UWorld questions obgyn

Question 1

Management of Pap smear showing atypical squamous cells of undetermined significance:

Answer 1

• Age 21-24 = repeat in 1 year
• Age > 25 = HPV testing; positive = colpo
• 3 consecutive Paps showing ASC = colpo

Question 2

Most common cause of physiologic galactorrhea:

Answer 2

hyperprolactinemia

Question 3

Evaluation of galactorrhea:

Answer 3

• Serum prolactin
• TSH
• Consider brain MRI

Question 4

Management of preterm labor (3):

Answer 4

• Tocolytics
• Betamethasone
• MgSO4 (protect vs. cerebral palsy)

Question 5

Features of androgen insensitivity syndrome:

Answer 5

• 46XY (male karyotype)
• Primary amenorrhea
• No uterus, cervix, or vagina

Question 6

3 D-symptoms of endometriosis + 1 more:

Answer 6

• Dyspareunia
• Dysuria
• Dyschezia
• Infertility

Question 7

Relation between thyroid and prolactin levels:

Answer 7

• TRH stimulates prolactin release

- Dopamine inhibits prolactin release

Question 8

Lecithin/sphingomyelin ratio:

Answer 8

• Evaluation of fetal lung maturity

- L/S

Question 9

Greatest risk factor for clear cell carcinoma:

Answer 9

DES exposure in utero

Question 10

Most common cause of mucopurulent cervicitis:

Answer 10

Chlamydia trachomatis, then Neisseria gonorrheae

Question 11

Management of CIN II/III on colposcopy:

Answer 11

Cytology and biopsy every 12 weeks

Question 12

First and second signs of magnesium toxicity:

Answer 12

1. Hyporeflexia

2. Respiratory depression

Question 13

Management of abnormal uterine bleeding:

Answer 13

Endometrial biopsy

Question 14

Management of endometrial hyperplasia:

Answer 14

• Without atypia = progestin therapy

- With atypia = hysterectomy or progestin therapy

Question 15

Most important method for preventing transmission of HIV from mother to fetus:

Answer 15

Antiretroviral therapy (even in pregnancy)

Question 16

Antibiotics for asymptomatic bacteriuria in pregnancy:

Answer 16

• Nitrofurantoin
• Amoxicillin +/- clavulanate
• Fosfomycin

Question 17

Workup for adnexal mass in postmenopausal woman:

Answer 17

Ultrasound + CA-125 level (r/o malignancy)

Question 18

Most common (?) complication with postterm labor:

Answer 18

Oligohydramnios (aging placenta has decreased perfusion, resulting in decreased fetal renal perfusion/urine output)

Question 19

Women should not be tested for HPV until what age?

Answer 19

30

Question 20

Limits for HPV vaccination:

Answer 20

ages 9-26 for women, 9-21 for men

Question 21

Cervical cancer screening guidelines:

Answer 21

21-29: pap smear
30-65: pap smear + HPV testing
65+: no screening if prior test negative
Immunocompromised: at onset of sexual activity, then q6 months twice, then annually

Question 22

Causes of elevated AFP:

Answer 22

• Open neural tube defects
• Ventral wall defects
• Multiple gestation

Question 23

Inevitable vs. threatened abortion:

Answer 23

Threatened = closed os
Inevitable = open os