• Question: A 30-year-old woman at 36 weeks of gestation presents with painless vaginal
bleeding. What is the most likely diagnosis?
• A) Placenta previa
• B) Placental abruption
• C) Vasa previa
• D) Cervical polyp
• Answer: A) Placenta previa
• Question: A 24-year-old woman presents with lower abdominal pain, fever, and a foul-
smelling vaginal discharge 5 days after an abortion. What is the most likely diagnosis?
• A) Endometritis
• B) Pelvic inflammatory disease
• C) Retained products of conception
• D) Ectopic pregnancy
• Answer: A) Endometritis
• Question: A 28-year-old woman presents with a missed period, lower abdominal pain, and
vaginal spotting. Her beta-hCG level is 1500 mIU/mL. Transvaginal ultrasound does not
show an intrauterine pregnancy. What is the most likely diagnosis?
• A) Ectopic pregnancy
• B) Molar pregnancy
• C) Missed abortion
• D) Normal early intrauterine pregnancy
• Answer: A) Ectopic pregnancy
• Question: A 45-year-old woman presents with heavy menstrual bleeding and pelvic
pressure. Ultrasound shows a large, well-defined uterine mass. What is the most likely
diagnosis?
• A) Uterine fibroid (leiomyoma)
• B) Endometrial carcinoma
• C) Adenomyosis
• D) Ovarian cyst
• Answer: A) Uterine fibroid (leiomyoma)
• Question: A 32-year-old woman with a history of two miscarriages presents for
evaluation. Which condition is most likely to be found on investigation?
• A) Antiphospholipid syndrome
• B) Polycystic ovary syndrome
• C) Hyperprolactinemia
• D) Uterine septum
• Answer: A) Antiphospholipid syndrome
• Question: A 34-year-old woman at 38 weeks of gestation presents with severe right upper
quadrant pain, nausea, and vomiting. Her blood pressure is 160/110 mmHg, and laboratory
results show elevated liver enzymes and low platelets. What is the most likely diagnosis?
• A) HELLP syndrome
• B) Acute fatty liver of pregnancy
• C) Pre-eclampsia with severe features
• D) Cholecystitis
• Answer: A) HELLP syndrome
• Question: A 29-year-old woman presents with pruritus, especially on her palms and soles,
in the third trimester of pregnancy. Liver function tests reveal elevated bile acids. What is the
most likely diagnosis?
• A) Intrahepatic cholestasis of pregnancy
• B) Acute fatty liver of pregnancy
• C) Preeclampsia
• D) Gestational diabetes
• Answer: A) Intrahepatic cholestasis of pregnancy
• Question: A 38-year-old woman presents with postmenopausal bleeding. What is the most
appropriate next step in management?
• A) Transvaginal ultrasound
• B) Hysteroscopy
• C) Endometrial biopsy
• D) Pelvic MRI
• Answer: C) Endometrial biopsy
• Question: A 27-year-old woman presents with severe dysmenorrhea and dyspareunia.
Pelvic examination reveals a tender, fixed, retroverted uterus. What is the most likely
diagnosis?
• A) Endometriosis
• B) Adenomyosis
• C) Pelvic inflammatory disease
• D) Uterine fibroid
• Answer: A) Endometriosis
• Question: A 26-year-old woman presents with amenorrhea and galactorrhea. Her serum
prolactin level is elevated. What is the most likely diagnosis?
• A) Prolactinoma
• B) Hypothyroidism
• C) Polycystic ovary syndrome
• D) Sheehan's syndrome
• Answer: A) Prolactinoma
• Question: A 20-year-old woman presents with lower abdominal pain and purulent cervical
discharge. Cervical motion tenderness is noted on examination. What is the most likely
diagnosis?
• A) Pelvic inflammatory disease
• B) Ectopic pregnancy
• C) Ovarian cyst rupture
• D) Appendicitis
• Answer: A) Pelvic inflammatory disease
• Question: A 35-year-old woman at 20 weeks gestation presents with painless cervical
dilation and a history of previous second-trimester losses. What is the most likely diagnosis?
• A) Cervical insufficiency
• B) Placenta previa
• C) Preterm labor
• D) Uterine fibroid
• Answer: A) Cervical insufficiency
• Question: A 40-year-old woman presents with a new onset of vulvar itching and a white,
atrophic appearance of the vulva. What is the most likely diagnosis?
