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Maternity and Women's Health Care

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Maternity and Women's Health Care

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EOR EXAM WOMEN'S HEALTH FULLY SOLVED #26
The fundus is at the umbilicus at approximately how many weeks? - correct answer 20

At how many weeks is the test for gestational diabetes performed - correct answer 24-
28

At what point during a normal pregnancy should exams go from every 4 weeks to every
3 weeks? - correct answer 28 weeks

A women whose LMP was on June 6th will have what estimated due date according to
Nägele's rule - correct answer 3/13

A blueish cervix seen at early pregnancy is known as whose sign? - correct answer
Chadwick's

When can chronic villus sampling be performed? - correct answer 10-12 weeks

What is quickening and when does it occur? - correct answer When mother first starts
feeling movement for first time. Typically around 20 weeks, may be earlier for
multiparous women.

Abnormal placenta development covering the cervix? - correct answer Placenta Previa

The umbilical vein carries _____ blood? - correct answer Oxygenated

Which of the following Lab studies would be seen in menopause-
A. High estradiol, low fsh and LH
B. Low estradiol, high fsh and lh
C. High estradiol, high fsh and lh
D. Low estradiol, low fsh and lh - correct answer b. Low estradiol, high fsh and lh

36 year old woman presents with noted mass in right breast that has remained
unchanged through three menstrual cycles. She has a history of smaller benign cystic
disease. What is the best diagnostic step after an initial ultrasound? - correct answer
Aspiration of dominant mass

24 year old female presents with complaint of inability to get pregnant over the last year
and is concerened about the growth of dark hair along her chin and jawline. Her last
menstrual period was 6 months ago, she is overweight. From the description what is the
most likely etiology of the patient's complaint- - correct answer PCOS

A hard, immobile, irregularly shaped solitary mass, with positive LAD is indicative of? -
correct answer breast cancer

,Which of the following best describes the purpose of intravenous magnesium sulfate in
patients with preeclampsia?
A. Prevention of convulsions
B. Prevention of HELLP syndrome
C. Lowering of blood pressure
D. Reversal of proteinuria - correct answer A. Magnesium sulfate is used to prevent and
treat eclamptic seizures. Magnesium sulfate is not sufficient to treat
Hypertension, therefore antihypertensives must be added. Magnesium sulfate is
excreted solely from the
Kidneys and urine output must be preserved to prevent accumulation of the drug.
Magnesium sulfate does
Nothing to prevent HELLP syndrome.

A 25 year-old female presents for a routine gynecological examination. You palpate a 2
cm breast mass in her right
Breast. Her menstrual period was last week. She has no family history of breast cancer.
What is the modality of
Choice to further evaluate her breast mass?
A. Magnetic resonance imaging (MRI)
B. Excisional biopsy
C. Ultrasound
D. Mammography - correct answer (u) A. MRI's of the breast are done in patients with
prior breast cancer or who have BRCA 1 or 2 positivity.
(u) B. Excisional biopsy is not indicated without differentiation of lesion by ultrasound.
CORRECT: C. In a 25 year-old an ultrasound is the best choice because of the density
of the breast tissue in young
Women.
(u) D. Mammographies are not recommended in women prior to the age of 35 without
family history of breast
Cancer or BRCA positive.

A 26 year-old woman requests screening after her boyfriend was treated for a sexually
transmitted infection recently.
On examination you find a painless vulvar ulcer. Which of the following is the most likely
diagnosis?
A. Herpes
B. Syphilis
C. Chancroid
D. Granuloma inguinale - correct answer (u) A. The classic presentation of herpes is a
painful vesicle.
CORRECT: B. The primary lesion of syphilis presents as a painless ulcer or chancre.
Secondary syphilis presents with a
Skin rash lymphadenopathy and mucocutaneous lesions.
(u) C. Chancroid presents with a painful genital ulcer and tender suppurative inguinal
adenopathy.
(u) D. Granuloma inguinale presents with raised, red lesions that bleed easily.

