PANCE, Medical exams, 7%

Reproductive System

This content area covers female and male reproductive health, including menstrual and menopausal disorders, breast disease, pregnancy and its complications, contraception, and reproductive-tract infection. Prenatal-care logic and screening intervals are commonly tested.

Position: 8 of 15 content areas
Published weighting: 7% in the official framework
Topics covered: 7 topics in this guide

What is covered

Topics inside this content area.

These topics describe the scope students most often review for this part of PANCE. Treat them as a study checklist rather than an exhaustive list of what a single exam form can sample.

Menstrual and ovulatory disorders: Abnormal uterine bleeding workups, polycystic ovary syndrome, and amenorrhea algorithms.
Breast disorders: Benign versus concerning masses, imaging pathways, and screening recommendations.
Cervical, uterine, and ovarian disease: Cervical-cancer screening rules, fibroids, endometriosis, and ovarian-mass triage.
Uncomplicated pregnancy and prenatal care: Visit cadence, trimester-specific screening, and normal physiologic changes.
Complicated pregnancy: Ectopic pregnancy, hypertensive disorders, bleeding in each trimester, and gestational diabetes.
Contraception and infertility: Method selection, contraindications, and the initial infertility evaluation.
Menopause and male reproductive disorders: Vasomotor-symptom management plus testicular, erectile, and infertility presentations.

Study tips

How to practice Reproductive.

Section-specific guidance that follows from how this material is usually tested.

Learn cervical screening and prenatal lab timing as schedules, then convert them into recall prompts.
Practice bleeding-in-pregnancy differentials by trimester with one distinguishing feature each.
Tie contraception contraindications to the underlying physiology instead of memorizing lists cold.

Where this fits

Reproductive System is 8 of 15 content areas in the PANCE guide, and it carries a published weighting of 7% in the official framework. Use the full guide to balance it against everything else you have to review.

Back to the PANCE guide Official exam information

Sample Reproductive questions

Practice questions, not yet expert-reviewed

Original practice questions written to the published framework for this section. No expert has reviewed them, and they are not taken from any official exam. Try each one before you open the answer.

Question 1Foundational
A woman at seven weeks of gestation has unilateral pelvic pain and vaginal bleeding, and transvaginal ultrasonography shows no intrauterine pregnancy despite a beta-hCG level above the discriminatory zone. What is the most likely diagnosis?
1. AThreatened abortion
2. BComplete abortion
3. CEctopic pregnancy
4. DComplete hydatidiform mole
Show answer
Answer: C. Ectopic pregnancy
When beta-hCG exceeds the discriminatory zone, an intrauterine gestational sac should be visible, so its absence with pain and bleeding points to an implantation outside the uterus. Threatened abortion is the tempting distractor because it also causes first-trimester bleeding, but it presents with an intrauterine pregnancy and a closed cervical os.
Key insight: A positive pregnancy test above the discriminatory zone with an empty uterus is an ectopic pregnancy until imaging proves otherwise.
Question 2Foundational
Which hypertensive disorder of pregnancy is defined by new-onset hypertension after 20 weeks of gestation accompanied by proteinuria or evidence of end-organ dysfunction?
1. AGestational hypertension
2. BChronic hypertension
3. CPreeclampsia
4. DEclampsia
Show answer
Answer: C. Preeclampsia
Preeclampsia is new hypertension after 20 weeks with proteinuria or end-organ findings such as thrombocytopenia, transaminase elevation, kidney injury, pulmonary edema, or new cerebral or visual symptoms. Gestational hypertension is the tempting distractor because it also begins after 20 weeks, but by definition it lacks proteinuria and end-organ involvement, and eclampsia adds generalized seizures.
Key insight: After 20 weeks: hypertension alone is gestational hypertension, hypertension plus end-organ damage is preeclampsia, and adding a seizure makes it eclampsia.
Question 3Intermediate
Under the Rotterdam criteria, how many of the three features of oligo-ovulation or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology are required to diagnose polycystic ovary syndrome?
1. AOne of the three
2. BTwo of the three
3. CAll three
4. DTwo of the three plus an elevated LH to FSH ratio
Show answer
Answer: B. Two of the three
The Rotterdam criteria require any two of the three features once other causes of hyperandrogenism and ovulatory dysfunction have been excluded. Requiring all three is the tempting distractor, but it would exclude the many patients with hyperandrogenism and irregular cycles whose ovaries look normal on ultrasound.
Key insight: Two of three Rotterdam features plus exclusion of mimics makes the diagnosis; polycystic ovaries on imaging are neither required nor sufficient.
Question 4Intermediate
Which medication is given to a patient with preeclampsia with severe features to prevent eclamptic seizures?
1. AMagnesium sulfate
2. BLabetalol
3. CPhenytoin
4. DLorazepam
Show answer
Answer: A. Magnesium sulfate
Magnesium sulfate is the agent of choice for both seizure prophylaxis in severe preeclampsia and treatment of eclamptic seizures, and it outperforms conventional anticonvulsants in that role. Labetalol is the tempting distractor because it is a standard drug in the same patient, but it controls severe hypertension and does not prevent seizures.
Key insight: Antihypertensives protect the brain vasculature; magnesium prevents the seizure.
Question 5Advanced
Which contraceptive method should be avoided in a woman who has migraine with aura because it raises the risk of ischemic stroke?
1. AProgestin-only pill
2. BCombined estrogen and progestin oral contraceptive
3. CCopper intrauterine device
4. DEtonogestrel subdermal implant
Show answer
Answer: B. Combined estrogen and progestin oral contraceptive
Estrogen-containing contraception multiplies the already elevated ischemic stroke risk that accompanies migraine with aura, so combined methods are avoided in that setting. The progestin-only pill, the copper intrauterine device, and the implant contain no estrogen and remain acceptable options.
Key insight: Aura plus estrogen is the combination to avoid; progestin-only and copper methods stay on the table.

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Reproductive System