• A) Lichen sclerosus
• B) Vulvar candidiasis
• C) Vulvar psoriasis
• D) Contact dermatitis
• Answer: A) Lichen sclerosus
• Question: A 28-year-old woman presents with a history of irregular menses and hirsutism.
Ultrasound shows multiple ovarian cysts. What is the most likely diagnosis?
• A) Polycystic ovary syndrome
• B) Ovarian cancer
• C) Endometriosis
• D) Functional ovarian cyst
• Answer: A) Polycystic ovary syndrome
• Question: A 33-year-old woman presents with a palpable breast lump. Mammography
shows a spiculated mass with microcalcifications. What is the most likely diagnosis?
• A) Breast cancer
• B) Fibroadenoma
• C) Fibrocystic changes
• D) Breast abscess
• Answer: A) Breast cancer
• Question: A 28-year-old woman presents with pelvic pain and an adnexal mass.
Ultrasound reveals a cystic structure with a hypoechoic fluid level. What is the most likely
diagnosis?
• A) Endometrioma
• B) Follicular cyst
• C) Corpus luteum cyst
• D) Dermoid cyst
• Answer: A) Endometrioma
• Question: A 50-year-old woman presents with pelvic pressure and urinary incontinence.
On examination, a bulging mass is seen at the vaginal introitus. What is the most likely
diagnosis?
• A) Cystocele
• B) Rectocele
• C) Uterine prolapse
• D) Enterocele
• Answer: A) Cystocele
• Question: A 35-year-old woman presents with secondary amenorrhea and a history of
dilatation and curettage (D&C) for a missed abortion. What is the most likely diagnosis?
• A) Asherman's syndrome
• B) Polycystic ovary syndrome
• C) Premature ovarian insufficiency
• D) Hyperprolactinemia
• Answer: A) Asherman's syndrome
• Question: A 28-year-old woman at 10 weeks of gestation presents with hyperemesis
gravidarum. Her beta-hCG level is markedly elevated for gestational age. What is the most
likely diagnosis?
• A) Molar pregnancy
• B) Multiple pregnancy
• C) Ectopic pregnancy
• D) Hyperthyroidism
• Answer: A) Molar pregnancy
• Question: A 30-year-old woman presents with a palpable adnexal mass. On ultrasound, the
mass is solid and complex with septations. What is the most likely diagnosis?
• A) Ovarian cancer
• B) Dermoid cyst
• C) Endometrioma
• D) Functional ovarian cyst
• Answer: A) Ovarian cancer
• Question: A 22-year-old woman presents with sudden onset of severe pelvic pain during
intercourse. Ultrasound shows free fluid in the pelvis. What is the most likely diagnosis?
• A) Ovarian cyst rupture
• B) Ectopic pregnancy
• C) Pelvic inflammatory disease
• D) Appendicitis
• Answer: A) Ovarian cyst rupture
• Question: A 34-year-old woman presents with dyspareunia and a tender, fluctuant mass at
the lower vestibule. What is the most likely diagnosis?
• A) Bartholin gland abscess
• B) Skene gland cyst
• C) Vaginal cyst
• D) Endometriosis
• Answer: A) Bartholin gland abscess
• Question: A 29-year-old woman at 28 weeks gestation presents with preterm contractions.
What is the most appropriate initial treatment?
• A) Tocolytics
• B) Magnesium sulfate
• C) Corticosteroids
• D) Antibiotics
• Answer: C) Corticosteroids
• Question: A 30-year-old woman presents with primary infertility. Hysterosalpingography
shows bilateral tubal blockage. What is the most likely cause?
• A) Pelvic inflammatory disease
• B) Endometriosis
• C) Uterine fibroids
• D) Asherman's syndrome
• Answer: A) Pelvic inflammatory disease
• Question: A 25-year-old woman presents with oligomenorrhea, acne, and obesity.
Laboratory tests reveal elevated testosterone and LH/FSH ratio >2. What is the most likely
diagnosis?
• A) Polycystic ovary syndrome
• B) Congenital adrenal hyperplasia
• C) Hyperprolactinemia
• D) Hypothyroidism
• Answer: A) Polycystic ovary syndrome
• Question: A 42-year-old woman presents with cyclic pelvic pain and menorrhagia. Pelvic
ultrasound shows a globular, enlarged uterus with a heterogeneous myometrial texture. What
is the most likely diagnosis?
