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1st Sem > OB > Flashcards

OB Flashcards

1
Q

A 24-year-old G3P0 (0020) presents in your clinic with 8 weeks amenorrhea and vaginal bleeding. Pregnancy test was positive. On speculum exam you noted a pooling of blood per vaginal vault. On lE cervix is soft and closed, uterus is slightly enlarged. Ultrasound revealed and intrauterine pregnancy with fetal heart activity. What is your most probable diagnosis?
a. Threatened abortion
b. Incomplete abortion
c. Missed abortion
d. Complete abortion

A

a. Threatened abortion

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2
Q

A gush of vaginal fluid that is seen pooling during sterile speculum examination confirms the diagnosis of this classification of abortion.
a. Threatened abortion
b. Incomplete abortion
c. Imminent abortion
d. Inevitable abortion

A

d. Inevitable abortion

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3
Q

True or False: In threatened abortion, bed rest is recommended and it greatly improves outcome.
a. True
b. False

A

b. False

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4
Q

In ultrasound, fetal cardiac activity can typically be detected at weeks.
a. 4-4.5 weeks
b. 5-5.5 weeks
c. 6-6.5 weeks
d. 7-7.5 weeks

A

c. 6-6.5 weeks

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5
Q

A 24-year-old G3PO(0020) at 10 weeks age of gestation presents in the emergency room with hypogastric pain and vaginal bleeding. On speculum exam, you noted a pooling of blood per vaginal vault and meaty materials impacted on the cervical os. On IE cervix is open with meaty material per os, uterus is slightly enlarged. What is your most probable diagnosis?
a. Threatened abortion
b. Incomplete abortion
c. Imminent abortion
d. Inevitable abortion

A

b. Incomplete abortion

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6
Q

Which of the following is the most single most frequent specific chromosomal abnormality which usually results in abortion?
a. Autosomal Trisomy
b. Monosomy X
с. Triploidy
d. Tetraploidy

A

b. Monosomy X

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7
Q

What is the most accurate method to establish or confirm gestational age?
a. Mean sac diameter
b. Crown-to-rump length
c. Yolk sac size
d. Gestational sac

A

b. Crown-to-rump length

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8
Q

True or False: Surgical procedures performed during early pregnancy do not increase the risk for abortion, even if it involves early removal of the corpus luteum or the ovary in which it resides.
a. True
b. False

A

b. False

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9
Q

Which of the following is incorrect with regard to gestational sac?
a. First definitive sonographic finding of pregnancy
b. Appears as early as 4 weeks
с. Measured as mean sac diameter or MSD
d. First anatomic structure identifiable within the sac is the amnion

A

d. First anatomic structure identifiable within the sac is the amnion

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10
Q

What is the first anatomic structure identifiable within the gestational sac?
a. Yolk sac
b. Embryo
c. Decidual cast
d. Amnion

A

a. Yolk sac

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11
Q

Cerclage is indicated in which of the following settings?
a. Twin pregnancy twin pregnancy
b. Patient with a cervical length of <25mm and a history of preterm birth
c. A nulliparous patient with cervical length of <25mm
d. Patient with noted uterine contractions and cervical length of 25mm

A

b. Patient with a cervical length of <25mm and a history of preterm birth

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12
Q

For the treatment of septic abortion, which of the following antibiotic coverages is most suitable?
a. Gram-positive
b. Gram-negative
c. Broad spectrum
d. Anaerobic, gram-positive

A

d. Anaerobic, gram-positive

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13
Q

Which of the following factors is least likely to be linked with higher first-trimester miscarriage rates?
a. Obesity
b. Diabetes mellitus
c. Parvovirus infection
d. Maternal age older than 40 years

A

c. Parvovirus infection

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14
Q

Which of the following tests would be the most effective in identifying an underlying cause of recurrent miscarriage?
a. Antithrombin III Assay
b. Serum progesterone level
с. Lupus anticoagulant assay
d. Luteinizing hormone assay

A

b. Serum progesterone level

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15
Q

Which of the following is not a clinical criterion for diagnosis of Antiphospholipid Antibody Syndrome?
a. Severe preeclampsia
b. Medium or high serum levels of IgG or IgM anticardiolipin antibodies.
c. Vascular thrombosis in any tissue or organ
d. One or more unexplained deaths of a morphologically normal fetus at or beyond 10 weeks

A

b. Medium or high serum levels of IgG or IgM anticardiolipin antibodies.

