a sexually active woman should be aware that genital herpes simplex virus:
a. may be transmitted to a partner or newborn even in the absence of lesions because of viral shedding
b. is suppressed during menstruation, physical or emotional stress, immunosup
a. may be transmitted to a partner or newborn even in the absence of lesions because of viral shedding
a 17 y/o female pat requests to start Depo-provera injections as her method of birth control. She discloses that she has had four sexual partners in the past year. Her LMP was 12 days ago and she had unprotected intercourse 3 days ago. The appropriate man
b. advise her to use another method for now and return with her next menses
in a premenopausal woman, the biggest heart attack risk factor is:
a. cigarette smoking
b. family hx
c. sedentary lifestyle
d. obesity
a. cigarette smoking
first line tx for polycystic ovary syndrome is:
a. a bilateral oophorectomy
b. oral testosterone therapy
c. a combination of diet modification, wt loss, and stress management
d. a laparoscopy with a bilateral wedge resection
c. a combination of diet modification, wt loss, and stress management
if a woman is using the basal body temperature (BBT) method of birth control and does not want to become pregnant, when would you tell her to avoid unprotected intercourse?
a. from the beginning of the menstrual cycle until the BBT has been elevated for 3
a. from the beginning of the menstrual cycle until the BBT has been elevated for 3 days
which of the following is a sexually transmitted infection?
a. candida vaginitis
b. trichomonal vaginitis
c. atrophic vaginitis
d. lactobacilli vaginitis
b. trichomonal vaginitis
in a pt dx with cervical gonococcal infection, you would also suspect a co-infection with:
a. candidiasis
b. syphilis
c. trichomoniasis
d. chlamydia
d. chlamydia
Jane, age 27, is c/o of lower abdominal pain. After doing some lab studies, you find leukocytosis, an elevated erythrocyte sed rate and an elevated C-reactive protein level. Which is the most appropriate dx?
a. ovarian cyst
b. PID
c. tubal pregnancy
d. di
b. PID
human papillomavirus may lead to:
a. pelvic inflammatory disease
b. molluscum contagiosum
c. cervical dysplasia
d. genital herpes
c. cervical dysplasia
Gean, a 33 y/o female pt, c/o external vaginal irritation after adding new fabric softener to her laundry. You have dx her with reactive vaginitis. The tx of choice for this condition includes:
a. metronidazole (flagyl) 500mg BID x 7 days
b. conjugated va
d. rewashing undergarments without fabric softener and applying corticosteroids to the affected area
a dancer from an adult club down the street comes in for a renewal of ther birth control pill prescription. She says that everything is fine. On exam, you find grayish-white vaginal discharge, greenish cervical discharge, and cervical motion tenderness. W
b. interstitial cystitis
leiomyomas are found:
a. within the uterine wall
b. on the vaginal wall
c. within the cervix
d. on the fallopian tube
a. within the uterine wall
when a woman complains of dyspareunia in the lower back during orgasm, you should consider:
a. endometriosis
b. cystitis
c. vaginitis
d. causes r/t pelvic inflammatory disease
a. endometriosis
a 27 y/o female presents to your office for a Mirena (levonorgestrel intrauterine system) insertion. She reports that her menses started 3 days ago and is normal. How soon after insertion will she be able to safely rely on it for contraception?
a. immedia
a. immediately
Melody, age 50, desires hormone replacement therapy (HRT) for her hot flashes, which she can't stand. You have discussed the pros and cons and given her some alternative suggestions. Her mother had a hx of osteoporosis. You have decided to initiate therap
b. yes, calcium intake should be increased to 1200mg/day along with 600mg of vitamin D to decrease bone turnover and increase intestinal absorption
Jane, age 60 asks, you about taking alendronate (Fosamax). What do you tell her about using the medication?
a. if you decide to take it, stick with a lower dose of 5mg because the side effects are much worse with a 10mg dose
b. fosamax works better in you
d. in addition to its efficacy in the tx of osteoporosis in postmenopausal women, it is also useful for the prevention of osteoporosis
which type of breast cancer involves infiltration of the nipple epithelium and has an initial sx of itching or burning of the nipple?
