Test Bank For Current Diagnosis & Treatment Obstetrics &
Gynecology 12th Edition by Alan , Ashley S. Roman, Lauren
Chapter 1-62 Complete Guide feedback
1. History & Physical/Obstetrics/Gynecology
A 26 year-old monogamous female presents with cyclic pelvic pain that has been increasing over the last
6 months. She complains of significant dysmenorrhea and dyspareunia. She uses condoms for birth
control. On physical examination her uterus is retroverted and non-mobile, and she has a palpable
adnexal mass on the left side. Her serum pregnancy test is negative. Which of the following is the most
likely diagnosis?
A. Ovarian cancer
B. Endometriosis
C. Functional ovarian cyst
D. Pelvic inflammatory disease - answer (u) A. It is important to consider ovarian cancer in a patient with
a pelvic mass however, ovarian cancer usually occurs in older women over age 55 and patients are often
asymptomatic until the disease is more advanced
(c) B. With endometriosis, the uterus is often fixed and retroflexed in the pelvis. The palpable mass is an
endometrioma or "chocolate cyst". The patient with endometriosis also often has dysmenorrhea,
dyspareunia, and dyschezia.
(u) C. Functional ovarian cysts occur from ovulation and usually are not symptomatic.
(u) D. With PID the patient will have abdominal tenderness, adnexal tenderness, cervical motion
tenderness and an elevated temperature.
,2. Health Maintenance/Obstetrics/Gynecology
What is the recommended method for screening pregnant women for gestational diabetes?
A. Fasting blood sugar and 2 hour post prandial
B. 50 gram glucose load followed by a blood sugar in 1 hour
C. 75 gram glucose load followed by a blood sugar in 2 hours
D. 100 gram glucose load followed by a blood sugar at 1 hour, 2 hours, and 3 hours - answer (u) A.
Fasting blood sugar and 2 hour postprandial blood test is used to follow patient with gestational
diabetes.
(c) B. One hour Glucola is the screening test for gestational diabetes. It is a 50 gram glucose load, with a
serum glucose obtained 1 hour after the dose. Normal value is less than 140 mg/dL.
(u) C. A 75 gram glucose load is used in non-pregnant patients.
(u) D. This describes a three-hour GTT, which is ordered if the 1 hour Glucola is elevated above 140
gm/dL.
3. Clinical Therapeutics/Obstetrics/Gynecology
What is the treatment of magnesium sulfate toxicity?
A. Nifedipine
B. Terbutaline
C. Potassium carbonate
D. Calcium gluconate - answer (u) A. Nifedipine, a calcium-channel blocker is used to treat both preterm
labor and hypertension in pregnancy. It works by inhibiting calcium transport through slow-type
channels, causing reduction in systemic and pulmonary vascular resistance and tocolysis.
(u) B. Terbutaline is a beta-blocker that is used to treat pre-term labor.
(u) C. Potassium carbonate is a treatment for metabolic acidosis, not magnesium sulfate toxicity.
(c) D. 10% calcium gluconate is used to treat magnesium sulfate toxicity.
4. Clinical Intervention/Obstetrics/Gynecology
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?
A. Total abdominal hysterectomy
B. Observation and endometrial biopsy in 3 months
,C. Endometrial curettage followed by progesterone daily
D. Oral progesterone days 16-25 of the month for 6 months and repeat biopsy - answer (c) A. Atypical
adenomatous hyperplasia contains cellular atypia and mitotic figures in addition to glandular crowding
and complexity. This has a 20-30% risk of progression to endometrial cancer and the recommendation is
hysterectomy.
(h) B. Observation and biopsy again in 3 months would increase the risk of endometrial cancer for this
patient.
(h) C. Endometrial curettage would remove the hyperplasia and progesterone will decrease the
endometrial glandular proliferation. This would be appropriate management in a patient with
endometrial hyperplasia without atypia.
(h) D. Oral progesterone for 10 days of the month will cause the patient to have a withdrawal bleed
every month. This would be an appropriate treatment in a premenopausal patient with endometrial
hyperplasia without atypia
5. Diagnostic Studies/Obstetrics/Gynecology
A 23 year-old female is in active labor and has progressed from 3 cm to 6 cm in the last six hours. Fetal
monitoring demonstrates mild repetitive late decelerations. Which of the following is the most likely
cause of this finding?
A. Fetal hypoxia
B. Head compression
C. Cord compression
D. Uteroplacental insufficiency - answer (u) A. Fetal hypoxia would be a concern if deep late FHR
decelerations were present with absent beat-to-beat variability.
(u) B. Early decelerations are due to head compression of the fetus. Pressure on the fetal head causes an
alteration in cerebral blood flow causing a central vagal stimulation and subsequent FHR deceleration.
The deceleration is a mirror image of the contraction.
