut by the father. There are no cervical
or vaginal lacerations. Within 10 minutes, there is minimal fresh blood in the vagina,
the umbilical cord has lengthened and the uterus has become firm. What is the
diagnosis? A abruptio placentae
B normal placental separation
C uterine atony
D vasa previa - ANSWER B
Spontaneous normal placental separation is impending when the uterus becomes firm,
there is a sudden gush of blood from the vagina and the umbilical cord moves down out
of the vagina.
When is the best time to draw maternal serum alpha fetoprotein?
A 10-12 weeks
B 15-18 weeks
C 20-22 weeks
D 24-28 weeks - ANSWER B
Maternal serum alpha-fetoprotein should be drawn at 15-18 weeks' gestation; it screens
for open neural tube defects.
A 23-year-old female who is G1P0 and 16 weeks pregnant presents to the emergency
department with painless vaginal bleeding x 2 hours. She denies fever or abdominal
pain or cramping. Ultrasound confirms intrauterine gestation. Fetal heart tones (FHTs)
,are strong at 165 bpm. She had a normal Pap smear 2 years ago. Exam reveals
cervical dilation at 2 cm. What is the most appropriate intervention at this time?
A cervical cerclage
B dilation and curettage
C dilation and evacuation
D delivery - ANSWER A
This patient presents with cervical insufficiency. This is still a viable pregnancy because
she has no abdominal cramping and she is now in the 2nd trimester but she is starting
to dilate. A cervical cerclage is recommended between 13-16 weeks' gestation.
Contraindications to cerclage placement include bleeding of unknown etiology, infection,
labor, ruptured membranes and fetal anomalies.
A 53-year-old woman presents to her primary care physician for a routine examination.
She notes that she began having hot flashes several months prior to presentation along
with occasional painful urination. She notes that her periods have become more
frequent and irregular, but have become lighter overall. Which of the following is most
likely to be true regarding this patient's levels of follicle stimulating hormone (FSH),
luteinizing hormone (LH), and androstenedione?
A Increased FSH, increased LH, increased androstenedione
B Increased FSH, increased LH, no change in androstenedione
C Decreased FSH, decreased LH, increased androstenedione
D Decreased FSH, no change in LH, no change in androstenedione
E No change in FSH, decreased LH, increased androstenedione - ANSWER B
This patient's clinical presentation is consistent with menopause, which is characterized
by increased FSH and LH, with no change in androstenedione levels.
Metronidazole 2 g orally as a single dose or 500 mg twice daily for 7 days is the
treatment regimen for which of the following vaginal infections?
A chlamydia
B candidiasis
C trichomoniasis
D Staphylococcus - ANSWER C
The high-dose regimen of metronidazole is for the treatment of Trichomoniasis.
Trichomonas vaginalis causes this common sexually transmitted disease. The clinical
characteristics include a profuse yellow, frothy, malodorous, pruritic discharge.
Sometimes a strawberry cervix (subepithelial redness) is seen. The pH is between 4.5
and 6. The treatment for chlamydia is azithromycin or doxycycline. Candidiasis would
be treated with an imidazole. Staphylococcus infection could be treated by many
different antibiotics other than metronidazole.
, A 25-year-old nullipara presents for consultation because she suddenly stopped
menstruating. On questioning her further it is found that she recently lost 19 lb after
starting long-distance running. The MOST appropriate step in her evaluation is
measurement of
A serum thyroid stimulating hormone (TSH) concentration
B serum testosterone concentration
C serum prolactin concentration
D human chorionic gonadotropin (hCG) concentration
E serum estradiol-17b concentration - ANSWER D
Although exercise-induced secondary amenorrhea may seem apparent in this case, it is
imperative that pregnancy is ruled out as a cause of the amenorrhea. All amenorrheic
women of reproductive age should be assumed to be pregnant until proven otherwise.
Therefore, an hCG test is indicated as a first step in the evaluation of this patient.
