Obstetrics

Question 1

most common alpha thalassemia disorder

Answer 1

alpha thalassemia minor

Question 2

in fetus with hydrops fetalis and no associated dysmorphic features (e.g. normal biparietal diameter and femur length), the most likely cause is

Answer 2

alpha thalassemia major

Question 3

When should Rh-negative pregnant women receive anti-D immunoglobulin prophylaxis?

Answer 3

At 28 weeks gestation, unless there are indications for earlier administration (e.g., trauma, vaginal bleeding).

Question 4

When should the patient receive the MMR vaccine?

Answer 4

In the immediate postpartum period to prevent future infection.

Question 5

When is the ideal time to administer the Tdap vaccine?

Answer 5

At 27-36 weeks gestation to allow transplacental maternal antibody transfer.

Question 6

What happens if the Tdap vaccine is given at 20 weeks gestation?

Answer 6

It results in suboptimal antibody levels in the newborn due to waning maternal antibody production.

Question 7

What complications can varicella cause in pregnancy?

Answer 7

Varicella can cause maternal complications such as pneumonia, meningitis, and encephalitis, as well as congenital anomalies like cicatricial lesions, cataracts, and chorioretinitis.

Question 8

What is the treatment for patients exposed to varicella without immunity?

Answer 8

Patients exposed to varicella but lacking immunity are treated with postexposure prophylaxis.

Question 9

What does postexposure prophylaxis include during pregnancy?

Answer 9

In pregnancy, postexposure prophylaxis includes varicella-zoster immunoglobulin administration.

Question 10

Is the live attenuated varicella-zoster vaccine safe during pregnancy?

Answer 10

The live attenuated varicella-zoster vaccine is contraindicated during pregnancy.

Question 11

What should be done if a pregnant patient has had recent varicella exposure but shows signs of immunity?

Answer 11

If a pregnant patient has had recent varicella exposure but shows positive varicella IgG antibodies, no further treatment is required.

Question 12

What are uterine fibroids commonly associated with in premenopausal women?

Answer 12

Uterine fibroids are a common cause of abnormal uterine bleeding, typically causing heavy, prolonged menses.

Question 13

What happens to fibroids after menopause?

Answer 13

fibroids typically decrease in size and become asymptomatic after menopause

Question 14

What is required for all patients with postmenopausal bleeding (PMB)?

Answer 14

All patients with PMB require endometrial evaluation.

Question 15

What are the methods for endometrial evaluation in PMB?

Answer 15

Endometrial evaluation for PMB is done with either transvaginal ultrasound or endometrial biopsy.

Question 16

What is a drawback of endometrial biopsy?

Answer 16

Endometrial biopsy is an invasive and uncomfortable procedure.

Question 17

How can PMB be initially evaluated?

Answer 17

PMB can be evaluated initially with transvaginal ultrasound.

Question 18

What does an endometrial thickness of ≤4 mm on ultrasound indicate?

Answer 18

An endometrial thickness ≤4 mm indicates a low likelihood of endometrial cancer and requires no additional evaluation.

Question 19

What should be done for patients with an endometrial thickness >4 mm?

Answer 19

Patients with an endometrial thickness >4 mm require an endometrial biopsy to assess for endometrial hyperplasia or cancer.

Question 20

How can endometrial hyperplasia be managed?

Answer 20

Endometrial hyperplasia may be managed medically (e.g., progestin) or surgically (e.g., hysterectomy).

Question 21

What is the typical management for endometrial cancer?

Answer 21

Endometrial cancer is typically managed surgically.