Practice Reproductive Medicine Questions on the Physician Assistant Exam

Reproductive medicine is a broad topic that covers many obstetric and gynecologic issues, so there will be several questions on the Physician Assistant Exam (PANCE) about this area of medical practice. These practice questions are similar to the reproductive medicine questions you may encounter on the PANCE.

Example PANCE Questions

1. Which one of the following is true concerning the evaluation of ovarian cysts?

   (A) They are seen in polycystic kidney disease.

   (B) They are always painful.

   (C) They are a precursor to ovarian carcinoma.

   (D) They almost always need to be removed surgically.

   (E) They can be part of a syndrome that includes hypertension and diabetes.

2. Which one of the following conditions can present with fever, tachycardia, heat intolerance, and hyperdefecation?

   (A) Hypothyroidism

   (B) Hydatidiform mole

   (C) Placenta previa

   (D) Endometriosis

   (E) Vaginitis

3. You’re evaluating a 65-year-old woman who presents with abdominal distention and bloating. An abdominal ultrasound confirms the presence of ascites. Which one of the following is she most likely to have?

   (A) Adrenal cancer

   (B) Renal cell carcinoma

   (C) Ovarian carcinoma

   (D) Cervical cancer

   (E) Liver cancer

4. The use of tamoxifen increases the risk of which type of cancer?

   (A) Breast

   (B) Ovarian

   (C) Cervical

   (D) Endometrial

   (E) Liver

5. Untreated hyperglycemia during pregnancy increases the risk of which one of the following?

   (A) Macrosomia

   (B) Spina bifida

   (C) Renal agenesis

   (D) Low birth-weight babies

   (E) Down syndrome

6. Which of the following is a risk factor for vulvar cancer?

   (A) Anorexia

   (B) Vitamin B₁₂ deficiency

   (C) Human papillomavirus

   (D) Epstein-Barr virus

   (E) Adenovirus

Example PANCE Answers and Explanations

Use this answer key to score the practice reproductive medicine questions. The answer explanations offer insight into why the correct answer is better than the other choices.

1. E. You see ovarian cysts with polycystic ovarian syndrome (PCOS), which is characterized by hypertension and diabetes as well as amenorrhea, obesity, and hyperlipidemia. You don’t see them with polycystic kidney disease, Choice (A). Ovarian cysts can be painful but are usually painless, making Choice (B) incorrect. They aren’t a precursor to ovarian carcinoma, Choice (C). They can be watched unless they cause significant pain, in which case they need to be surgically removed, so Choice (D) is wrong.

2. B. A hydatidiform mole is an example of gestational trophoblastic disease (GTD). It can present with symptoms that mimic hyperthyroidism. Choice (A), hypothyroidism, would present with the opposite symptoms, including cold intolerance and constipation. Choice (C), placenta previa, presents with painless bleeding. Choice (D), endometriosis, can present with abdominal and pelvic pain, especially around the menses. Choice (E), vaginitis, presents with a vaginal discharge. Depending on the type of vaginitis, a fever and pelvic pain may also be present.

3. C. With the presence of ascites in an older woman, think about ovarian cancer. Adrenal cancer, Choice (A), is very rare. The adrenal glands are common sites of lung metastasis. Renal cell carcinoma, Choice (B), can present with hematuria, and usually a renal mass is found incidentally. It commonly spreads to the lung and the bones, and it isn’t known to cause ascites. You most often see cervical cancer, Choice (D), in younger females in their 40s. Liver cancer, Choice (E), can cause ascites, but the question says “most likely.” In a 65-year-old woman with ascites, ovarian cancer is the first thing you’d think of and try to rule out.

4. D. The use of tamoxifen (Valodex) can increase the risk of endometrial cancer. It does not increase the risk of breast, ovarian, cervical, or liver cancer.

5. A. Gestational diabetes is associated with the development of a big baby (fetal macrosomia), not a low birth-weight baby, Choice (D). One significant risk as a result of macrosomia is shoulder dystocia. Spina bifida, Choice (B), is related to folic acid deficiency, which is why women of childbearing age need to take prenatal vitamins even before becoming pregnant. ACE inhibitors should never be taken during pregnancy because they can cause babies to be born with the congenital absence of kidneys, Choice (C). Down syndrome, Choice (E), is associated with advanced maternal age.

6. C. HPV isn’t just associated with cervical cancer; it’s also a risk factor for the development of vulvar cancer. Anorexia, Choice (A), is associated with electrolyte abnormalities and amenorrhea, not with vulvar cancer; obesity, on the other hand, is a risk factor for just about every cancer. Vitamin B₁₂ deficiency, Choice (B), is not a risk factor for the development of vulvar cancer; a deficiency of this important vitamin can have many effects, including neuropathy, diarrhea, and dementia. Choice (D), Epstein-Barr virus, is associated with mononucleosis, hepatitis, and an increased risk of lymphomas in the organ-transplant patient. Choice (E), adenovirus, is a viral cause of pharyngitis and conjunctivitis.