Sudden weight loss and increased physical activity can cause secondary amenorrhea,
as can hypothyroidism and hyperprolactinemia. If ordering serum estradiol
concentrations, an FSH level should also be ordered. Serum estradiol levels alone are
less useful than FSH in deciphering cause of amenorrhea. Decreased estradiol occurs
with either hypothalamic-pituitary axis failure or ovarian failure. Decreased FSH
indicates hypothalamic-pituitary axis failure whereas elevated FSH indicates ovarian
failure. Ordering serum testosterone levels should only be considered if the patient has
symptoms of PCOS or androgen excess.
A 25-year-old nulliparous white woman has a chief complaint of heavy and frequent
menstrual bleeding for the past year. She has never been sexually active; is moderately
overweight; and has hirsutism and acne. She denies vaginal dryness, mood swings, or
hot flashes. She also denies hot or cold intolerance, diarrhea, or heart palpitations.
Which part of this history suggests polycystic ovarian syndrome?
A her age and parity
B sexual activity
C weight, skin, and hair changes
D moods and temperature - ANSWER C
Polycystic ovarian syndrome (PCOS) is suggested by her being moderately overweight
and having hirsutism and acne. As has been claimed in many clinical medicine lectures
over the years, 80% to 90% of the diagnosis can be made from the medical history. The
essential parts of the history when investigating the causes of dysfunctional uterine
bleeding are age of menarche, menstrual history, date of the first day of the last normal
menstrual period, contraceptive use, signs and symptoms of coagulopathy (nosebleeds,
petechiae, and ecchymoses), endocrine symptoms, menopause symptoms, weight
changes, and stress.
Verified 100% Correct
A 23-year-old female presents complaining of vaginal irritation, pruritus and a discharge
described as grayish with a "fishy" odor. LNMP was 1 week ago, urine hCG is negative
and she denies recent sexual activity. What is most likely to be found on microscopic
exam?
A clue cells
B Gram negative diplococci
C motile organisms
D spores - ANSWER A
This patient has bacterial vaginosis. It is a polymicrobial disease with overgrowth of
Gardnerella which is not sexually transmitted. The discharge is malodorous, "fishy",
sometimes frothy. On wet mount, epithelial cells appear covered with bacteria obscuring
cell borders (clue cells).
A 33-year-old G2P1 has just delivered a singleton male infant with no complications.
The umbilical cord was doubly clamped and cut by the father. There are no cervical
or vaginal lacerations. Within 10 minutes, there is minimal fresh blood in the vagina,
the umbilical cord has lengthened and the uterus has become firm. What is the
diagnosis? A abruptio placentae
B normal placental separation
C uterine atony
D vasa previa - ANSWER B
Spontaneous normal placental separation is impending when the uterus becomes firm,
there is a sudden gush of blood from the vagina and the umbilical cord moves down out
of the vagina.
When is the best time to draw maternal serum alpha fetoprotein?
A 10-12 weeks
B 15-18 weeks
C 20-22 weeks
D 24-28 weeks - ANSWER B
Maternal serum alpha-fetoprotein should be drawn at 15-18 weeks' gestation; it screens
for open neural tube defects.
A 23-year-old female who is G1P0 and 16 weeks pregnant presents to the emergency
department with painless vaginal bleeding x 2 hours. She denies fever or abdominal
pain or cramping. Ultrasound confirms intrauterine gestation. Fetal heart tones (FHTs)
,are strong at 165 bpm. She had a normal Pap smear 2 years ago. Exam reveals
cervical dilation at 2 cm. What is the most appropriate intervention at this time?
A cervical cerclage
B dilation and curettage
C dilation and evacuation
D delivery - ANSWER A
This patient presents with cervical insufficiency. This is still a viable pregnancy because
she has no abdominal cramping and she is now in the 2nd trimester but she is starting
to dilate. A cervical cerclage is recommended between 13-16 weeks' gestation.
Contraindications to cerclage placement include bleeding of unknown etiology, infection,
labor, ruptured membranes and fetal anomalies.
