NCCPA Obstetrics and Gynecology 3

Question 1

A 24-year-old woman with a history of chlamydia presents with right upper quadrant pain, fever, and cervical motion tenderness.
Liver function tests are mildly elevated.
What is the most likely diagnosis?

Accepted Answer

Fitz-Hugh–Curtis syndrome

Answer

Acute cholecystitis

Answer

Hepatitis B infection

Answer

Right-sided ectopic pregnancy

Question 2

A 30-year-old woman at 32 weeks gestation presents with painful uterine contractions every 5 minutes, back pain, and a small amount of vaginal bleeding. Cervical exam shows 2 cm dilation. She denies rupture of membranes. What is the most appropriate initial pharmacological intervention?

Accepted Answer

Administer IV magnesium sulfate for neuroprotection and betamethasone for fetal lung maturity

Answer

Start oxytocin augmentation

Answer

Administer oral nifedipine for tocolysis only

Answer

Perform emergency cesarean delivery

Question 3

A 27-year-old woman at 38 weeks gestation with chronic hypertension suddenly develops severe, continuous abdominal pain and a board-like rigid uterus. Fetal heart monitoring shows late decelerations. There is dark vaginal bleeding. What is the most likely diagnosis?

Accepted Answer

Placental abruption

Answer

Placenta previa

Answer

Uterine rupture

Answer

Vasa previa

Question 4

A 36-year-old nulliparous woman desires long-term contraception. She has a history of migraines with aura and hypertension. Which contraceptive method is safest for her?

Accepted Answer

Levonorgestrel intrauterine device (LNG-IUD)

Answer

Combined oral contraceptive pills (estrogen + progestin)

Answer

Combined hormonal patch

Answer

Vaginal contraceptive ring (NuvaRing)

Question 5

According to USPSTF guidelines, women with average risk should begin mammography breast cancer screening at what age?

Accepted Answer

40 years

Answer

35 years

Answer

45 years

Answer

50 years

Question 6

A 31-year-old woman at 28 weeks gestation is found to have a fasting glucose of 96 mg/dL and a 1-hour 50-g glucose challenge test (GCT) result of 158 mg/dL. What is the next most appropriate step?

Accepted Answer

Perform a 3-hour 100-g oral glucose tolerance test (OGTT)

Answer

Diagnose gestational diabetes and start insulin

Answer

Reassure the patient and repeat GCT in 4 weeks

Answer

Begin dietary modifications and discharge

Question 7

A 26-year-old Rh-negative woman at 28 weeks gestation has an Rh-positive partner and a negative antibody screen. Which of the following is the most appropriate management?

Accepted Answer

Administer Rh(D) immune globulin (RhoGAM) 300 mcg IM now and again within 72 hours of delivery

Answer

No intervention needed since she has not been sensitized

Answer

Administer RhoGAM only if she has vaginal bleeding

Answer

Perform amniocentesis to determine fetal Rh status before administering RhoGAM