Women's Health Example Questions

​Women's Health Example Questions

By Megan Persenaire

Multiple Choice

A 22-year-old woman presents with infertility, irregular periods, obesity, excess hair, and velvety, hyperpigmented lesions on her neck. She has no abnormalities on breast and pelvic exams. What is the most likely diagnosis?

• Premature Ovarian Failure

• Polycystic Ovarian Syndrome

• Type II Diabetes

• Psoriatic Arthritis

Multiple Choice

A 53-year-old woman has hot flashes, painful urination, and increasingly frequent but lighter periods. What is most likely true regarding her FSH and LH levels?

• Elevated FSH

  Elevated LH

• Elevated FSH

  Low LH

• Low FSH

  Elevated LH

• Low FSH

  Low LH

Multiple Choice

A patient presents with copious yellow-green, frothy, malodorous vaginal discharge, a "strawberry cervix," and a vaginal pH of 5.5. What is the most likely diagnosis?

• Gardneralla

• Candida

• Chlamydia

• Trichomonas

Multiple Choice

A 28-year-old female has a routine Pap smear result of a high-grade squamous intraepithelial lesion (HSIL). What is the next most appropriate step in management

• Repeat a pap smear in 1 year

• HPV testing

• Colposcopy

• LEEP Procedure

Multiple Choice

A 25-year-old female presents with a single, mobile, firm, nontender solid breast mass. What is the most likely diagnosis?

• Breast Cancer

• Galactocele

• Fibrocystic Breast Disease

• Fibroadenoma

Multiple Choice

A 22-year-old female presents with lower abdominal pain, a new purulent vaginal discharge, and fever. On pelvic exam, she has marked cervical motion tenderness. What is the most common organism responsible for this condition?

• Gonorrhea/Chlamydia

• Gardnerella

• E. Coli

• Trichomonas

Multiple Choice

A 30-year-old woman complains of a thin, off-white, malodorous vaginal discharge, with a "fishy" odor, especially after intercourse. The vaginal pH is 5.0. What would you expect to see on a wet mount?

• Budding Yeast

• Clue Cells

• Pseudohyphae

• Leukorrhea

Multiple Choice

A 30-year-old female presents with severe dysmenorrhea, dyspareunia, and cyclic pelvic pain. A pelvic exam may reveal a fixed, retroverted uterus. What is the definitive method for diagnosis?

• Pelvic Ultrasound

• Hysteroscopy

• Exploratory Laproscopy

• Dilation and Curettage

Multiple Choice

A 30-year-old woman is found to have an incidental ovarian mass on a routine ultrasound. It is a 6-cm, multilocular cyst with a calcified component. She is asymptomatic. What is the most likely diagnosis? 

• Mature Cystic Teratoma

• Follicular Cyst

• Ovarian Cancer

• Hemorrhagic Cyst

Multiple Choice

A 26-year-old woman with a history of a dilation and curettage (D&C) procedure following a miscarriage presents with amenorrhea for the past six months. She reports a negative home pregnancy test. Her prolactin and TSH levels are within normal limits. A progesterone challenge test produces no withdrawal bleeding. What is the most likely diagnosis?

• Hypothalamic Amenorrhea

• Premature Ovarian Insufficiency

• Polycystic Ovarian Syndrome

• Asherman's Syndrome

Multiple Choice

A 30-year-old female presents with a 7-month history of amenorrhea and a milky discharge from both breasts (galactorrhea). She denies being pregnant or breastfeeding. Lab results show a markedly elevated serum prolactin level, and her thyroid-stimulating hormone (TSH) is normal. What is the most appropriate next step in management?

• Begin a trial of oral contraceptive pills

• Order a progesterone challenge test

• Order an MRI of the sella turcica

• Prescribe cabergoline for hyperprolactinemia

Multiple Choice

A 25-year-old woman presents with a history of recurrent, painful, and deep-seated nodules in her groin and axillae that sometimes drain foul-smelling pus. She also has multiple tunnels and scars under the skin in these areas. What is the most likely diagnosis?

