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Clinical Medicine 5 > OB Review > Flashcards

OB Review Flashcards

1
Q
  1. A 32 year old woman G2P1 with previous vaginal delivery presents at 38 weeks’ gestation. On examination, her cervix is 5 centimeters dilated and 40% effaced. Cervical dilation slowed remarkably over the next 6 hours and the fetus did not descend into the pelvis. Augmentation of labor with oxytocin failed to dilate the cervix further. This probably represents:
    a. Dystocia
    b. Inadequate pelvis
    c. Abnormal presentation
    d. Maternal fatigue
A

a. Dystocia

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2
Q
  1. A 30-year-old gravida 1 para 0 female at approximately 16 weeks’ gestation presents to the clinic for routine prenatal care visit. One month ago, she underwent triple screen which was abnormal. Last week she underwent Quad screen which indicated decreased alpha-fetoprotein, estriol, and beta human chorionic gonadotropin. What is the most appropriate next step?
    a. Amniocentesis
    b. Combined test
    c. Serum free folate levels
    d. Fetal stress test
A

a. Amniocentesis

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3
Q
  1. Which of the following medications is the most common and safest for use in the seizures associated with eclampsia?
    a. Carbamazepine
    b. Hydralazine
    c. Magnesium sulfate
    d. Diazepam
A

c. Magnesium sulfate

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4
Q
  1. 28 year old pregnant woman at 8 weeks gestation presents for her first prenatal appointment. During the medication review, you identify several drugs. She has been taking for chronic conditions. Which of the following medications is contraindicated due to its known teratogenic effects during pregnancy?
    a. Metformin
    b. Cephalexin
    c. Laptabol
    d. Valproic acid
A

d. Valproic acid

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5
Q
  1. The most common complication of multiple pregnancy is:
    a. Preterm birth
    b. Pregnancy - induced hypertension
    c. Cord accidents
    d. Gestational diabetes
A

a. Preterm birth

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6
Q
  1. In the ER, a 38 year old G6P4Ab1 presents at 37 weeks’ gestation with decreased fetal movement and vaginal bleeding. No ultrasound has been performed during the pregnancy. On examination, fetal heart tones are present at 90 beats per minute; BP 150/100; Pulse 120 BPM, and a moderate amount of blood visible on the external genitalia. After calling the obstetrical service, the next step should be to:
    a. Establish IV access, send blood for type and crossmatch, andorder coagulation studies
    b. Perform a careful digital examination
    c. Prepare the patient for an immediate cesarean section
    d. Order and ultrasound to check the location of the placenta
A

a. Establish IV access, send blood for type and crossmatch, andorder coagulation studies

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7
Q
  1. Which of the following is considered a probable sign of pregnancy?
    a. Chadwick sign
    b. Nausea and vomiting
    c. Positive pregnancy test
    d. Breast tenderness
A

a. Chadwick sign

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8
Q
  1. What is the primary cause of early deceleration in fetal heart rate during labor?
    a. Fetal head compression during contractions
    b. Umbilical cord compression
    c. Uteroplacental insufficiency
    d. Maternal hypotension
A

a. Fetal head compression during contractions

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9
Q
  1. A 32 year old woman G2P1 with previous vaginal delivery presents at 38 weeks’ gestation. On examination, her cervix is 5 centimeters dilated and 40% effaced. This patient is in the
    a. Third stage of labor
    b. First stage of labor
    c. Fourth stage of labor
    d. Second stage of labor
A

b. First stage of labor

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10
Q
  1. Which of the following vaccines is recommended for all pregnant women during each pregnancy, regardless of previous vaccination status?
    a. Measles, Mumps, and rubella vaccine
    b. Varicella vaccine
    c. Human papillomavirus vaccine
    d. Tetanus, Diptheriae, and pertussis vaccine
A

d. Tetanus, Diptheriae, and pertussis vaccine

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11
Q
  1. The most important complication of untreated Rh incompatibility is
    a. Fetal hemolytic anemia or death
    b. Development of antibiotics to the Rh factor
    c. Maternal anaphylaxis
    d. Fetal-maternal hemorrhage
A

a. Fetal hemolytic anemia or death

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12
Q
  1. The patient is a married, nulliparous 28 year old woman who stopped her oral contraceptives 8 months ago in order to become pregnant. Her husband is 30 years old. Her previous examinations have all been normal and she has no history of sexually transmitted disease. She comes in for her annual physical examination worried about infertility. Finding nothing on physical examination, the next step should be:
    a. Reassuring her and asking her to return if she does not become pregnant in the next 4 months
    b. Referring her to a gynecologist for laparoscopy
    c. Ordering a hysterosalpingogram
    d. Sending her husband for a complete examination by a urologist
A

a. Reassuring her and asking her to return if she does not become pregnant in the next 4 months