a. ductal cancer
b. Paget's disease
c. mammaryd uct ectasia
d. fibroadenoma
b. Paget's disease
which type of incontinence has an associated sx of recurrent cystitis?
a. stress incontinence
b. urge incontinence
c. overflow incontinence
d. function incontinence
a. stress incontinence
the most common type of vaginal infection is:
a. candidiasis
b. trichomoniasis
c. gonorrhea
d. bacterial vaginosis
d. bacterial vaginosis
which of the following is an indication for a colposcopy?
a. pap smear showing dysplasia
b. recurrent STIs
c. HIV infection
d. hx of leiomyomas
a. pap smear showing dysplasia
which of the following statements do you use when instructing women about their fertile period (when they are most likely to become pregnant)?
a. ovulation occurs on the 14th day, plus or minus 2 days, before the next menses
b. sperm are viable for 24 hrs
a. ovulation occurs on the 14th day, plus or minus 2 days, before the next menses
Jenn, a 25 y/o female pt, c/o dysuria. In taking a thorough hx to formulate a dx, it is most important to ask:
a. do you have painful intercourse?
b. do you have an associated vaginal discharge or irritation?
c. do you also have a problem with defecation?
b. do you have an associated vaginal discharge or irritation?
Sally, age, 21 is taking an oral contraceptive. She c/o acne. How should you adjust the estrogen in the oral contraceptive?
a. increase the estrogen content
b. decrease the estrogen content
c. delete the estrogen content
d. no adjustment should be made to
a. increase the estrogen content
Mary, age 59, presents with depression. According to the diagnostic criteria for a major depressive d/o, which of the following criterion needs to be met?
a. the depression must have a specific cause, like alcohol, drugs, medication s/e, or physical illne
b. the sxs must be severe enough to upset the cl'ts daily routine or to impact his/ or her work or interfere with relationships
the best method to dx uterine polyps is a:
a. hysteroscopy
b. dilation and curettage
c. colposcopy
d. laparoscopy
a. hysteroscopy
Dolly, is to undergo a cone-needle biopsy for a suspicious breast mass. This procedure includes:
a. 21 or 22 gauge needle that is used to aspirate cells from the lesion for analysis
b. removal of a large core of tissue from the lesion for histological eva
b. removal of a large core of tissue from the lesion for histological eval utilizing a large-gauge cutting needle
which of the following lifestyle factors is associated with an increased risk for breast cancer?
a. being underweight
b. having one to two drinks of alcohol per day
c. smoking
d. eating a low-fat diet
c. smoking
Susan says that her previous doctor never discussed why he took her off HRT. You share with her some of the results of the women's Health Initiative (WHI). which statement is true regarding the study?
a. estrogen plus progestin increased the risk of a car
a. estrogen plus progestin increased the risk of a cardiac event in apparently healthy women
Mrs. W. would like to schedule an appt to bring her 18 y/o daughter in to see you for her first gyn exam and Pap smear. the most appropriate reply would include:
a. I would be happy to see your daughter and complete her gyn exam and Pap smear
b. your daug
d. I would be happy to see your daughter and complete her gyn exam; however, she does not need a Pap smear until the age of 21
women who take oral contraceptives are less likely to experience:
a. human papillomavirus infection
b. migraine headace
c. iron -deficiency anemia
d. herpes simplex virus
c. iron -deficiency anemia
the average age of menopause int he US is:
a. 45 yrs
b. 48 yrs
c. 50 yrs
d. 53 yrs
c. 50 yrs
a 26 y/o female comes to your office to discuss birth control options. Her hx includes migraine headaches with aura while on combination oral contraceptives in the past. She does not want to become pregnant. Which of the following birth control options wo
c. mirena IUD
unilateral galactorrhea may be present with:
a. an intraductal papilloma
b. a woman who is lactating
c. a ruptured breast implant
d. pregnancy
a. an intraductal papilloma
which of the following drugs may have their effects enhanced when used in combination with an oral contraceptive?
a. beta blockers
b. oral anticoagulants
c. antacids
d. anti-convulsants
a. beta blockers
which of the following drugs may diminish the effectiveness of oral contraceptives?
