100+ Free ABPS Obstetrics & Gynecology Practice Questions

Antenatal Complications (HTN, GDM, Preeclampsia, IUGR)

Gestational hypertension and preeclampsia (ACOG severe features ≥160/110, magnesium sulfate seizure prophylaxis, delivery timing — 37 wks for preeclampsia without severe features, 34 wks with severe features), HELLP, eclampsia, chronic hypertension in pregnancy, gestational diabetes (1-hour 50-g screen at 24-28 weeks, 3-hour 100-g GTT thresholds, glycemic targets, insulin first-line if uncontrolled), pregestational diabetes (A1c <6%), fetal growth restriction (umbilical artery Doppler surveillance, delivery at 37 wks for FGR with normal Dopplers), preterm labor (cervical length, fFN, betamethasone 24-34 wks, magnesium neuroprotection <32 wks), PPROM (latency antibiotics ampicillin+azithromycin).

Labor & Delivery Management

Bishop score and induction (oxytocin titration, prostaglandins PGE1/PGE2, Foley balloon), ARRIVE trial supporting elective induction at 39 weeks for low-risk nulliparas, normal labor stages and Friedman/Zhang labor curves, intrapartum fetal monitoring NICHD Category I/II/III with Cat II management, ACOG/SMFM 2014 safe-prevention-of-cesarean criteria (active labor at 6 cm, allow 4+ hr arrest with adequate contractions), shoulder dystocia (HELPERR mnemonic), cord prolapse, uterine rupture, twin delivery routes, breech presentation and external cephalic version after 36-37 wks.

Prenatal Care & Antenatal Surveillance

Routine prenatal visits, dating ultrasound (CRL most accurate ≤13+6), first-trimester aneuploidy screening (cell-free DNA preferred for high-risk; NT/PAPP-A/hCG combined), second-trimester quad screen, anatomy ultrasound 18-22 weeks, GBS screening at 36-37 6/7 wks with intrapartum penicillin if positive, Tdap at 27-36 weeks each pregnancy, RhoGAM at 28 weeks for Rh-negative, IOM weight-gain ranges by pre-pregnancy BMI, antepartum fetal surveillance (NST, BPP, modified BPP, umbilical artery Doppler), kick counts.

Operative Obstetrics (Cesarean, Vaginal Operative)

Cesarean delivery indications (NRFHR, arrest, malpresentation, placenta previa/accreta, prior classical), low transverse vs classical incisions, ERAS-cesarean protocols, VBAC/TOLAC counseling (success calculator, uterine rupture risk ~0.5-1% with one prior low transverse, ~4-9% classical contraindicated), repeat cesarean at 39 weeks, vacuum-assisted (kiwi/Mityvac, ≤3 pop-offs, ≤20 min) and forceps deliveries, criteria for operative vaginal delivery (engaged head, dilated cervix, ROM, known position, anesthesia), 3rd/4th-degree lacerations, neonatal cephalohematoma vs subgaleal hemorrhage.

Postpartum Care & Hemorrhage

Routine postpartum care, ACOG postpartum hemorrhage bundle (>1000 mL after any delivery — vaginal or cesarean), uterine atony first-line uterotonics in stepwise order (oxytocin → methylergonovine avoiding HTN → carboprost avoiding asthma → misoprostol), TXA 1 g IV within 3 hours of birth (WOMAN trial), Bakri/Jada intrauterine balloons, B-Lynch suture, uterine artery embolization, peripartum hysterectomy, retained products, placenta accreta spectrum, postpartum endometritis (clindamycin + gentamicin), Sheehan syndrome, postpartum depression (Edinburgh Postnatal Depression Scale), VTE prophylaxis.

Contraception & Family Planning

USMEC 2024 (US Medical Eligibility Criteria for Contraceptive Use) categories 1-4, LARC (copper IUD up to 12 yrs, levonorgestrel IUDs 8 yrs, etonogestrel implant 5 yrs — Tier 1, <1% failure), combined hormonal contraception estrogen contraindications (USMEC 4: migraine with aura, smoker ≥35, hx of VTE, uncontrolled HTN, <21 days postpartum, hx breast cancer), progestin-only methods, depo-medroxyprogesterone (BMD black box, weight gain), emergency contraception (ulipristal acetate up to 120 hr, copper IUD most effective up to 5 days), permanent contraception (bilateral salpingectomy preferred per ACOG), lactational amenorrhea criteria.