(u) C. Variable decelerations are from cord compression. The decelerations have a sharp, angular, decline
in FHR with duration less than 2 minutes.
(c) D. Late decelerations are from uteroplacental insufficiency. The decelerations have a smooth, gradual
symmetrical decrease in FHR beginning at or after the peak of the contraction.
6. Diagnosis/Obstetrics/Gynecology
A 16 year-old G0P0 patient presents complaining of lower pelvic pain that alternates from right to left
side of her pelvis. She states that it is related to her cycle and occurs most commonly midcycle. She
, denies sexual activity. She reports that she has taken ibuprofen at the time of the discomfort with some
relief. Her pelvic examination is unremarkable. Which of the following is the most likely diagnosis?
A. Endometriosis
B. Mittelschmerz
C. Functional ovarian cyst
D. Pelvic inflammatory disease 29 - answer (u) A. With endometriosis, the uterus is often fixed and
retroflexed in the pelvis. The palpable mass is an endometrioma or "chocolate cyst". The patient with
endometriosis also often has dysmenorrhea, dyspareunia, and dyschezia.
(c) B. Women may experience pain at the time of ovulation, may alternate side to side.
(u) C. Functional ovarian cysts occur from ovulation and are not usually symptomatic.
(u) D. Patients with pelvic inflammatory disease often present with fever, pain, and more acute
symptoms.
7. Clinical Therapeutics/Obstetrics/Gynecology
A patient with preterm labor may be given corticosteroids to
A. decrease uterine activity.
B. prevent chorioamnionitis.
C. enhance fetal lung maturity.
D. prevent the development of gestational diabetes. - answer (u) A. Tocolytics are given to decrease
uterine activity with preterm labor.
(u) B. IV antibiotics are given to patients with chorioamnionitis.
(c) C. Corticosteroids may be given from 24-34 weeks in patients with preterm labor or who have
pregnancy complications which may cause premature birth. The corticosteroids enhance pulmonary
maturity.
(u) D. There are no medications to prevent the development of gestational diabetes, however, patients
who have gestational diabetes may be treated with a diabetic diet and/or insulin to manage the
condition and decrease complications.
8. History & Physical/Obstetrics/Gynecology
An 18 year-old female comes to the clinic with the complaint of increased vaginal discharge and vaginal
odor. She also complains of urinary frequency. On physical examination there is evidence of thin, gray,
frothy discharge in the vagina. The cervix appears erythematous and the vaginal pH is 6. Which of the
following is the most likely diagnosis?
Gynecology 12th Edition by Alan , Ashley S. Roman, Lauren
Chapter 1-62 Complete Guide feedback
1. History & Physical/Obstetrics/Gynecology
A 26 year-old monogamous female presents with cyclic pelvic pain that has been increasing over the last
6 months. She complains of significant dysmenorrhea and dyspareunia. She uses condoms for birth
control. On physical examination her uterus is retroverted and non-mobile, and she has a palpable
adnexal mass on the left side. Her serum pregnancy test is negative. Which of the following is the most
likely diagnosis?
A. Ovarian cancer
B. Endometriosis
C. Functional ovarian cyst
D. Pelvic inflammatory disease - answer (u) A. It is important to consider ovarian cancer in a patient with
a pelvic mass however, ovarian cancer usually occurs in older women over age 55 and patients are often
asymptomatic until the disease is more advanced
(c) B. With endometriosis, the uterus is often fixed and retroflexed in the pelvis. The palpable mass is an
endometrioma or "chocolate cyst". The patient with endometriosis also often has dysmenorrhea,
dyspareunia, and dyschezia.
(u) C. Functional ovarian cysts occur from ovulation and usually are not symptomatic.
(u) D. With PID the patient will have abdominal tenderness, adnexal tenderness, cervical motion
tenderness and an elevated temperature.
,2. Health Maintenance/Obstetrics/Gynecology
What is the recommended method for screening pregnant women for gestational diabetes?
A. Fasting blood sugar and 2 hour post prandial
B. 50 gram glucose load followed by a blood sugar in 1 hour
C. 75 gram glucose load followed by a blood sugar in 2 hours
D. 100 gram glucose load followed by a blood sugar at 1 hour, 2 hours, and 3 hours - answer (u) A.
Fasting blood sugar and 2 hour postprandial blood test is used to follow patient with gestational
diabetes.
(c) B. One hour Glucola is the screening test for gestational diabetes. It is a 50 gram glucose load, with a
serum glucose obtained 1 hour after the dose. Normal value is less than 140 mg/dL.
(u) C. A 75 gram glucose load is used in non-pregnant patients.
(u) D. This describes a three-hour GTT, which is ordered if the 1 hour Glucola is elevated above 140
gm/dL.
3. Clinical Therapeutics/Obstetrics/Gynecology
What is the treatment of magnesium sulfate toxicity?
