OB/GYN BLUE-PRINT 5TH ED. Q&A
WITH VERIFIED SOLUTIONS 2024
Immediate induction of labor for anticipated vaginal delivery - ANSWER A 22 year old G2P0 at 33 weeks'
gestation is found to have a BP of 166/114 mmHg on a routine office visit. Her BP at her first prenatal
visit at 7 weeks was 124/72. Her urine dip at this most recent visit shows 3+ protein although it
previously had 0 to trace protein. The patient is also complaining of a persistent headache although she
has no history of migraines. Her ALT and AST are elevated at 92 and 105, respectively. After starting an
antihypertensive agent, magnesium sulfate, and betamethasone, what do you do next?
February 11, 2015 - ANSWER A 22 year old G2P0 at 33 week's gestation had her last menstrual period on
May 4, 2014. What is estimated date of confinement using the Nagele rule?
Prior preterm delivery - ANSWER A 19 year old G3P1 at 31 weeks' gestation presents with contractions
every 3 to 4 minutes. On examination, her cervix is found to be dilated 2 cm and 50% effaced. The
patient's history is remarkable for a delivery at 33 weeks' gestation in her last pregnancy of a 5 lb 3 oz
infant 3 years ago, and a miscarriage 2 years ago. She has a history of a half pack per day smoking for 6
years. Which of the following is the most predictive risk factor for recurrent preterm labor?
Placenta previa - ANSWER A 28 year old G2P1 woman with a history of a prior cesarean delivery presents
at 36 weeks gestation with a complaint of vaginal bleeding. She notes no contractions, but awoke this
morning with vaginal bleeding equivalent to heavy menstrual flow. You obtain an ultrasound as part of
her workup for third trimester bleeding. Ultrasound is the primary diagnostic tool for which cause of
third trimester bleeding?
Alcohol - ANSWER A 19 year old primigravid patient presents for an initial prenatal visit as 7 weeks
gestation. She is concerned because she used both cocaine and heroin in the month before she
discovered she was pregnant. In a long discussion with her about the risks of substance abuse during
pregnancy, you tell her that use of which of the following has the highest correlation with congenital
abnormalities?
Onset of lactation, or milk letdown - ANSWER A 32 year old G2P2 patient is 7 days postpartum after
repeat cesarean section. She presents to labor and delivery complaining of fever and chills. She is
breastfeeding and her breasts are sore and tender. In you differential diagnosis of fever in this patient,
which of the following is unlikely because of the timing of the presentation?
, G6P2124 - ANSWER A 32 year old woman present for her first prenatal visit. She has a history of two
singleton births, at 39 and 40 weeks; a twin birth at 28 weeks, and two miscarriages. All four of her
children are alive and well. Which of the following is her designation of gravidity (G) and parity (P)?
Chorioamnionitis - ANSWER A 19 year old G1P0 at 38 weeks gestation present to labor and delivery. On
arrival, she is having contractions every 2 to 3 minutes and claims that her water broke 2 days earlier but
that she didn't com in because she hadn't reached her due date. She has a temperature of 101.2 F, HR of
110, BP of 116/72 mmHg, and uterine tenderness on palpation. The fetal heart rate is in the 170's with
small accelerations and no decelerations. Which of the following is your diagnosis of this patient?
Contractions at 34 weeks gestation - ANSWER A 25 year old G1P0 at 9 weeks gestation presents for her
initial prenatal visit. She has no medical or surgical history and has a certain LMP that is consistent with
her examination. The patient has donated blood in the past and knows that she is Rh negative. In which
of the following situations would the patient be cared for without being treated with RhoGAM?
administer calcium gluconate - ANSWER A 23 year old G1P0 at week 38 is being managed with
magnesium sulfate while she undergoes induction of labor for severe preeclampsia. She received a 4-g
bolus followed by a constant infusion of 1.0 g/hr. However, the nurse found the patient to have absent
patellar reflexes and a respiratory rate of 6 breaths/minute. The patent can be aroused but is very
drowsy. In addition to discontinuing the magnesium, what should your next management step be?
Amniocentesis - ANSWER A 27 year old G1P0 African American woman presents at 16 weeks gestation
for a prenatal visit. She has had one prior prenatal visit and no known medical complications of
pregnancy. Which of the following genetic tests would only be offered if one of the other tests was
positive?
Offer induction of labor between weeks 39 and 40 of gestation - ANSWER A 28 year old class A2 diabetic
at 34 weeks of gestation present for a prenatal appointment. In addition to managing her insulin
regimen and performing routine counseling, you also discuss plans for deliver. In general, in the well-
controlled, insulin-requiring gestational diabetic woman, which mode and timing of delivery is usually
employed?
uterine atony - ANSWER A 37 year old G7P6 with a dichorionic/diamnionic, vertex/vertex twin gestation
at 38 weeks presents to labor and delivery for induction of labor. She is started on oxytocin and begins
having contractions after several hours. The patient progresses slowly over the next 16 hours until she is
5 cm dilated and, at this point, develops a fever and fetal tachycardia. The woman is diagnosed with
chorioamnionitis and antibiotic therapy is started. She delivers the babies vaginally 6 hours later. Right
WITH VERIFIED SOLUTIONS 2024
Immediate induction of labor for anticipated vaginal delivery - ANSWER A 22 year old G2P0 at 33 weeks'
gestation is found to have a BP of 166/114 mmHg on a routine office visit. Her BP at her first prenatal
visit at 7 weeks was 124/72. Her urine dip at this most recent visit shows 3+ protein although it
previously had 0 to trace protein. The patient is also complaining of a persistent headache although she
has no history of migraines. Her ALT and AST are elevated at 92 and 105, respectively. After starting an
antihypertensive agent, magnesium sulfate, and betamethasone, what do you do next?