a. beta blockers
b. oral anticoagulants
c. antibiotics
d. oral hypoglycemis
c. antibiotics
which of the following drugs may have their effects diminished when used in combination with an oral contraceptive?
a. corticosteroids
b. oral anticoagulants
c. antibiotics
d. anticonvulsants
b. oral anticoagulants
during a pelvic exam, you ask Mrs. K to Valsalva (strain). While doing this, a pouching is seen on the anterior wall of the vagina. This is indicative of:
a. a cystocele
b. a rectocele
c. an enterocele
d. a uterine prolapse
a. a cystocele
Sally has a dx of a chlamydia vaginal infection. You believe that is is questionable whether she will fill the prescription that you write or take it for 7 days as order. What would you do?
a. give azithromycin (zithromax) 1g PO now
b. emphasize the impor
a. give azithromycin (zithromax) 1g PO now
infertility is best defined as the:
a. inability to conceive with multiple sex partners
b. inability to conceive for 9 months of unprotected intercourse when both partners are younger than 30 yrs of age
c. state of voluntary childlessness
d. inability to
d. inability to conceive after 1 full yr of unprotected intercourse
Reiter's syndrome is a complication of:
a. bacterial vaginosis
b. syphilis
c. chlamydia
d. gonorrhea
d. gonorrhea
Mrs. H. inquires about why she needs progestereone in addition to her estrogen for hormone replacement. Women who have an intact uterus need to add progesterone to their prescribed estrogen because progestin:
a. assists in relieving the typical hot flashe
b. reduces the incidence of endometrial hyperplasia and cancer
a 21 y/o woman comes to your ofice and reports a hx of genital warts. In reference to the HPV vaccination (Gardasil or Cervarix), she should be educated that:
a. she is not in the correct age grp and is not a candidate for the vaccination
b. she should re
b. she should receive the HPV vaccination
Jane wants to use some form of birth control, but because she is getting married next year,s he wants to be able to stop the birth control method after the wedding and have her fertility restored almost immediately. Which method do you recommend for her?
d. Lea's shield
Belle is breastfeeding her 3 month old infant with no supplementation./ She says she has heard that she cannot get pregnant during this time. What do you tell her?
a. it is highly likely that you may become pregnant, so you should use another method of bi
c. for the first 6 months, if you breastfeed and have very little supplementation, your chances are less than 2% that you'l get pregnant
the most common reason for surgery for macromastia is:
a. back and shoulder pain
b. breast cancer
c. fibrocystic breast disease
d. inability to breastfeed
a. back and shoulder pain
You have just finished a Pap smear on Sally, age 39. during the wet mount, you see cells with bacteria adherent to the cell wall giving it a stippled, granular appearance. What do you suspect?
a. candidiasis
b. bacterial vaginosis
c. trichomoniasis
d. cer
b. bacterial vaginosis
the majority of breast carcinomas are found in which anatomical site in the breast?
a. around the areola
b. in the upper outer quadrant
c. in the lower half of the breast
d. toward the sternum
b. in the upper outer quadrant
Ann, age 19, is going to begin taking birth control pills. She asks you if she is safe immediately. How do you respond?
a. yes, you should not get pregnant once you start the pill. However, it doesn't protect you from STIs
b. for the first month, you need
c. a second birth control method needs to be used during intercourse for the first 7 days while taking the pill. However, it doesn't protect you from STIs
J. age 42 presents for her well-woman exam and you notice "dimpling" on her left breast. Your initial reaction is that is may possible be:
a. breast cancer
b. fibrocystic breast disease
c. Paget's disease
d. striae from recent dieting
a. breast cancer
what is the most common cause of mastitis in breastfeeding women?
a. escherichia coli
b. streptococcus
c. mycobacterium tuberculosis
d. staphylococcus aureus
d. staphylococcus aureus
which of the following drugs given to nursing mothers may cause a reduction in the milk supply?