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16
Q

Which of the following statements is incorrect regarding cervical incompetence?
a. Prior cervical conization is a risk factor.
b. It is characterized by painless, second-trimester cervical dilatation.
c. Rupture of membranes is not a contraindication to rescue cerclage placement.
d. It may be suspected sonographically by membranes funneling past the internal os and shortening of the cervix to <25mm.

A

c. Rupture of membranes is not a contraindication to rescue cerclage placement.

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17
Q

Your patient is a 21-year-old nulligravida currently desiring pregnancy and attempting conception. Her LMP was 6 weeks ago. She presents with complaints of vaginal spotting and right lower quadrant pain. On physical examination, her abdomen is soft and nontender. The cervical os is closed, the scant blood is seen in the vagina and uterine size approximates that of a lemon. What is the next best clinical step?
a. Obtain urine B-hCG assay
b. Perform transvaginal sonography
c. Perform dilatation and curettage
d. Discharge her home after assessing hematocrit

A

a. Obtain urine B-hCG assay

18
Q

A patient opted to use methotrexate for the treatment of ectopic pregnancy. Which of the following is NOT an expected possible complication of methotrexate therapy for ectopic pregnancy?
a. Stomatitis
b. Endocarditis
с. Hepatotoxicity
d. Anemia

A

b. Endocarditis

19
Q

Which of the following may lower complications associated with dilatation and curettage?
a. Perioperative antibiotics
b. Preoperative cervical laminaria
c. Preoperative bimanual examination
d. All of the above

A

d. All of the above

20
Q

Which of the following is not a contraindication for methotrexate therapy?
a. Breastfeeding
b. Migraine headache
с. Thrombocytopenia
d. Intraabdominal hemorrhage

A

b. Migraine headache

21
Q

Which of the following would be the most closely associated with methotrexate therapy failure during ectopic pregnancy treatment?
a. Increased party
b. Ectopic size of 2.5cm
c. Prior ectopic pregnancy
d. Serum B-hCG level of 9000mlU/ml

A

d. Serum B-hCG level of 9000mlU/ml

22
Q

Which of the following is a common ultrasound finding among all types of ectopic pregnancy?
a. An empty cervical canal
b. Absent intrauterine gestational tissue
c. Echogenic line extending from the gestational sac to the endometrial cavity
d. Myometrium between the bladder and gestational sac is absent

A

b. Absent intrauterine gestational tissue

23
Q

Which of the following is not a sonographic finding in cesarean scar pregnancy?
a. An empty uterine cavity
b. Gestational tissue at the level of the cervix
c. An intrauterine mass is seen in the anterior part of the uterine isthmus
d. Myometrium between the bladder and gestational sac is absent

A

d. Myometrium between the bladder and gestational sac is absent

24
Q

Which of the following clinical outcome of tubal pregnancy is has the lowest potential for maternal morbidity?
a. Tubal rupture
b. Tubal abortion
c. Chronic persistence
d. Pregnancy resorption

A

d. Pregnancy resorption

25
Q

Which of the following is least likely to increase the risk for ectopic pregnancy?
a. Prior ectopic pregnancy
b. Prior pelvic inflammatory disease
c. Prior hydatidiform mole
d. Salpingits isthmica nodusa

A

c. Prior hydatidiform mole

26
Q

What risk factor for ectopic pregnancy will affect ciliary action and smooth muscle contraction in the fallopian tubes?
a. Cigarette smoking
b. Prior pelvic infection
c. Endometriosis
d. None of the above

A

a. Cigarette smoking

27
Q

With contraceptive failure, which method has a relative increased risk of ectopic pregnancy?
a. Condoms
b. Vasectomy
c. Tubal sterilization
d. All of the above