February 11, 2015 - ANSWER A 22 year old G2P0 at 33 week's gestation had her last menstrual period on
May 4, 2014. What is estimated date of confinement using the Nagele rule?
Prior preterm delivery - ANSWER A 19 year old G3P1 at 31 weeks' gestation presents with contractions
every 3 to 4 minutes. On examination, her cervix is found to be dilated 2 cm and 50% effaced. The
patient's history is remarkable for a delivery at 33 weeks' gestation in her last pregnancy of a 5 lb 3 oz
infant 3 years ago, and a miscarriage 2 years ago. She has a history of a half pack per day smoking for 6
years. Which of the following is the most predictive risk factor for recurrent preterm labor?
Placenta previa - ANSWER A 28 year old G2P1 woman with a history of a prior cesarean delivery presents
at 36 weeks gestation with a complaint of vaginal bleeding. She notes no contractions, but awoke this
morning with vaginal bleeding equivalent to heavy menstrual flow. You obtain an ultrasound as part of
her workup for third trimester bleeding. Ultrasound is the primary diagnostic tool for which cause of
third trimester bleeding?
Alcohol - ANSWER A 19 year old primigravid patient presents for an initial prenatal visit as 7 weeks
gestation. She is concerned because she used both cocaine and heroin in the month before she
discovered she was pregnant. In a long discussion with her about the risks of substance abuse during
pregnancy, you tell her that use of which of the following has the highest correlation with congenital
abnormalities?
Onset of lactation, or milk letdown - ANSWER A 32 year old G2P2 patient is 7 days postpartum after
repeat cesarean section. She presents to labor and delivery complaining of fever and chills. She is
breastfeeding and her breasts are sore and tender. In you differential diagnosis of fever in this patient,
which of the following is unlikely because of the timing of the presentation?
, G6P2124 - ANSWER A 32 year old woman present for her first prenatal visit. She has a history of two
singleton births, at 39 and 40 weeks; a twin birth at 28 weeks, and two miscarriages. All four of her
children are alive and well. Which of the following is her designation of gravidity (G) and parity (P)?
Chorioamnionitis - ANSWER A 19 year old G1P0 at 38 weeks gestation present to labor and delivery. On
arrival, she is having contractions every 2 to 3 minutes and claims that her water broke 2 days earlier but
that she didn't com in because she hadn't reached her due date. She has a temperature of 101.2 F, HR of
110, BP of 116/72 mmHg, and uterine tenderness on palpation. The fetal heart rate is in the 170's with
small accelerations and no decelerations. Which of the following is your diagnosis of this patient?
Contractions at 34 weeks gestation - ANSWER A 25 year old G1P0 at 9 weeks gestation presents for her
initial prenatal visit. She has no medical or surgical history and has a certain LMP that is consistent with
her examination. The patient has donated blood in the past and knows that she is Rh negative. In which
of the following situations would the patient be cared for without being treated with RhoGAM?
administer calcium gluconate - ANSWER A 23 year old G1P0 at week 38 is being managed with
magnesium sulfate while she undergoes induction of labor for severe preeclampsia. She received a 4-g
bolus followed by a constant infusion of 1.0 g/hr. However, the nurse found the patient to have absent
patellar reflexes and a respiratory rate of 6 breaths/minute. The patent can be aroused but is very
drowsy. In addition to discontinuing the magnesium, what should your next management step be?
Amniocentesis - ANSWER A 27 year old G1P0 African American woman presents at 16 weeks gestation
for a prenatal visit. She has had one prior prenatal visit and no known medical complications of
pregnancy. Which of the following genetic tests would only be offered if one of the other tests was
positive?
Offer induction of labor between weeks 39 and 40 of gestation - ANSWER A 28 year old class A2 diabetic
at 34 weeks of gestation present for a prenatal appointment. In addition to managing her insulin
regimen and performing routine counseling, you also discuss plans for deliver. In general, in the well-
controlled, insulin-requiring gestational diabetic woman, which mode and timing of delivery is usually
employed?
uterine atony - ANSWER A 37 year old G7P6 with a dichorionic/diamnionic, vertex/vertex twin gestation
at 38 weeks presents to labor and delivery for induction of labor. She is started on oxytocin and begins
having contractions after several hours. The patient progresses slowly over the next 16 hours until she is
5 cm dilated and, at this point, develops a fever and fetal tachycardia. The woman is diagnosed with
chorioamnionitis and antibiotic therapy is started. She delivers the babies vaginally 6 hours later. Right