a. antihistamines
b. antithyroid medication
c. oral contraceptives
d. laxatives
c. oral contraceptives
J. has severe pain monthly with her fibrocystic breast disease. Which medication do you suggest she try?
a. micronized estradiol (estrace)
b. danazol (danocrine)
c. paroxetine (paxil)
d. venlafaxine (effexor)
b. danazol (danocrine)
emotional support is best given to the clt with a sexually transmitted infection by:
a. offering many alternatives
b. authentic active listening
c. assuring the clt that everything will be okay
d. emphasizing the duration of the disease
b. authentic active listening
M., age 40 has been given a dx of rheumatoid arthritis. She asks you whether she should continue taking her birth control pills. You tell her:
a. to check with her rheumatologist
b. to stop
c. to continue
d. the dose will have to be altered
c. to continue
Mrs. L. would like to be fitted for a diaphragm. She has been on numerous hormones int he past and does not like the side effects. It is important to remember that when properly fitting a pt for a diaphragm, it should:
a. allow a fingertip between it and
a. allow a fingertip between it and the pubic arch
herpes implex virus can be potentially acquired through maternal transmission. This is least likely to occur:
a. before labor
b. during delivery
c. postnatally
d. during the neonatal period
d. during the neonatal period
a tx used to improve the chance of pregnancy in an infertile woman who has minimal or mild endometriosis is:
a. laparoscopic resection or ablation of the lesions
b. dilation and curettage
c. the use of gonadotropin-releasing hormone analogues
d. the use o
a. laparoscopic resection or ablation of the lesions
S., age 29, c/o premenstrual syndrome. She state she was told that changing her diet might help in managing some of the sxs. What changes in her diet do you recommend?
a. increase her intake of protein
b. increase her intake of complex carbohydrates
c. in
b. increase her intake of complex carbohydrates
which form of estrogen is secreted in the greatest amount by the ovaries during the reproductive yrs and considered most potent?
a. estrone (E1)
b. estradiol (E2)
c. estriol (E3)
d. the potency and secretion of all of the above are in equal amts
b. estradiol (E2)
J., age 26, who has genital herpes, ask if her partner has to use a condom during sexual intercourse even if she does not have a visible lesion. How do you respond?
a. yes, we are not sure if its still transmitted when the lesions are not visible, so it i
d. yes, shedding of the herpes simplex virus from mucocutaneous surfaces int he absence of visible lesions is a primary mode of transmission
when a woman has extreme spasticity, which position should she assume for a Pap smear?
a. OB stirrups position
b. knee-chest position while prone
c. v-shaped position without stirrups
d. side-lying position
b. knee-chest position while prone
on PE, J., has pubic hair that spreads over her mons pubis with a slt lateral spread. In addition, her breast development shows breast enlargement with secondary mound formation by the developing areola. Which Tanner best describes J.'s development?
a. st
c. stage IV
of the sxs listed below, the most commonly expressed sx of women with premenstrual syndrome is:
a. fatigue
b. depression
c. breast tenderness
d. swelling of the extremities
a. fatigue
the Mobiluncus species is responsible for which sexually transmitted infection?
a. condylomata acuminata
b. bacterial vaginosis
c. human papillomavirus
d. lymphogranuloma venereum
b. bacterial vaginosis
an occurrence of genital herpes is:
a. cured with acyclovir
b. best managed with trichloroacetic acid 80%-90% applied directly to the lesion
c. expected to be completely resolved within 21 days (for the primary lesion)
d. not a factor in continuing with i
c. expected to be completely resolved within 21 days (for the primary lesion)
L., age 43 comes to your office in tears, stating that last night she had unprotected sex and forgot to take her birth control pill. she wants to know about the morning -after pill. You tell her:
a. if your period does not start at the schedule time, come
c. I'll go ahead and order the Yuzpe regimen
L., age 38 states that she has not had a pelvic exam in 5 yrs because she does not like having the digital rectal exam. How do you respond?
a. let's schedule an exam now because women no longer need a rectal exam with routine pelvic exams
b. ok, we'll do
a. let's schedule an exam now because women no longer need a rectal exam with routine pelvic exams
Lactobacilli in the vagina:
a. decreases glycogen metabolism
b. maintains an acid pH range
c. increases the development of WBCs
d. maintains an alkaline pH range
b. maintains an acid pH range
D., is a 23 y/o pt dx with dyspareunia. Which of the following is NOT a cause for this condition?