,A 16 year-old nulliparous acutely ill female presents with bilateral lower abdominal pain.
She has a temperature of
100.4 degrees F and on examination has a tender, enlarged left adnexa. Cervical
culture is positive for Chlamydia.
Ultrasound reveals a complex tubular structure in the left adnexal area. What is the
recommended treatment?
A. Outpatient treatment with IM ceftriaxone and oral doxycycline
B. Oral doxycycline
C. IM procaine penicillin
D. Hospitalization with parenteral doxycycline and cefoxitin - correct answer D. This
patient has pelvic inflammatory disease and most likely a tubo-ovarian abscess. It is
recommended that
The patient be hospitalized and treated with high-dose IV antibiotic therapy. For patients
with tubo-ovarian
Abscesses, surgical drainage is often necessary.

Dysmenorrhea would most likely occur in which of the following patients?
A. A young teenager who just started having her menses
B. A woman on birth control pills
C. A marathon runner with one menses per year
D. A 35 year-old woman with regular cycles - correct answer (u) A. Young teenagers
who have just started their menses are unlikely to have dysmenorrhea, because they
Usually are anovulatory for up to one year.
(u) B. Women on birth control pills do not have dysmenorrhea because they do not
ovulate on oral contraceptives
And ocps are used to treat dysmenorrhea.
(u) C. Marathon runners are often amenorrheic or have oligoamenorrhea. They do not
have dysmenorrhea because
Dysmenorrhea is a function of ovulatory cycles.
CORRECT: D. Women with regular menstrual cycles are most likely to have
dysmenorrhea. Dysmenorrhea is caused by a
Excess of prostaglandin F 2 alpha. Prostaglandin production increases under the
influence of progesterone,
Reaching a peak at, or soon after, the start of menstruation.

A 25 year-old female, G2 P1001, presents to your office at 11-weeks gestation with
vaginal bleeding, mild lower
Abdominal cramping, and bilateral lower pelvic discomfort. On examination, blood is
noted at the dilated cervical os.
No tissue is protruding from the cervical os. The uterus by palpation is 8-9 weeks
gestation. No other abnormalities
Are found. Which of the following is the most likely diagnosis?
A. Threatened abortion
B. Inevitable abortion
C. Incomplete abortion

, D. Complete abortion - correct answer (u) A. Threatened abortion is characterized by
bleeding in the first trimester without loss of fluid or tissue.
CORRECT: B. Inevitable abortion is the gross rupture of membranes in the presence of
cervical dilation.
(u) C. Incomplete abortion is when the cervical os is open and allows passage of blood.
The products of conception
May remain in utero or may partially extrude through the open os.
(u) D. Complete abortion refers to a documented pregnancy that spontaneously passes
all of the products of
Conception.

Which of the following is recommended to reduce the risk for perinatal transmission of
HIV in a patient with a viral
Load of >1000 copies/ml?
A. Vaginal delivery with female condom
B. Episiotomy to shorten second stage of labor
C. Use of forceps or vacuum extractor to shorten second stage of labor
D. Cesarean section prior to onset of labor and rupture of membranes - correct answer
D. Cesarean section performed prior to the onset of labor and rupture of membranes
significantly reduces the
Risk of perinatal HIV transmission. Planned cesarean section delivery at 38 weeks of
gestation to prevent
Perinatal transmission of HIV is recommended in women with a viral load of >1000
copies/ml.

On physical examination of a pregnant patient, which can be considered a normal
finding?
A. Increased second heart sound split with inspiration
B. Diastolic murmur
C. Facial edema
D. Hyperreflexia - correct answer CORRECT: A. Increased second heart sound split
with inspiration is common in pregnancy due to the increased blood flow
Across the aortic and pulmonic valves.
(u) B. Diastolic murmurs in pregnancy should be considered pathological and evaluated
further.
(u) C. Facial edema in uncommon in pregnancy and if it occurs, the medical provider
should consider preeclampsia.
(u) D. Hyperreflexia occurs with preeclampsia and does not occur in a normal
pregnancy.

When is the recommendation for the next Pap smear in a 36 year-old patient with a
history of 3 consecutive negative
Annual Pap smears and no history of cervical dysplasia?
A. Yearly Pap smears
B. Pap smear in 4 years
C. Pap smear in 3 years
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