Obstetrics & Gynecology Practice Questions
Obstetrics and gynecology tests pre-eclampsia diagnosis, ectopic pregnancy management, antepartum bleeding, and postpartum hemorrhage, which is high-yield on the MCCQE, USMLE Step 2 CK, and PLAB. These four sample questions come from MediLingo's bank of 3,900+ questions across 23 specialties.
Sample questions
Question 1
Which findings are diagnostic of pre-eclampsia?
a) BP ≥140/90 after 20wk + proteinuria or end-organ dysfunction ✓ Correct
b) BP ≥140/90 documented before 20 weeks without proteinuria or end-organ dysfunction
c) Gestational hypertension with proteinuria developing at 18 weeks gestation
d) New-onset generalized tonic-clonic seizures in a woman with a history of chronic hypertension
Key teaching point: Pre-eclampsia: BP ≥140/90 after 20wk + proteinuria (≥300mg/24h, PCR≥30, or dipstick 1+) or end-organ damage (thrombocytopenia, elevated LFTs, renal impairment, pulmonary edema, CNS).
Question 2
A stable patient at 7 weeks has an unruptured tubal ectopic pregnancy (mass 2.5 cm, beta-hCG 1800 IU/L, no fetal cardiac activity). What is an appropriate non-surgical option?
a) Single-dose IM methotrexate with follow-up hCG monitoring ✓ Correct
b) Immediate laparotomy with salpingectomy for tubal rupture and hemorrhage control
c) Expectant management with serial hCG every 48 hours and no pharmacologic intervention
d) Oral methotrexate 15 mg daily for 5 days with weekly hCG monitoring
Key teaching point: Methotrexate (single-dose 50mg/m² IM) criteria: stable, unruptured, hCG <5000, mass <3.5cm, no fetal cardiac activity, normal liver/renal/blood counts. Monitor hCG days 4 and 7 (must fall ≥15%).
Question 3
A patient at 32 weeks presents with painless vaginal bleeding. She has had two prior cesarean sections. What is the most likely diagnosis?
a) Placenta previa ✓ Correct
b) Placental abruption — vaginal bleeding with uterine tenderness and contractions
c) Vasa previa — painless bleeding following rupture of membranes with fetal heart rate abnormalities
d) Uterine rupture — sudden severe abdominal pain with loss of fetal station and fetal distress
Key teaching point: Placenta previa: painless bleeding after 20wk, prior C-section risk. Confirm with transvaginal US (more accurate than transabdominal). Avoid digital vaginal exam. Cesarean delivery if persists at term.
Question 4
What is the definition of primary postpartum hemorrhage (PPH)?
a) Blood loss ≥500mL vaginal or ≥1000mL cesarean within 24h of delivery ✓ Correct
b) Blood loss >300 mL occurring between 24 hours and 12 weeks after delivery
c) Any visible bleeding within 6 weeks of delivery regardless of estimated volume
d) A hemoglobin drop of 5 g/L or more within 24 hours of delivery
Key teaching point: Primary PPH: ≥500mL vaginal / ≥1000mL C-section within 24h. Secondary PPH: bleeding 24h-12wk. Causes: Tone (atony), Tissue (retained POC), Trauma, Thrombin (coagulopathy) — the 4 Ts.
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