a. vulvovaginitis
b. an incompletely stretch hymen
c. vaginismus
d. multiple pregnancies
d. multiple pregnancies
there are many causes of amenorrhea. In ballet dancers or marathon runners, which anatomical structure is the probable cause?
a. outflow tract
b. ovary
c. anterior pituitary
d. hypothalamus
d. hypothalamus
what is the most common virus to be transmitted in utero?
a. cytomegalovirus
b. rubella
c. varicella
d. toxoplasmosis
a. cytomegalovirus
S. has been dx with fibrocystic breast disease. Which of the following may exacerbate the condition?
a. daily dose of aspirin
b. spicy foods
c. chocolate
d. wearing tight bras
c. chocolate
how long can the vaginal contraceptive ring (Nuvaring) be out of the vagina before an additional form of contraception is necessary?
a. 3o min
b. one hr
c. 2 hrs
d. 3 hrs
d. 3 hrs
which of the following ovarian tumors or cysts has the potential for malignancy?
a. follicle cysts
b. Brenner's tumor
c. fibroma
d. secondary ovarian tumors
d. secondary ovarian tumors
the Jameses are thinking about going for infertility counseling because they have been married for 5 yrs and have been unable to conceive. They ask you whether the man or the woman is usually the cause of the infertility. What do you tell them about the e
d. male and female infertility rates are almost the same in the majority of cases
B., age 24 c/o urgency, frequency, and dysuria. Your dipstick test shows no hematuria, and her urine culture shows no growth. What is your next action?
a. you suspect a sexually transmitted infection, so you obtain a culture of the urethra, do a potassium
a. you suspect a sexually transmitted infection, so you obtain a culture of the urethra, do a potassium hydroxide wet prep, and obtain another urine culture
J., has a seizure disorder and wants to get pregnant. What is the drug of choice for her during pregnancy
a. valproate (depakene)
b. trimethadione (tridione)
c. phenobarbital (luminal)
d. phenytoin (dilantin)
c. phenobarbital (luminal)
when premenstrual syndrome sxs do not respond to dietary and nonmedical therapies, which of the following drugs might you try?
a. antidepressants
b. antihistamines
c. corticosteroids
d. anticholinergics
a. antidepressants
a vagina Ph of 4.2 is an expected finding in:
a. a healthy prepubertal age girl
b. a woman with trichomoniasis vaginalis
c. a postmenopausal woman with atropic vaginitis
d. a healthy woman of reproductive age
d. a healthy woman of reproductive age
J. is nursing her 8 wk old baby and states that he is very irritable and sleeps poorly. What medication or substance do you ask her if she is taking or using?
a. cimetidine
b. ergotamine
c. nicotine
d. caffeine
d. caffeine
which of the following conditions is a contraindication to using the copper IUD?
a. hx of ectopic pregnancy
b. nulliparity
c. tx cervical dysplasia
d. heart disease
d. heart disease
candidiasis is more common in:
a. teenage girls
b. women on low fat diets
c. women with diabetes
d. women with frequent UTIs
c. women with diabetes
which blood tumor marker is highly specific to epithelial ovarian cancer?
a. PSA
b. CA 125
c. CA 15-3
d. CA 19-9
b. CA 125
emergency contraception refers to:
a. an induced abortion inan emergency room
b. quickly starting on birth control pills in anticipation of sexual intercourse
c. having a medroxyrogesterone injection in the ER q12 wks
d. taking emergency contraceptive pil
d. taking emergency contraceptive pills (ECPs)
toxic shock syndrome (TSS) may be causes by which of the following?