• A) Adenomyosis
• B) Uterine fibroid
• C) Endometriosis
• D) Endometrial hyperplasia
• Answer: A) Adenomyosis
• Question: A 55-year-old postmenopausal woman presents with vaginal dryness and
dyspareunia. What is the most likely diagnosis?
• A) Atrophic vaginitis
• B) Lichen sclerosus
• C) Vulvar lichen planus
• D) Vulvar intraepithelial neoplasia
• Answer: A) Atrophic vaginitis
• Question: A 36-year-old woman presents with chronic pelvic pain and deep dyspareunia.
Laparoscopy reveals "chocolate cysts" on the ovaries. What is the most likely diagnosis?
• A) Endometriosis
• B) Polycystic ovary syndrome
• C) Ovarian cancer
• D) Tubo-ovarian abscess
• Answer: A) Endometriosis
• Question: A 25-year-old woman presents with acute onset of right lower quadrant pain and
fever. Pelvic ultrasound shows an enlarged right ovary with decreased blood flow. What is
the most likely diagnosis?
• A) Ovarian torsion
• B) Ectopic pregnancy
• C) Appendicitis
• D) Ruptured ovarian cyst
• Answer: A) Ovarian torsion
• Question: A 34-year-old woman with a history of cesarean section presents with severe
abdominal pain and signs of shock at 38 weeks of gestation. What is the most likely
diagnosis?
• A) Uterine rupture
• B) Placenta previa
• C) Placental abruption
• D) Chorioamnionitis
• Answer: A) Uterine rupture
• Question: A 28-year-old woman at 34 weeks gestation presents with sudden onset of
severe abdominal pain, vaginal bleeding, and a tender, rigid uterus. What is the most likely
diagnosis?
• A) Placental abruption
• B) Placenta previa
• C) Uterine rupture
• D) Preterm labor
• Answer: A) Placental abruption
• Question: A 22-year-old woman presents with acute lower abdominal pain and positive
beta-hCG test. Transvaginal ultrasound reveals an adnexal mass and no intrauterine
pregnancy. What is the most likely diagnosis?
• A) Ectopic pregnancy
• B) Ovarian cyst
• C) Pelvic inflammatory disease
• D) Molar pregnancy
• Answer: A) Ectopic pregnancy
• Question: A 30-year-old woman presents with primary amenorrhea. Physical examination
reveals a short stature, webbed neck, and widely spaced nipples. What is the most likely
diagnosis?
• A) Turner syndrome
• B) Androgen insensitivity syndrome
• C) Kallmann syndrome
• D) Mayer-Rokitansky-Küster-Hauser syndrome
• Answer: A) Turner syndrome
• Question: A 24-year-old woman presents with a history of deep dyspareunia and painful
bowel movements during menstruation. What is the most likely diagnosis?
• A) Endometriosis
• B) Pelvic inflammatory disease
• C) Interstitial cystitis
• D) Irritable bowel syndrome
• Answer: A) Endometriosis
• Question: A 28-year-old woman presents with a history of multiple partners and now has
lower abdominal pain, mucopurulent cervical discharge, and fever. What is the most likely
diagnosis?
• A) Pelvic inflammatory disease
• B) Bacterial vaginosis
• C) Trichomoniasis
• D) Cervical cancer
• Answer: A) Pelvic inflammatory disease
• Question: A 33-year-old woman presents with a sudden onset of unilateral pelvic pain and
a history of irregular menstrual cycles. Transvaginal ultrasound shows a complex adnexal
mass. What is the most likely diagnosis?
• A) Ovarian cyst rupture
• B) Ectopic pregnancy
• C) Pelvic inflammatory disease
• D) Ovarian torsion
• Answer: D) Ovarian torsion
• Question: A 26-year-old woman presents with vaginal bleeding and abdominal pain. Her
last menstrual period was 8 weeks ago, and her beta-hCG levels are decreasing. What is the
most likely diagnosis?
• A) Spontaneous abortion
• B) Ectopic pregnancy
• C) Molar pregnancy
• D) Implantation bleeding
• Answer: A) Spontaneous abortion
• Question: A 30-year-old woman presents with heavy, painful menstrual periods and a
uniformly enlarged uterus. What is the most likely diagnosis?
