OB/GYN REVIEW FROM AAFP

The most common cause of abnormal vaginal discharge in a sexually active 19-year-old female is (check one) A. Candida albicans B. Trichomonas vaginalis C. Staphylococcus D. Group B Streptococcus E. Bacterial vaginosis - Answer- Bacterial vaginosis (BV) is the most common cause of acute vaginitis, accounting for up to 50% of cases in some populations. It is usually caused by a shift in normal vaginal flora. BV is considerably more common as a cause of vaginal discharge than C. albicans and T. vaginalis. An asymptomatic 24-year-old white female comes to your office for a refill of oral contraceptive pills. A speculum examination is normal with the exception of a slightly friable, well-demarcated, 1.4-cm raised lesion involving a portion of the cervix. All previous Papanicolaou (Pap) tests have been normal and she has no history of abnormal bleeding or leukorrhea. Which one of the following would be most appropriate at this point? - Answer- A Pap test and a colposcopically-directed biopsy. The finding of a red, raised, friable lesion on the cervix, or a well-demarcated cervical lesion, mandates a biopsy to exclude cervical carcinoma. Which one of the following fetal ultrasound measurements gives the most accurate estimate of gestational age in the first trimester (up to 14 weeks)? (check one) A. Femur length B. Biparietal diameter C. Abdominal circumference D. Crown-rump length E. Scapulo-sacral length - Answer- Crown-rump length is the distance from the top of the head to the bottom of the fetal spine. It is most accurate as a measure of gestational age at 7-14 weeks. After that, other measurements are more reliable. In the 2nd trimester, biparietal diameter and femur length are used. Late decelerations on fetal monitoring are thought to indicate which one of the following? (check one) A. Fetal head compression B. Umbilical cord compression C. Fetal sleep D. Uterine hypotonus E. Uteroplacental insufficiency - Answer- Late decelerations are associated with uteroplacental insufficiency and fetal hypoxia due to decreased blood flow in the placenta. This pattern is a warning sign and is associated with increasing fetal compromise, worsening fetal acidosis, fetal central nervous system depression, and/or direct myocardial hypoxia. Early decelerations result from the vagus nerve response to fetal head compression. Variable deceleration