a. tampon contamination with staphylococcus aureus
b. a short vaginal canal
c. the use of superabsorbent tampons
d. a UTI involving the bladder and kidneys
a. tampon contamination with staphylococcus aureus
Mrs. G., called the office to make an appt for her annual Pap smear. She needs to be given the following instructions prior to her appt:
a. insert nothing in the vagina for 24 hrs before the exam
b. douching enhances visualization of the cervix and should
a. insert nothing in the vagina for 24 hrs before the exam
Procidentia is a:
a. cystocele
b. rectocele
c. vaginal fistula
d. third-degree uterine prolapse
d. third-degree uterine prolapse
endometrial cancer, hirsutism, acne, breast cancer, increased risk of diabetes,infertility, menstrual bleeding problems, and an increased risk of cardiovascular disease are clinical consequences of:
a. mastalgia
b. menorrhagia
c. endometriosis
d. persiste
d. persistent anovulation
menses at irregular intervals with excessive flow and duration is defined as:
a. oligomenorrhea
b. polymenorrhea
c. menorrhagia
d. metrorrhagia
d. metrorrhagia
the most likely cause of amenorrhea is:
a. an anatomical deviation
b. a genetic factor
c. an endocrine abnormality
d. pregnancy
d. pregnancy
M., age 42, is having dysfunctional uterine bleeding (DUB) and cannot take oral contraceptives due to a hx of a blood clot (emboli). Management includes which medication?
a. medroxyprogestone
b. ethinyl estradiol
c. conjugated estrogen
d. piroxicam
a. medroxyprogestone
characteristics of polycystic ovary syndrome include:
a. hirsutism, thinness, hypoinsulinemia
b. menopausal onset, vitilgo, hyperinsulemia
c. alopecia, thinness, abdominal cramping
d. premenarchial onset, obesity, hyperinsulinemia
d. premenarchial onset, obesity, hyperinsulinemia
dysfunctional uterine bleeding is usually associated with:
a. pregnancy
b. anovulation
c. genital tumor
d. inflammation
b. anovulation
S., states that she has heard that douching effectively washes out the sperm after intercourse and that she has been using this as a method of birth control. Which of the following statements about douching is true?
a. douching prevents sperm from enterin
d. douching may increase the risk of ectopic pregnancy
C., says that her healthcare provider wants to do a colposcopy. She ask you what this is. You tell her that a colposcopy:
a. visualizes the cervical, vaginal, or vulvar epithelium under magnification to identify abnormal areas that may require a biopsy
b.
a. visualizes the cervical, vaginal, or vulvar epithelium under magnification to identify abnormal areas that may require a biopsy
which type of cyst fo the female reproductive system usually results in pain, redness, a perineal mass, and dyspareunia?
a. ovarian cyst
b. Bartholin's cyst
c. Gardner's cyst
d. Nabothian cyst
b. Bartholin's cyst
what is the positionof the uterus when the cervix is on the anterior vaginal wall?
a. midposition
b. retroverted
c. retroflexed
d. anteverted
d. anteverted
small-quantity incontinence with nearly continous dribbling is symptomatic of which kind of incontinence?
a. stress incontinence
b. urge incontinence
c. overflow incontinence
d. functional incontinence
c. overflow incontinence
which of the following terms describes the bluish or purplish discoloration of the vulva, vagina, and a portion of the cervix that occurs in pregnancy?
a. Goodell's sign
b. Hegar's sign
c. Piskacek's sign
d. Chadwick's sign
d. Chadwick's sign
which glands are posterior on each side of the vaginal orifice and open onto the sides of the vestibule int he groove between the labia minora and hymen?
a. Bartholin's glands
b. Skene's glands
c. paraurethral glands
d. cystocele
a. Bartholin's glands
thelarche is the first sign of puberty in most girls. It usually occurs at about what age?
a. 8 yrs
b. 10 yrs
c. 11 yrs
d. 13 yrs
c. 11 yrs
which of the following signs and/or sxs of a genital herpes infection usually occurs first?
a. painful or pruritic vesicles
b. dysuria
c. prodromal tingling or pruritus of the genital region
d. white, curdlike plaques on a red base in the vagina
c. prodromal tingling or pruritus of the genital region
a 17 y/o female presents to your office with the c/o lower abdominal pain since her period ended 2 days ago. She has a new sexual partner in the past 3 months and does not use condms. On PE, you find that she has cervical motion tenderness. You are concer
c. lower abdominal tenderness and adnexal tendernes