UWorld

Question 1

fever, uterine tenderness postpartum, foul-smelling lochia. Dx? RF?

Answer 1

endometritis. RF = prolonged ROM/labor, operative delivery

Question 2

management of SAB

Answer 2

check VS and hemoglobin -> D&C if unstable

Question 3

modifiable risk for osteoporosis

Answer 3

excess alcohol

Question 4

trisomy workup

Answer 4

suspicion based on serum -> confirm dates first w/ US

suspicion based on NT -> proceed to CVS (10-13wks) or amnio (after 15wks)

Question 5

pseudocyesis

Answer 5

psych pregnancy

Question 6

gross proteinuria + RBC casts + ANA

Answer 6

SLE glomerulonephritis (not pre-eclampsia)

Question 7

placenta abruptio mgmt

Answer 7

stable -> allow vaginal delivery

unstable/nonreassuring/not in labor -> c/s

Question 8

gestational maternal virilization + virilization of XX fetuses, normal internal genitalia. Elevated testos, undetectable estrogen

Answer 8

aromatase def

Question 9

mgmt of variable decels

Answer 9

cord compression -> lateral position + oxygen + discontinue uterotonic drugs

Question 10

PCOS tx

Answer 10

OCP + metformin (if 2hr glucose >140)

Question 11

normal contraction stress test ->

Answer 11

antepartum fetal testing in 1 wk (don’t need BPP)

Question 12

4 options of antepartum fetal surveillance

Answer 12

1. NST: want 2 or > accelerations in 20-40min -> if normal then weekly testing antepartum
2. BPP: (US + AFV + breathing + mvmt + tone) want 8 or 10, equivocal if 6 and abnormal if 4 or < or oligohydramnios
3. CST: want no late or recurrent variable decels
4. ubmilical artery doppler: want high velocity diastolic flow; abnormal is decreased/absent/reversed end-diastolic flow

Question 13

dx fo GDM

Answer 13

GLT > 140

GTT: F>95, 1h>180, 2h>155, 3hr>140

Question 14

intolerance to PO i/s/o PID ->

Answer 14

IV cefotetan + doxycycline

Question 15

vaginismus

Answer 15

kegel (to relax) + gradual dilatation

Question 16

galactorrhea workup

Answer 16

pregnancy test, TSH/PRL, pituitary MRI

Question 17

acute unilateral midcycle adnexal pain w/ benign hx and clinical exam

Answer 17

Mitttelschmerz

Question 18

Evaluation of primary amenorrhea that started w/ PUS

Answer 18

+uterus -> FSH ->

1. increased = karyotyping
2. decreased = cranial MRI

• uterus -> karyotype and testosterone ->
  1. 46XX + low testosterone = abnormal Mullerian
  2. 46XY + high testosterone = androgen insensitivity syndrome

Question 19

first step in mgmt of a patient p/w menopausal sx

Answer 19

TSH and FSH

Question 20

Postterm complications for baby

Answer 20

oligo
meconium aspiration
still birth
macrosomia
convulsion

Question 21

postterm complications for mommy

Answer 21

c/s
infection
hemorrhage
perineal trauma

Question 22

low platelets

Answer 22

HELLP or DIC

Question 23

phase? profuse cervical mucus, basic pH

Answer 23

ovulatory

Question 24

latent phase of labor vs. active phase of labor

Answer 24

6cm dilation

Question 25

protraction of labor

Answer 25

<1.2-1.5cm/hr during active labor

Question 26

arrest of labor

Answer 26

no change for 4 hrs despite adequate contractions OR no change for 6 hrs w/ inadequate contractions (200 Montevideo units)

Question 27

mgmt of complete placenta previa

Answer 27

scheduled c/s