A 53-year-old woman presents to her primary care physician for a routine examination.
She notes that she began having hot flashes several months prior to presentation along
with occasional painful urination. She notes that her periods have become more
frequent and irregular, but have become lighter overall. Which of the following is most
likely to be true regarding this patient's levels of follicle stimulating hormone (FSH),
luteinizing hormone (LH), and androstenedione?
A Increased FSH, increased LH, increased androstenedione
B Increased FSH, increased LH, no change in androstenedione
C Decreased FSH, decreased LH, increased androstenedione
D Decreased FSH, no change in LH, no change in androstenedione
E No change in FSH, decreased LH, increased androstenedione - ANSWER B
This patient's clinical presentation is consistent with menopause, which is characterized
by increased FSH and LH, with no change in androstenedione levels.
Metronidazole 2 g orally as a single dose or 500 mg twice daily for 7 days is the
treatment regimen for which of the following vaginal infections?
A chlamydia
B candidiasis
C trichomoniasis
D Staphylococcus - ANSWER C
The high-dose regimen of metronidazole is for the treatment of Trichomoniasis.
Trichomonas vaginalis causes this common sexually transmitted disease. The clinical
characteristics include a profuse yellow, frothy, malodorous, pruritic discharge.
Sometimes a strawberry cervix (subepithelial redness) is seen. The pH is between 4.5
and 6. The treatment for chlamydia is azithromycin or doxycycline. Candidiasis would
be treated with an imidazole. Staphylococcus infection could be treated by many
different antibiotics other than metronidazole.
, A 25-year-old nullipara presents for consultation because she suddenly stopped
menstruating. On questioning her further it is found that she recently lost 19 lb after
starting long-distance running. The MOST appropriate step in her evaluation is
measurement of
A serum thyroid stimulating hormone (TSH) concentration
B serum testosterone concentration
C serum prolactin concentration
D human chorionic gonadotropin (hCG) concentration
E serum estradiol-17b concentration - ANSWER D
Although exercise-induced secondary amenorrhea may seem apparent in this case, it is
imperative that pregnancy is ruled out as a cause of the amenorrhea. All amenorrheic
women of reproductive age should be assumed to be pregnant until proven otherwise.
Therefore, an hCG test is indicated as a first step in the evaluation of this patient.
Sudden weight loss and increased physical activity can cause secondary amenorrhea,
as can hypothyroidism and hyperprolactinemia. If ordering serum estradiol
concentrations, an FSH level should also be ordered. Serum estradiol levels alone are
less useful than FSH in deciphering cause of amenorrhea. Decreased estradiol occurs
with either hypothalamic-pituitary axis failure or ovarian failure. Decreased FSH
indicates hypothalamic-pituitary axis failure whereas elevated FSH indicates ovarian
failure. Ordering serum testosterone levels should only be considered if the patient has
symptoms of PCOS or androgen excess.
A 25-year-old nulliparous white woman has a chief complaint of heavy and frequent
menstrual bleeding for the past year. She has never been sexually active; is moderately
overweight; and has hirsutism and acne. She denies vaginal dryness, mood swings, or
hot flashes. She also denies hot or cold intolerance, diarrhea, or heart palpitations.
Which part of this history suggests polycystic ovarian syndrome?
A her age and parity
B sexual activity
C weight, skin, and hair changes
D moods and temperature - ANSWER C
Polycystic ovarian syndrome (PCOS) is suggested by her being moderately overweight
and having hirsutism and acne. As has been claimed in many clinical medicine lectures
over the years, 80% to 90% of the diagnosis can be made from the medical history. The
essential parts of the history when investigating the causes of dysfunctional uterine
bleeding are age of menarche, menstrual history, date of the first day of the last normal
menstrual period, contraceptive use, signs and symptoms of coagulopathy (nosebleeds,
petechiae, and ecchymoses), endocrine symptoms, menopause symptoms, weight
changes, and stress.
