Obstetrics & Gynecology for USMLE Step 2 CK: Exam Questions and Preparation
How Obstetrics & Gynecology is tested on Step 2 CK and Step 3, the high-yield topics, a preparation approach and original practice questions with explained answers.
Obstetrics and gynecology tests prenatal care, complications of pregnancy and labor, and common gynecologic problems. Many questions are about what to do now in an urgent situation, such as a seizure, a bleed or an abnormal test during pregnancy.
Step 2 CK and Step 3 test clinical judgment: given a patient, what is the most likely diagnosis, the best next step in management, or the most important thing to prevent or monitor. The practice questions here are original and written to show the style of reasoning the exam rewards; they are not real exam items. Management guidance changes, so confirm current guidelines and the official USMLE content outline.
How Obstetrics & Gynecology is tested
Vignettes ask for the diagnosis, the best next test or the treatment. Management of hypertensive disorders, bleeding in pregnancy and postpartum hemorrhage appears frequently, as do contraception and screening.
High-yield topics
- Prenatal care, screening and the management of gestational diabetes
- Hypertensive disorders of pregnancy: preeclampsia, eclampsia and HELLP syndrome
- Bleeding in pregnancy: ectopic pregnancy, placenta previa and abruption
- Preterm labor, rupture of membranes and induction of labor
- Normal and abnormal labor, and postpartum hemorrhage
- Contraception, infertility, amenorrhea and polycystic ovary syndrome
- Cervical and breast screening, menopause and gynecologic cancers
Preparation approach
- Learn the management steps for the pregnancy emergencies as short ordered lists.
- Make a table comparing the causes of third-trimester bleeding.
- Review the screening schedule by age and the next step for each abnormal result.
- Practice reading the pregnancy and newborn clues in a stem, such as gestational age and risk factors.
Practice questions
Question 1
A woman at 32 weeks of gestation has a blood pressure of 170/110 mm Hg, a severe headache and proteinuria. Which medication should be started to prevent seizures?
- A. Phenytoin
- B. Magnesium sulfate
- C. Diazepam
- D. Labetalol only
- E. Furosemide
Answer: B. This is preeclampsia with severe features. Magnesium sulfate prevents eclamptic seizures, and an antihypertensive is added, with plans for delivery.
Question 2
A hemodynamically stable woman has a positive pregnancy test, left pelvic pain and light vaginal bleeding. Her beta-hCG is 2,500 mIU/mL, and transvaginal ultrasonography shows no intrauterine pregnancy. What is the most appropriate treatment?
- A. Dilation and curettage
- B. Methotrexate
- C. Observation for 2 weeks
- D. Oral progesterone
- E. Immediate laparotomy
Answer: B. This is an ectopic pregnancy. In a stable patient with an unruptured ectopic pregnancy and no contraindications, methotrexate is appropriate. Rupture or instability requires surgery.
Question 3
A woman has heavy bleeding immediately after vaginal delivery. Her uterus is soft and boggy. What is the most appropriate first step?
- A. Hysterectomy
- B. Bimanual uterine massage and oxytocin
- C. Repeat cervical examination only
- D. Observation
- E. Packing the vagina
Answer: B. Uterine atony is the most common cause of postpartum hemorrhage. Fundal massage and oxytocin are first, followed by other uterotonics if needed.
Make it a plan
Put this subject inside a dedicated study block with timed mixed question blocks and careful review. See our Step 2 CK preparation timeline for a schedule and weekly milestones. This article is general educational guidance and not an individualized study plan.
Educational content only. Confirm current exam requirements with USMLE.