A

c. Tubal sterilization

28
Q

During sonographic examination, in addition to the trilaminar endometrial lining seen, other findings include normal myometrium, a cui-de-sac without free fluid and normal adnexae. Her serum B-hCG level is 1400 mlU/mL. What is her diagnosis?
a. Ectopic pregnancy
b. Completed abortion
c. Intrauterine pregnancy
d. Pregnancy of unknown location

A

a. Ectopic pregnancy

29
Q

Sonographic findings that may suggest abdominal pregnancy include which of the following?
a. Oligohydramnios
b. Fetus outside and separate from the uterus
c. Absent myometrium between the fetus and maternal anterior abdominal wall
d. All of the above

A

d. All of the above

30
Q

Conservative surgical management for ectopic pregnancy if best for tubal pregnancies with size:
a. <2 cm
b. <10 cm
c. <5 cm
d. <20 cm

A

a. <2 cm

31
Q

This is a surgical procedure whereby an incision is made over the fallopian tube to evacuate the ectopic pregnancy, without suturing it close (heal by secondary intention)
a. Salpingostomy
b. Salpingotomy
c. Salpingectomy
d. All of the above

A

a. Salpingostomy

32
Q

Toxic effects of methotrexate treatment may be blunted using this medication:
a. Leucovorin
b. Magnesium sulfate
c. Folic acid
d. Progesterone

A

a. Leucovorin

33
Q

Lowest level of progesterone that rules out the possibility of ectopic pregnancy:
a. 5 ng/ml
b. 10 ng/ml
c. 15 ng/ml
d. 25 ng/ml

A

b. 10 ng/ml

34
Q

Discriminatory level of BHCG
a. 1000 mlU/ml
b. 1500 mlU/ml
c. 5000 mlU/ml
d. 500 mlU/ml

A

b. 1500 mlU/ml

35
Q

Ana, a G1P0 patient, came to the emergency room due to severe abdominal pain. In history, she has amenorrhea for 14 weeks. On the physical exam, she has direct and rebound tenderness all over her abdomen. On IE, her cul-de-sac is full. The adnexal area could not be. assessed due to severe abdominal guarding. Ultrasound revealed hemoperitoneum with presence of 5 cm left adnexal mass that presents with a ring of fire pattern on color flow; uterine cavity is empty. Pregnancy test is positive. Diagnosis is ectopic (tubal) pregnancy. What is the most likely location of the ectopic pregnancy given the number of weeks of amenorrhea?
a. Ampula
b. Interstitium
c. Isthmus
d. Infundibulum

A

b. Interstitium

36
Q

Patient was rushed to the ER due to loss of consciousness. BP was 90/60; C 115; RR 18. tender abdomen. The pregnancy test was positive. what is your management?
a. Immediate surgery
b. Request for serum quantitative BHCG
c. Do ultrasound
d. All of the above

A

c. Do ultrasound

37
Q

A fluid collection between the endometrial layers and conforms to the cavity shape in a patient with a positive pregnancy test
a. Pseudo gestational sac
b. Decidual cyst
c. Gestational sac
d. Endometrial fluid

A

a. Pseudo gestational sac

38
Q

Patient with hemoperitoneum, positive pregnancy test and hemodynamically stable. Culdocentesis can be done
a. Yes
b. No
c. Maybe

A

a. Yes

39
Q

Patient complained of vaginal spotting. Ultrasound revealed subchorionic hemorrhage. CRL compatible with 8 weeks AOG. What is the diagnosis?
a. Threatened abortion
b. Incomplete abortion
c. Missed abortion
d. Complete abortion

A

a. Threatened abortion

40
Q

Patient with an ultrasound of embryonic demise came in for a check-up. The result was 2 wks ago. On examination, the cervix is closed. What is your advice?
a. Admit and do dilatation and curettage
b. Send her home and give Methylergometrine
c. Maleate tell her to observe
d. All of the above

A

d. All of the above

1st Sem (6 decks)

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