Gynecologic Infections & STIs

Bacterial vaginosis (Amsel/Nugent, metronidazole 500 mg BID 7 days), vulvovaginal candidiasis (fluconazole 150 mg single dose), trichomoniasis (single-dose metronidazole 2 g — updated to multi-day 500 mg BID 7 days for women per CDC 2021, expedited partner therapy), chlamydia (doxycycline 100 mg BID 7 days first-line per CDC 2021), gonorrhea (ceftriaxone 500 mg IM single dose; 1 g if ≥150 kg), pelvic inflammatory disease (CDC 2021 outpatient: ceftriaxone 500 mg IM + doxycycline 100 mg BID 14 days + metronidazole 500 mg BID 14 days), tubo-ovarian abscess, syphilis staging and benzathine PCN, HSV, HPV, HIV in pregnancy.

Abnormal Uterine Bleeding (PALM-COEIN)

PALM-COEIN classification (Polyp, Adenomyosis, Leiomyoma, Malignancy/hyperplasia; Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified), evaluation (TVUS, saline infusion sonography for endometrial pathology, hysteroscopy, endometrial biopsy in all postmenopausal bleeding and women ≥45 with AUB or <45 with risk factors — obesity, unopposed estrogen, Lynch), levonorgestrel IUD as first-line medical therapy for AUB, tranexamic acid, NSAIDs, OCPs, leiomyoma management (myomectomy for fertility-sparing, UAE, hysterectomy), endometrial ablation contraindicated if future fertility desired.

Menopause & Hormone Therapy

Natural menopause (median age 51, defined retrospectively after 12 months amenorrhea), STRAW+10 staging, vasomotor symptoms (HT remains most effective therapy), genitourinary syndrome of menopause (low-dose vaginal estrogen safe), NAMS 2022 hormone therapy position statement (most favorable benefit-risk in women <60 yrs or within 10 yrs of menopause — window of opportunity), risks (oral estrogen → VTE; combined HT >5 yrs → modest breast cancer risk; estrogen-only safer for hysterectomized women), nonhormonal options (paroxetine 7.5 mg FDA-approved, gabapentin, fezolinetant NK3 antagonist), USPSTF DEXA at 65 (younger if FRAX risk equivalent).

Pelvic Pain & Endometriosis

Acute vs chronic pelvic pain workup, endometriosis (cyclic dysmenorrhea, dyspareunia, dyschezia, infertility — laparoscopy is gold-standard diagnosis but empiric treatment acceptable; first-line NSAIDs + OCPs/progestins; second-line GnRH agonists [leuprolide] or antagonists [elagolix] with add-back therapy), adenomyosis, primary dysmenorrhea (NSAIDs first), ovarian torsion (acute pain + adnexal mass — surgical emergency), ruptured ovarian cyst, ectopic pregnancy (methotrexate criteria: hemodynamically stable, β-hCG <5000, mass <3.5 cm, no FCA; salpingostomy vs salpingectomy).

Gynecologic Oncology Screening

Cervical cancer screening — ACS 2020 (primary HPV testing every 5 yrs starting at age 25) and USPSTF 2024 update (age 21-29 cytology q3y; age 30-65 HPV alone q5y, co-testing q5y, or cytology q3y; stop at 65 with adequate prior screening; HPV self-collection now FDA-approved), HPV vaccination (Gardasil 9 ages 9-45, 2-dose <15 yrs / 3-dose ≥15 yrs), endometrial cancer (postmenopausal bleeding — endometrial biopsy mandatory; tamoxifen and unopposed estrogen risk), ovarian cancer (no routine screening — USPSTF D recommendation for general population; CA-125 + TVUS only for symptomatic), BRCA1/2 risk-reducing salpingo-oophorectomy.

Urogynecology & Infertility

Pelvic organ prolapse (POP-Q staging, pessary first-line, sacrocolpopexy abdominal vs vaginal native-tissue repair), stress urinary incontinence (midurethral sling gold standard), urgency incontinence (behavioral and bladder training first, then anticholinergics or β3-agonist mirabegron, then sacral neuromodulation or onabotulinumtoxinA), recurrent UTI, fecal incontinence; infertility (evaluate after 12 months of regular intercourse if <35 yrs, or 6 months if ≥35 yrs; semen analysis per WHO 2021 criteria, hysterosalpingogram, ovarian reserve AMH/AFC, ovulation induction with letrozole first-line for PCOS per ASRM).