OB GYN ROSH REVIEW Exam Questions
With Correct Answers
Which of the following combination of lab findings is most suggestive of hemolysis, elevated
liver enzymes, and low platelet count syndrome of pregnancy?
A. Decreased total bilirubin, elevated aspartate aminotransferse and alanine aminotransferase >
500 U/L, decreased hemoglobin
B. Increased total bilirubin, elevated aspartate aminotransferase and alanine aminotransferase
levels < 500 U/L
C. Schistocytes, thrombocytopenia, and elevated aspartate aminotransferase and alanine
aminotransferase > 500 U/L
D. Schistocytes, thrombocytopenia, elevated aspartate aminotransferase and alanine
aminotransferase levels < 500 U/L - answer✔C.
The patients present with nonspecific symptoms of weight gain, right upper quadrant pain,
nausea, and vomitting. Jaundice may or may not be present.
What does the management of HELLP syndrome include? - answer✔Best rest, blood pressure
management, and mag sulfate for prevention of eclamptic seizures.
What is the definitive treatment of HELLP syndrome? - answer✔Delivery of the fetus
What complication should be suspected in a patient with HELLP syndrome with clinically
significant bleeding and elevated prothrombin time (PT), partial thromboplastin time (PTT) and
decreased fibrinogen? - answer✔disseminated intravascular coagulation (DIC)
A 41 year old woman suffers from heavy and irregular menses, which at time leads to fatigue,
lightheadedness and dyspnea. She had three hospitalizations in the past year for such episodes.
Her gynecological evaluation has not revealed any pathological cause. The heavy menses
continue despite hormonal therapy. Which of the following treatment options should be
considered next?
A. Colposcopy
B. Hysterectomy
C. Hysteroscopy
Name two treatments for secondary allergic vulvitis? - answer✔Remove offending agent
1% hydrocortisone cream
A 14 year old woman presents to clinic with some frustration over never having a menstrual
period. She is short in stature and has Tanner stage 2 breast development. As you begin a
gynecological exam, you realize that you cannot pass a speculum into the vagina. Which of the
following is the most likely diagnosis?
A. DUB
B. Primary amenorrhea
C. Secondary dysmenorrhea
D. Sheehan's syndrome - answer✔B.
What is the initial work up of a patient with primary amenorrhea? - answer✔Breast and pelvic
exam, pregnancy test, pelvic ultrasound and serum follicle-stimulating hormone
A 39 year old woman in her third trimester presents with two days of bloody "spotting" on her
underwear. This is her third pregnancy, which thus far has been uncomplicated. Her initial
delivery was vaginal and her second delivery was via cesarean section. She is currently sexually
active, and has a history of trichomoniasis. She denies any pelvic pain. Lab examination reveals
hematocrit of 32%, white blood cell count of 10,000, platelet count of 260,000 INR of 1.1 and
aPTT of 32 seconds. Pelvic examination show a nonerythematous cervix with clear mucus.
Vaginal examination is normal, and there is no discharge present. Which of the following is the
most likely diagnosis?
D. Placenta Previa - answer✔D.
MC cause of 3rd trimester bleeding is placenta previa
Other than peri peri partum hemorrhage, name a fetal complications of placenta previa? -
answer✔Congenital malformations doubles with placenta previa
Which of the following is the most common cause of post-partum hemorrhage?
A. Laceration to the cervix
B. Retained placenta
C. Uterine Antony
D. Uterine rupture - answer✔C.
What is the most common condition associated with placental abruption? - answer✔Maternal
hypertension
You are treating a patient for primary amenorrhea. Her diagnostic evaluation has determined that
the etiology is primary ovarian failure. Which of the following disorders is this patient at risk
for?
A. Cluster headaches
B. Gastrointestinal bleeding
C. Menorrhagia
D. Osteoporosis - answer✔D.
Which medications offer decent replacement therapy for hypoestrogenic women? - answer✔Oral
contraceptive pills
A 26 year old woman presents with abdominal cramping after a positive home pregnancy test.
Her vitals are T 98.7, HR 94, BP 110/66, RR 18, oxygen sat 97%. Her exam is unremarkable.
Labs reveal a serum beta HCG of 1000 mIU and she is Rh positive. An ultrasound shows the
gestational sack. Which of the following is an appropriate management for this patient?
A. Administer methotrexate
B. Administer Rhogam and discharge home with repeat beta HCG in 48 hrs
C. Administer Rhogam and methotrexate
What is the most common malpresentation in fetal delivery? - answer✔Breech presentation
A 15 year old G1Po woman at 23 weeks presents with sharp, left lower quad abdominal pain for
1 hour. She has had an ultrasound confirming the presence of a single intrauterine pregnancy.
The pain is severe and associated with nausea. Pelvic exam reveals tenderness of the left adnexa.
The patient's urinalysis is unremarkable. What test should be ordered to diagnose the patient?
A. Abdominal x-ray
B. CT scan of the abdomen and pelvis
C. Pelvic ultrasound
D. White blood cell count - answer✔C.
History is concerning for ovarian torsion- more commonly seen on the right side
Why is ovarian torsion more common on the right side? - answer✔Believed that the sigmoid
colon stabilizes the left ovary so that it is less likely to torse
A 19 year old woman presents with lower abdominal pain for 5 days. You consider pelvic
inflammatory disease as a diagnosis. Which of the following is a likely contributor for this
condition?
A. Age of 25 years
B. Barrier contraception
C. Multiple sexual partners
D. Pregnancy - answer✔C.
What are 3 consequences of PID? - answer✔Tubo-ovarian abscess, infertility, ectopic pregnancy
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