A. Nifedipine
B. Terbutaline
C. Potassium carbonate
D. Calcium gluconate - answer (u) A. Nifedipine, a calcium-channel blocker is used to treat both preterm
labor and hypertension in pregnancy. It works by inhibiting calcium transport through slow-type
channels, causing reduction in systemic and pulmonary vascular resistance and tocolysis.
(u) B. Terbutaline is a beta-blocker that is used to treat pre-term labor.
(u) C. Potassium carbonate is a treatment for metabolic acidosis, not magnesium sulfate toxicity.
(c) D. 10% calcium gluconate is used to treat magnesium sulfate toxicity.
4. Clinical Intervention/Obstetrics/Gynecology
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?
A. Total abdominal hysterectomy
B. Observation and endometrial biopsy in 3 months
,C. Endometrial curettage followed by progesterone daily
D. Oral progesterone days 16-25 of the month for 6 months and repeat biopsy - answer (c) A. Atypical
adenomatous hyperplasia contains cellular atypia and mitotic figures in addition to glandular crowding
and complexity. This has a 20-30% risk of progression to endometrial cancer and the recommendation is
hysterectomy.
(h) B. Observation and biopsy again in 3 months would increase the risk of endometrial cancer for this
patient.
(h) C. Endometrial curettage would remove the hyperplasia and progesterone will decrease the
endometrial glandular proliferation. This would be appropriate management in a patient with
endometrial hyperplasia without atypia.
(h) D. Oral progesterone for 10 days of the month will cause the patient to have a withdrawal bleed
every month. This would be an appropriate treatment in a premenopausal patient with endometrial
hyperplasia without atypia
5. Diagnostic Studies/Obstetrics/Gynecology
A 23 year-old female is in active labor and has progressed from 3 cm to 6 cm in the last six hours. Fetal
monitoring demonstrates mild repetitive late decelerations. Which of the following is the most likely
cause of this finding?
A. Fetal hypoxia
B. Head compression
C. Cord compression
D. Uteroplacental insufficiency - answer (u) A. Fetal hypoxia would be a concern if deep late FHR
decelerations were present with absent beat-to-beat variability.
(u) B. Early decelerations are due to head compression of the fetus. Pressure on the fetal head causes an
alteration in cerebral blood flow causing a central vagal stimulation and subsequent FHR deceleration.
The deceleration is a mirror image of the contraction.
(u) C. Variable decelerations are from cord compression. The decelerations have a sharp, angular, decline
in FHR with duration less than 2 minutes.
(c) D. Late decelerations are from uteroplacental insufficiency. The decelerations have a smooth, gradual
symmetrical decrease in FHR beginning at or after the peak of the contraction.
6. Diagnosis/Obstetrics/Gynecology
A 16 year-old G0P0 patient presents complaining of lower pelvic pain that alternates from right to left
side of her pelvis. She states that it is related to her cycle and occurs most commonly midcycle. She
, denies sexual activity. She reports that she has taken ibuprofen at the time of the discomfort with some
relief. Her pelvic examination is unremarkable. Which of the following is the most likely diagnosis?
A. Endometriosis
B. Mittelschmerz
C. Functional ovarian cyst
D. Pelvic inflammatory disease 29 - answer (u) A. With endometriosis, the uterus is often fixed and
retroflexed in the pelvis. The palpable mass is an endometrioma or "chocolate cyst". The patient with
endometriosis also often has dysmenorrhea, dyspareunia, and dyschezia.
(c) B. Women may experience pain at the time of ovulation, may alternate side to side.
(u) C. Functional ovarian cysts occur from ovulation and are not usually symptomatic.
(u) D. Patients with pelvic inflammatory disease often present with fever, pain, and more acute
symptoms.
7. Clinical Therapeutics/Obstetrics/Gynecology
A patient with preterm labor may be given corticosteroids to
A. decrease uterine activity.
B. prevent chorioamnionitis.
C. enhance fetal lung maturity.
D. prevent the development of gestational diabetes. - answer (u) A. Tocolytics are given to decrease
uterine activity with preterm labor.
(u) B. IV antibiotics are given to patients with chorioamnionitis.
(c) C. Corticosteroids may be given from 24-34 weeks in patients with preterm labor or who have
pregnancy complications which may cause premature birth. The corticosteroids enhance pulmonary
maturity.
(u) D. There are no medications to prevent the development of gestational diabetes, however, patients
who have gestational diabetes may be treated with a diabetic diet and/or insulin to manage the
condition and decrease complications.
8. History & Physical/Obstetrics/Gynecology
An 18 year-old female comes to the clinic with the complaint of increased vaginal discharge and vaginal
odor. She also complains of urinary frequency. On physical examination there is evidence of thin, gray,
frothy discharge in the vagina. The cervix appears erythematous and the vaginal pH is 6. Which of the
following is the most likely diagnosis?
