OBGYN NBME Practice Exams

OBGYN NBME Practice Exams 27yo 14 wks pregnant. 24hrs N, RLQ pain, LOA last 2 days. Pregnancy uncomplicated. F, HR 94, RR 20, BP 120/80. fetal heart okay. Abd exam shows RLQ tenderness, no rigidity or rebound. WBC 16500 80%PMN. Chorioamnitis UTI Appendicitis Salpingitis - Appendicitis rebound tenderness less common in pregnancy women Turner syn. What is FSH? elevated, decreased, normal - elevated because no E2 from streak ovaries = no negative inhibition DHEAS and DHEA ovary, adrenal - DHEA = ovary DHEAS = adrenal 4 wks after c/s, woman feels pulling on incision, worse with mvmt. normal temp, tenderness to deep palp lateral to incision, more on L than R. wound c/d/i. 2 shotty inguinal LN. diverticulitis incisional seroma normal postoperative course - normal course seroma = drainage of clear fluid woman has heavy periods and a fibroid. where is the fibroid? intramural parasitic pedunculated submucosal subserosal - submucosal = heavy bleeding intracavitary = can prevent pregnancy uterine cavity - submucosal - intramural - subserosal Rx thyroid storm (2) - BB and PTU 18 hrs after c/s lady has F. HR 94, RR 18, BP 112/74, decreased breath sounds bilaterally w/ no crackles or rhonchi. No r/m/g on cardiac. Uterus nontender, incision c/d/i. 2+ pitting edema of calves. Foley in place atelectasis endometritis pyelo thrombophlebitis wound infection - atelectasis is most common cause of F w/in 24 hrs of surgery why no combined OCP with breastfeeding? decreased effectiveness preventing pregnancy decreased protein in milk delayed uterine involution increased incidence mastitis - decreased protein in milk treatment molar pregnancy MTX misprostol suction and curettage - suction and curettage bilateral breast tenderness, erythema vs unilateral mastitis vs engorgement - bilateral = engorgment unilateral = mastitis what two systems does systemic administration of epidural work? - neurogenic and then cariogenic 15 yo w/o period yet severe abd pain. past year had 10 episodes of cramping for 3-5 days. has a temp, HR 120, RR 16, BP 90/50. abd tenderness, mass in suprapubic region. cant see cervix b.c bluish bulging vaginal tissue. adenomysosi ectopic pregnancy hematocolopos fibroid ruptured corpus luteum cyst - hematocolpos: imperforate hymen = have period by cant get out and builds up in vagina