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13
Q
  1. Prior to allowing a patient to attempt a vaginal birth after cesarean section, it is vital to obtain records regarding:
    a. Nature of previous surgical incision
    b. Results of prenatal diagnostic test
    c. Medical history
    d. Previous prenatal record
A

a. Nature of previous surgical incision

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14
Q
  1. Macrosomia is associated with:
    a. Gestational diabetes
    b. Pregnancy induced hypertension
    c. Multiple pregnancies
    d. Smoking
A

a. Gestational diabetes

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15
Q

At 20 weeks gestation:
a. The uterus will be at the umbilicus, quickening is probable
b. The uterus will be at the umbilicus; no quickening will have occurred
c. The uterus will be at the symphysis with positive fetal heart tones
d. The uterus will be midway between the symphysis and the umbilicus; no quickening will have occured

A

a. The uterus will be at the umbilicus, quickening is probable

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16
Q

The APGAR score is used to assess a newborn’s condition immediately after birth. Which of the following components is NOT included in the APGAR scoring system?
a. Respiratory effort
b. Blood pressure
c. Muscle tone
d. Heart rate

A

b. Blood pressure

17
Q
  1. Which type of fetal heart rate deceleration is characterized by a gradual decrease in heart rate that begins with the onset of a contraction and returns to baseline after the contraction ends?
    a. Late deceleration
    b. Prolonged deceleration
    c. Early deceleration
    d. Variable deceleration
A

c. Early deceleration

18
Q
  1. If a patient and her husband seek medical attention because they have been unable to conceive after one year, what should the first step be?
    a. Measures should be instituted for an infertility work up
    b. They should be counseled to relax, and eventually pregnancy will probably occur
    c. Basal body temperature graphs should be taken and folic acid supplementation begun
    d. They should be told to seek counseling for an underlying sexual dysfunction
A

a. Measures should be instituted for an infertility work up

19
Q
  1. In the context of the triple screen test during pregnancy, which of the following markers is primarily associated with an increased risk of neural tube defects?
    a. Inhibin A
    b. Estriol
    c. Human chorionic gonadotropin (hCG)
    d. Alpha-fetoprotein (AFP)
A

d. Alpha-fetoprotein (AFP)

20
Q
  1. A 20 year old woman comes into the office with a possibility of ruptured membranes at 36 weeks’ gestation. Her fetus is in the breech position. There is obvious evidence of amniotic fluid because a large amount of watery, clear, nitrazine-positive liquid is evident on the external genitalia. On bimanual examination, a ropelike, elongated, soft mass is palpated in the vagina. This probably represents:
    a. Prolapsed umbilical cord
    b. Placenta previa
    c. Compound presentation
    d. Cephalohematoma
A

a. Prolapsed umbilical cord

21
Q
  1. A 37 year old woman is delighted when she comes into your office because her home pregnancy test was positive. Her last menstrual period was 7 weeks ago, and she and her husband had been attempting pregnancy for the past 3 years. She does report a small amount of spotting in the past week. On examination, her uterus is not enlarged. Her urine pregnancy test in your office was also positive. Your next laboratory tests would include:
    a. Qualitative serum human chorionic gonadotropin (hCG) and a transvaginal ultrasound
    b. Quantitative serum human chorionic gonadotropin (hCG) and transvaginal ultrasound
    c. A qualitative serum human chorionic gonadotropin (hCG) and an abdominal ultrasound
    d. A quantitative serum human chorionic gonadotropin (hCG) and an abdominal ultrasound
A

b. Quantitative serum human chorionic gonadotropin (hCG) and transvaginal ultrasound

22
Q
  1. A 32 year old woman with a history of previous preterm delivery calls the office. She is now at 28 weeks’ gestation and complains of low back pain. She should be advised to:
    a. Report to the office for an examination
    b. Go to the hospital laboratory for urinalysis and culture
    c. Take an analgesic for her pain and call if it continues
    d. Rest and use heat for back
A

a. Report to the office for an examination

23
Q
  1. A 15 year old expectant mother at 36 weeks’ gestation has an increase in her baseline BP form 100/70 to 140/85 and is complaining of difficulty removing her rings. A random urinalysis shows pH 5, WBCs 0-1, RBC 0-1, negative nitrates and 3+/4+ protein urine dipstick. All of the following laboratory studies would be important in managing this patient EXCEPT:
    a. Liver function tests
    b. Complete blood cell count with a differential and platelets
    c. 24-hour urinalysis for protein
    d. Urine culture
A

d. Urine culture

24
Q
  1. Which of the following occurs in 8-10% of pregnancies and is the leading cause of neonatal death not due to congenital anomalies?
    a. Preterm delivery
    b. Abruptio placentae
    c. Gestational diabetes
    d. Pregnancy-induced hypertension
A

a. Preterm delivery

25
Q
  1. How effective is Rh immunoglobulin in prevention of sensitization?
    a. 99%
    b. 89%
    c. 69%
    d. 79%
A

a. 99%

Clinical Medicine 5 (10 decks)

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