• Recurrent folliculitis

• Pilonidal cyst

• Herpes simplex virus

• Hidradenitis suppurativa

Multiple Choice

A 68-year-old postmenopausal woman presents with a 9-month history of severe vulvar pruritus. She also reports pain with intercourse and complains of a tearing sensation. On exam, you note thin, whitish, crinkled "cigarette paper" skin on the labia minora and perianal area, and some areas of ecchymosis. What is the most appropriate initial treatment for this patient?

• Topical antifungal cream

• High-potency topical corticosteroids

• Oral antihistamines

• Topical estrogen cream

Multiple Choice

A 28-year-old female presents with a painful, erythematous, and fluctuant unilateral mass in the posterior portion of her labia majora. She reports pain when walking and sitting. What is the most appropriate management for this condition?

• Sclerotherapy with silver nitrate

• Word catheter placement

• Referral for surgical excision

• Broad-spectrum oral antibiotics

Multiple Choice

A 45-year-old woman with a history of human papillomavirus (HPV) presents with an unremitting pruritic vulvar lesion that has not responded to topical steroids for several months. On exam, you see a well-demarcated, hyperpigmented, and slightly raised plaque on the right labia majora. What is the most appropriate next step in management

• Perform a vulvar biopsy.

• Prescribe a higher-potency topical steroid.

• Cryosurgery to ablate the lesion.

• Begin treatment with imiquimod cream

Multiple Choice

A 48-year-old perimenopausal woman presents with a 6-month history of irregular and heavy menstrual bleeding. She denies pain, fever, or any other systemic symptoms. Her last Pap smear was normal. A transvaginal ultrasound reveals a normal-appearing uterus with a thickened endometrial stripe, but no masses, fibroids, or polyps. Her pregnancy test, CBC, TSH, and prolactin levels are all normal. Which of the following is the most appropriate next step in management

• Endometrial biopsy

• OCP's

• Repeat pelvic ultrasound in 3-6 months for surveillance

• Dilation and Curettage

Multiple Choice

A 35-year-old woman presents with a 9-month history of severe, sharp, burning, and stinging pain at the entrance of her vagina. The pain is triggered by light touch, intercourse, and tampon insertion. A physical exam reveals significant tenderness upon cotton-swab testing of the vulvar vestibule, but no visible lesions or infection. Which of the following is the most appropriate initial treatment approach?

• Topical estrogen cream

• Topical antifungal cream

• Systemic antibiotics

• Tricyclic antidepressants and pelvic floor therapy

Multiple Choice

A 19-year-old female presents to the emergency department with profuse, continuous vaginal bleeding for the past 7 days, saturating more than one pad per hour. Her last menstrual period was 3 months ago. She is pale but hemodynamically stable. A pregnancy test is negative. Her CBC shows a hemoglobin of 8.5 g/dL. Pelvic exam is unremarkable. What is the most appropriate initial treatment for this patient's acute bleeding?

• Endometrial biopsy

• Combination oral contraceptive pills (high-dose)

• Intrauterine levonorgestrel device (IUD)

• Endometrial ablation

Multiple Choice

A 54-year-old postmenopausal woman presents with a several-month history of increasingly heavy, irregular, and malodorous vaginal discharge. She has no complaints of pain or fever. Her last cervical cytology was six months ago and was unremarkable. A pelvic ultrasound reveals a collection of fluid in the endometrial cavity, also known as a hydrometra. What is the most likely underlying cause of this patient's findings?

• Endometrial atrophy

• Cervical cancer

• Endometrial hyperplasia

• Cervical stenosis

Multiple Choice

A 35-year-old female presents with heavy menstrual bleeding and significant pelvic pressure due to multiple large uterine fibroids. She and her partner are actively trying to conceive. Her symptoms have not improved with oral contraceptives and iron supplementation. Which of the following is the most appropriate next step in management?

• Hysterectomy

• Uterine artery embolization (UAE)

• Gonadotropin-releasing hormone (GnRH) agonist therapy

• Myomectomy