SP: Women's Rotation EOR (Answered) Over 180
Questions and Correct Answers, With Rationale.
Updated Fall 2024/2025.
On examination of a pregnant patient the physician assistant notes a bluish or purplish discoloration
of the vagina and cervix. This is called
A Hegar's sign.
B McDonald's sign
C Cullen's sign
D Chadwick's sign
Chadwick's sign
Chadwick's sign is a bluish or purplish discoloration of the vagina and cervix.
Hegar's sign is the softening of the cervix that often occurs with pregnancy.
McDonald's sign is when the uterus becomes flexible at the uterocervical junction at 7-8 weeks.
Cullen's sign is a purplish discoloration periumbilical and noted in pancreatitis.
On examination of a pregnant patient the physician assistant notes the fundal height is at the level
of the umbilicus. This corresponds to what gestational age?
A 16 weeks
B 20 weeks
C 24 weeks
D 28 weeks
20 weeks
At 20-22 weeks the fundal height is typically at the level of the umbilicus.
Which of the following is the most common manifestation of polycystic ovarian syndrome?
A Desquamation
B Hirsutism
C Galactorrhea
D Rebound tenderness
Hirsutism
The patient with polycystic ovarian syndrome typically presents with hirsutism or infertility
Desquamation is noted in toxic shock syndrome.
Galactorrhea is noted in hyperprolactinemia.
Rebound tenderness is noted in conditions causing peritonitis.
,25 year-old female presents with vulvar pruritus and a thick, white vaginal discharge. Which of the
following tests will be most helpful in making the correct diagnosis?
A KOH prep
B Gram stain
C Tzanck smear
D FTA-ABS
KOH prep
KOH prep is used to assist in the diagnosis of vaginal candidiasis, which presents with vulvar pruritus
and white curd like, cheesy vaginal discharge.
Gram stain is used in the diagnosis of bacterial infections.
Tzanck smear is used to diagnose herpes infections.
FTA-ABS is used to diagnose syphilis.
25 year-old presents with pelvic pain and uterine bleeding. Her Beta-HCG was 1200 mIU/L six days
ago. Her current Beta-HCG is 1600 mIU/L. What is the next best test in the evaluation of this patient?
A Laparoscopy
B Culdocentesis
C Dilation and curettage
D Transvaginal ultrasound
Transvaginal ultrasound
Transvaginal ultrasound is the best test to separate ectopic from intrauterine pregnancy.
The use of laparoscopy in the diagnosis of an ectopic pregnancy has decreased, but is still useful
when a definitive diagnosis is difficult.
Culdocentesis is used in the diagnosis of intraperitoneal bleeding, which may or may not be present
in an ectopic pregnancy.
Dilation and curettage may confirm or exclude intrauterine pregnancy but is not the next best test in
the evaluation of ectopic pregnancy.
A couple presents having not been able to conceive over the past 12 months. Evaluation of the male
has been normal. The female has had regular menses. Ovulation can be confirmed with mid-luteal
phase measurement of which of the following?
A Thyroid stimulating hormone
B Luteinizing hormone
C Progesterone
D Prolactin
Progesterone
Ovulation can best be confirmed by measuring serum progesterone levels in the mid-luteal phase
TSH is used only if signs of thyroid disease are present.
,LH, FSH, and prolactin are used to confirm ovulation in patients with irregular menstrual cycles.
30 year-old presents with persistent vaginal discharge and vulvar pruritus. The discharge is profuse,
frothy, greenish, and foul smelling. pH of the vagina is 6.0. Which of the following is the most likely
diagnosis?
A Vulvovaginal candidiasis
B Bacterial vaginosis
C Trichomoniasis
D Atrophic vaginitis
Trichomoniasis
- Trichomoniasis presents with vulvar pruritus and a profuse, frothy, greenish, foul-smelling vaginal
discharge with a pH usually exceeding 5.0.
Vulvovaginal candidiasis presents with a thick, curd-like discharge and vulvar pruritus.
Bacterial vaginosis presents with malodorous, gray-white discharge. The pH is typically 5.0-5.5.
Atrophic vaginitis is usually without discharge, but presents with vaginal dryness.
30-week pregnant patient presents with sudden onset of profuse, painless vaginal bleeding. Which
of the following is the most likely diagnosis?
A Abruptio placentae
B Uterine rupture
C Placenta previa
D Disseminated intravascular coagulation
Placenta previa
- Placenta previa presents with sudden, painless, profuse bleeding in the third trimester
Abruptio placentae presents with abdominal pain and vaginal bleeding.
Uterine rupture presents with vaginal bleeding or hematuria with suprapubic pain and tenderness.
Disseminated intravascular coagulation presents with systemic signs of bleeding and thrombosis and
typically presents at the time of delivery.
A 25 year-old female presents with constant premenstrual pelvic pain. She also notes dysmenorrhea
and dyspareunia. Which of the following is the most likely diagnosis?
A Uterine leiomyoma
B Endometrial polyps
C Ovarian cysts
D Endometriosis
Endometriosis
- Endometriosis presents with premenstrual pelvic pain, dysmenorrhea, and dyspareunia.
Leiomyomas of the uterus may present with abnormal uterine bleeding, but typically do not present
with any symptoms.
, Endometrial polyps present with menorrhagia and intermenstrual and premenstrual bleeding, pain
is not typical.
Ovarian cysts present with adnexal mass and acute pain upon rupture.
Which of the following prenatal vitamins has been shown to decrease the risk of neural tube
defects?
A Riboflavin
B Niacin
C Thiamine
D Folic acid
Folic acid
- Folic acid given daily has been shown to effectively reduce the risk of neural tube defects. It should
be started 1-3 months prior to pregnancy.
35 year-old female presents with a solitary breast mass. Fine needle aspiration reveals bloody fluid
with no malignant cells. What is the next best step in the care of this patient?
A Monthly follow-up
B Excisional biopsy
C Hormone therapy
D Repeat fine needle aspiration
Excisional biopsy
- Excisional biopsy is the next step in cases of bloody fluid, residual mass or thickening.
Monthly follow-up is indicated in cases where the mass disappears with aspiration or the fluid is
clear.
Hormone therapy is indicated in cases of breast cancer that express hormone receptors.
Repeat fine needle aspiration is indicated in solid masses which are benign or in which cytologic
findings are inconclusive.
What is the primary treatment for an infected Bartholin's duct cyst?
A Acyclovir
B Azithromycin
C Warm compresses
D Incision and drainage
Incision and drainage
- Incision and drainage is the treatment of choice for a Bartholin duct cyst.
AcyclovirHint:Herpes infections are not a common cause of Bartholin's duct cysts.
AzithromycinHint:Antibiotics are reserved for cases having surrounding inflammation.
Warm compressesHint:Warm compresses are not indicated in the treatment of infected Bartholin's
duct cysts.
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