• A) Adenomyosis
• B) Uterine fibroids
• C) Endometriosis
• D) Endometrial hyperplasia
• Answer: A) Adenomyosis
• Question: A 42-year-old woman presents with a unilateral breast lump and nipple
discharge. Mammography reveals a spiculated mass with calcifications. What is the most
likely diagnosis?
• A) Invasive ductal carcinoma
• B) Fibroadenoma
• C) Ductal carcinoma in situ
• D) Mastitis
• Answer: A) Invasive ductal carcinoma
• Question: A 50-year-old postmenopausal woman presents with vulvar pruritus and a
white, atrophic appearance of the vulva. What is the most likely diagnosis?
• A) Lichen sclerosus
• B) Vulvar candidiasis
• C) Vulvar psoriasis
• D) Contact dermatitis
• Answer: A) Lichen sclerosus
• Question: A 25-year-old woman presents with a painless, firm, and mobile breast lump.
Ultrasound shows a well-circumscribed, hypoechoic mass. What is the most likely diagnosis?
• A) Fibroadenoma
• B) Breast cyst
• C) Breast abscess
• D) Invasive ductal carcinoma
• Answer: A) Fibroadenoma
• Question: A 32-year-old woman presents with postpartum fever, uterine tenderness, and
foul-smelling lochia. What is the most likely diagnosis?
• A) Endometritis
• B) Retained placenta
• C) Mastitis
• D) Urinary tract infection
• Answer: A) Endometritis
• Question: A 30-year-old woman presents with cyclic pelvic pain, dysmenorrhea, and a
nodular uterosacral ligament on examination. What is the most likely diagnosis?
• A) Endometriosis
• B) Adenomyosis
• C) Pelvic inflammatory disease
• D) Uterine fibroids
• Answer: A) Endometriosis
• Question: A 45-year-old woman presents with postcoital bleeding and a visible cervical
lesion on examination. What is the most likely diagnosis?
• A) Cervical cancer
• B) Cervicitis
• C) Cervical polyp
• D) Endometrial cancer
• Answer: A) Cervical cancer
• Question: A 25-year-old woman presents with a sudden onset of right lower quadrant pain.
She has a history of irregular menstrual cycles. Ultrasound shows an adnexal mass and free
pelvic fluid. What is the most likely diagnosis?
• A) Ovarian cyst rupture
• B) Ectopic pregnancy
• C) Appendicitis
• D) Pelvic inflammatory disease
• Answer: A) Ovarian cyst rupture
• Question: A 29-year-old woman presents with lower abdominal pain and heavy menstrual
bleeding. Ultrasound shows a heterogeneous, globular uterus. What is the most likely
diagnosis?
• A) Adenomyosis
• B) Endometriosis
• C) Uterine fibroids
• D) Endometrial hyperplasia
• Answer: A) Adenomyosis
• Question: A 38-year-old woman presents with abnormal uterine bleeding and an
endometrial biopsy showing atypical hyperplasia. What is the most appropriate next step?
• A) Hysterectomy
• B) Hormonal therapy
• C) Dilation and curettage
• D) Repeat biopsy in 6 months
• Answer: A) Hysterectomy
• Question: A 30-year-old woman presents with a palpable breast lump and no associated
symptoms. Mammogram reveals a well-circumscribed lesion. What is the most likely
diagnosis?
• A) Fibroadenoma
• B) Breast abscess
• C) Invasive ductal carcinoma
• D) Phyllodes tumor
• Answer: A) Fibroadenoma
• Question: A 28-year-old woman presents with lower abdominal pain and irregular vaginal
bleeding. Her beta-hCG is 2500 mIU/mL. Transvaginal ultrasound does not show an
intrauterine pregnancy. What is the most likely diagnosis?
• A) Ectopic pregnancy
• B) Molar pregnancy
• C) Missed abortion
• D) Normal early intrauterine pregnancy
• Answer: A) Ectopic pregnancy
• Question: A 32-year-old woman presents with chronic pelvic pain and an enlarged, tender
uterus. What is the most likely diagnosis?
• A) Adenomyosis
• B) Uterine fibroids
• C) Endometriosis
• D) Chronic pelvic inflammatory disease
• Answer: A) Adenomyosis
