Answers to the CME Quiz for "Adolescent Gynecology" by Joseph S. Sanfilippo, MD, MBA, and Eduardo Lara-Torre, MD (Obstet Gynecol 2009;113[4])

1. The most common cause for disorders of menstruation in adolescent patients is:

D. Anovulation

2. The American College of Obstetricians and Gynecologists (ACOG) currently recommends that the initial pelvic examination for an adolescent who is not sexually active may be delayed until:

E. Age 21

3. Annual cervical cytology testing should be considered beginning with the initial visit in an adolescent with a history of:

C. Multiple sexual partners

4. Sexually transmitted disease testing for adolescents should be performed:

C. With each new sexual partner

5. To reduce the discomfort of the initial speculum examination, the examiner may exert finger pressure on the:

A. Perineum at the introitus

6. A 19-year-old woman undergoes her first cervical cytology examination and the result indicates atypical squamous cells of undetermined significance (ASC-US). Hospital protocol resulted in reflex human papillomavirus (HPV) testing, which indicated the presence of at least one high-risk subtype. Based on current recommendations, the most appropriate next step in the management of this patient’s abnormal cervical cytology is:

E. Repeat cytology in 12 months

7. Currently available HPV vaccines are thought to have approximately what level of prevention for patients not previously exposed?

E. More than 90%

8. Two years after the onset of menstruation, is it estimated that approximately what percentage of girls remain anovulatory or oligoovulatory?

B. 20%

9. A 14-year-old girl with heavy, irregular vaginal bleeding and a hemoglobin count of 9 g/dL is started on oral contraceptives prescribed as one every 6 hours. In addition to this prescription, the patient should also be prescribed:

C. An antiemetic

10. Which of the following would be required to establish the diagnosis of polycystic ovary syndrome (PCOS)?

C. Clinical evidence of hyperandrogenism

ACCME Accreditation: The American College of Obstetricians and Gynecologists (ACOG) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. (Continuing medical education credit for "Adolescent Gynecology" will be available through April 2012.)

AMA PRA Category 1 Credit^TM and ACOG Cognate Credit: The American College of Obstetricians and Gynecologists (ACOG) designates this educational activity for a maximum of 2 AMA PRA Category 1 Credits^TM or up to a maximum of 2 Category 1 ACOG cognate credits. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclosure Statement: Current guidelines state that continuing medical education (CME) providers must ensure that CME activities are free from the control of any commercial interest. All authors, reviewers, and contributors have disclosed to ACOG all relevant financial relationships with any commercial interests. The authors have made the following disclosures: Dr. Lara-Torre has been a speaker for Merck (Whitehouse Station, NJ) and Werner-Chilcott (Rockaway, NJ), and he has been an Implanon trainer for Organon (Roseland, NJ). Dr. Sanfilippo did not report any potential conflicts of interest. Any conflicts have been resolved through group and outside review of all content.

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