A 26-year-old woman comes to the physician for a follow-up appointment. She recently had a miscarriage and wants to discuss options for future care.

Which of the following is the most likely to be seen in this patient?

A) Anti-cyclic citrullinated peptide antibodies
B) Anti-histone antibodies
C) Increased partial thromboplastin time
D) Increased platelet count
E) Syphilis

A 21-year-old woman comes to the physician for a 2-month history of an intermittent pulling sensation in her left groin. Ultrasound shows a 1-cm heterogenous mass. A biopsy confirms dysgerminoma. Physical examination shows a well-appearing female at 4’10”. Her neck is webbed. There is a systolic murmur. Which of the following is most likely to be seen in this patient?

A) Aortic regurgitation
B) Decreased blood pressure
C) Decreased serum FSH
D) Endometrial hyperplasia
E) 45XO/46XY mosaic karyotype

A 33-year-old woman G1P0 at 38 weeks’ gestation presents to the physician for a routine antenatal appointment. She has had a 1-month history of progressive shortness of breath with exertion. There is mild ankle edema. Cardiopulmonary examination shows diffuse crackles. Which of the following is the most appropriate next step in diagnosis?

A) Autoantibody screening
B) ECG
C) No specific diagnostic test necessary at this time
D) Transesophageal echocardiography
E) Transthoracic echocardiography

A 31-year-old woman comes to the physician for a 12-month history of inability to conceive with her partner. Her BMI is 30. Her menses occur every 2-3 months. Mild acne is visible on her upper back and cheeks. Which of the following is most likely to be seen in this patient?

A) Decreased ovarian aromatase activity
B) Decreased stimulation of theca interna cells
C) Increased FSH/LH ratio
D) Increased risk of breast neoplasia
E) Increased risk of ovarian neoplasia

A 59-year-old woman comes to the physician for a 1-month history of periodic palpitations, sweating, and the feeling that the room is too hot. She also mentions a slight pulling sensation in the left groin. Menopause occurred at age 52. Vitals are: temperature 99 F, HR 85, RR 14, BP 120/80. A gynecologic ultrasound shows a mass in the left ovary. A biopsy confirms the diagnosis. Which of the following is most likely to be seen in this patient?

A) BRCA1 missense mutation
B) Direct nuclear receptor binding
C) Microinvasion
D) MLH1 missense mutation
E) Pseudomyxoma

A 43-year-old woman comes to the physician for a 1-week history of rusty colored discharge from her left nipple. She can manually induce the discharge. In addition, she finds there to be discharge even without manual expression. Which of the following is the most likely explanation for this patient’s findings?

A) Ductal carcinoma in situ
B) Ductal carcinoma (invasive)
C) Intraductal papilloma
D) Lobular carcinoma
E) Sclerosing adenosis

A 62-year-old woman comes to the physician for a 1-month history of increasing fatigue.

Which of the following is the most likely diagnosis?

A) Dermoid cyst
B) Dysgerminoma
C) Endometrial adenocarcinoma
D) Mucinous cystadenocarcinoma
E) Serous cystadenocarcinoma

A 24-year-old woman comes to the physician with her partner for a follow-up appointment. For approximately the past two years her menses have occurred at irregular intervals.

Which of the following is most likely to be seen in this patient?

A) Decreased LH + high FSH
B) Decreased theca interna cell stimulation
C) Narrow endometrial stripe
D) Positive progesterone withdrawal test
E) Theca-lutein cysts

A 61-year-old woman comes to the physician for a 2-day history of intermittent vaginal bleeding. Menopause occurred at age 53. BMI is 22. Pelvic ultrasound shows a thickened endometrial stripe and a 1.6-cm mass in the right ovary. Which of the following is the most likely explanation for this patient’s acute presentation?

A) Dermoid cyst
B) Dysgerminoma
C) Endodermal sinus tumor
D) Mixed germ cell tumor
E) Sex cord stromal tumor

A 24-year-old woman comes to the physician for a 1-year history of inability to conceive. The uterus demonstrates external fundal indentation. A hysterosalpingogram is shown.

Which of the following is most likely to be seen in this patient?

A) Failure of canalization of the vaginal plate
B) Failure of degeneration of the paramesonephric septum
C) Failure of development of the urogenital sinus
D) Failure of fusion of the mesonephric ducts
E) Failure of fusion of the paramesonephric ducts