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2024 Written Exam Questions

Here at ExamPro we want to be your partner in passing your exams. Keeping that in mind, we have created a new FREE resource for you. Question of the Week. Each week one question will be posted to our website. These questions will be difficult. Getting the correct answer will require some logic and deduction, just like the real exam.We are excited to bring you this tool to help you. Remember the questions will be posted on Thursdays and will only be up for one week. (Answers will be published the next week with the new question).

QUESTION: “Least Likely” Question Format
 
The least likely secondary cause of bone loss in post-menopausal osteoporosis is:
 
A.   Vitamin D Deficiency
B.   Diabetes Mellitus
C.   Malignancy
D.   Hypoparathyroidism

Last Week's Question:

Use of Similar Wording in Answer Choices, “Discrimination of answer choices”

A 20-year-old G0 had her last menstrual cycle 6 weeks ago and presents with a positive home pregnancy test for confirmation of pregnancy. UPT in the office confirms her pregnancy. TVUS is non-diagnostic, and she strongly desires the pregnancy. Early diagnosis of ectopic pregnancy is associated with each of the following except:

A. Decreased mortality
B. Decreased morbidity
C. Decreased future fertility
D. Higher success with use of methotrexate

Correct Answer:  C
 
Reference:  ACOG Practice Bulletin 193, March 2018, “Tubal Ectopic Pregnancy”
 
Discussion:
 
This question illustrates the use of similar terminology in answer choices which has been combined with a negative stem (as in this case, “except.”)
This exam question technique appears often in questions which involve discriminating between treatment outcomes or counseling statements.
 
This format for answer choices can be confusing because a series of answer choices will be offered which set up a pattern (in this case “decreased”) with one answer choice that contradicts the pattern but is not necessarily incorrect. 
 
In a time-pressured exam setting, our brains may “read what we want to see, not what is actually there”, and this can lead us to omit a systematic evaluation of the answer choices and choose a wrong answer that we actually thought was an easy correct answer.
 
Another important thing to note in this question is the final word “except.”  If missed, you would be looking for a true statement as your answer choice, however, with “except” added you are actually looking for an answer choice that is not true.  This is a critical point because answer choice “a” will often be a true answer so that test takers who are rushing and miss the “except” will erroneously choose it without even reading the other choices.
 
Analysis of the question and the answer choices:
 
The first 3 sentences of the question actually have no bearing on choosing the correct answer.  The 4th sentence is a simple declarative question.  There is only one correct answer.
 
(A).  Incorrect.
Early diagnosis of ectopic pregnancy decreases the morbidity and mortality due to ectopic pregnancy by allowing for initiation of treatment in many cases prior to rupture of the ectopic.  ACOG Practice Bulletin 193, “In 2011–2013, ruptured ectopic pregnancy accounted for 2.7% of all pregnancy-related deaths and was the leading cause of hemorrhage-related mortality.”
         
(B)  Incorrect.
As stated for choice A, early diagnosis of ectopic pregnancy decreases the morbidity and mortality due to ectopic pregnancy by allowing for initiation of treatment in many cases prior to rupture of the ectopic. 
 
(C)  Correct (this is the answer choice this is not true, remember “except”)
This answer choice can easily be misinterpreted.  Ectopic pregnancy and infertility share some common risk factors such as tubal damage due to prior infection or surgery.  Infertility treatment is associated with increased risk of an ectopic also. 
 
Early diagnosis of an ectopic pregnancy may allow for medical treatment with preservation of the fallopian tube; however, it appears from the available data that fertility rates are similar whether a patient receives medical or surgical treatment for their ectopic.  Decreased fertility is likely due to the underlying tubal dysfunction from previous tubal damage rather than the timing of diagnosis or treatment modality for the ectopic pregnancy.
 
(D)  Incorrect
ACOG Practice Bulletin 193, “Predictors of methotrexate treatment failure include the presence of an advanced or rapidly growing gestation.”  In other words, early diagnosis reduces the risk of treatment failure which can be restated as saying it results in a higher success with use of methotrexate.
 

 

The Written Skills Technique Course, part of our ExamPro Board Review Course for the ABOG written board exam, teaches you how to systematically approach each and every question to maximize your score AND your chance of passing. Don’t just “do multiple choice questions,” get our course and learn how to actually take the OB/GYN multiple choice board exam!

Don’t just “do multiple choice questions,” get our course and learn how to actually take the OB/GYN multiple choice board exam!

ExamPro Written Board Review Course