OBGYN UW & Uwise EXAM WITH COMPLETE
SOLUTION VERIFIED BY EXPERTS
1. 35-37 eweeks egestation: eWhen edo ewe etest efor egroup eB estrep e(strep
eagalactiae)?
2. : eFlowchart: emanagement eof epostpartum ehemorrhage e(PPH)terine edue eto eu
wome
3. Mittelschmerz: ePRESENTATION: eAcute epelvic e/ elower eabd epain ein
n:
4. ectopic epregnancy: ePRESENTATION: eAcute epelvic e/ elower eabd epein
ain
5. Ovarian eTorsion
Enlarged eovary ew/ edecreased eor eabsent eblood eflow eon eUS: ePRES ENTATION
eAcute epelvic e/ elower eabd epain ein ewomen: :
6. Ruptured eovarian ecyst
pw efree efluid eon eUS
When esevere, emay epw ehemiperitoneum e(rigid eabdomen, erebound, eguarding): e-
e
PRESENTATION: eAcute epelvic e/ elower eabd epain ein ewomen:
e
7. PID
+/- etuboovarian eabscess: ePRESENTATION: eAcute epelvic e/ elower eab e
d epain
ewomen:
8. SSRI e- elow edose
Black ecohash e(not eFDA eregulated)
Clonidine e(a-adrenergic eagonist, evasoactive): eWhat eare ethe enon-hormonal
1 e/
,ethera- epies efor ehot eflashes?
9. Hemorrhage
eHypovolemic eshock
DIC: eMajor ecomplications efor emother ein eabruptio eplacentae?
10.: eFlowchart: emanagement eof eHSV ein epregnancy
The egoal eis eto eavoid eneeding eto edo ea ec-section. eIf elesionsannot
edevelop, ewe ec ebaby eto epass ethrough evagina. eHence, eallow e36
eprophylaxis e(acyclovir) estarting eat enecessary eto eprevent
elesions efrom edeveloping.
11.Within e3 emonths e(may estill ebe esorta eabnormal efor ea ewhile ethereafter): eHow
elong eshould eit etake efor emenses eto ereturn eafter ediscontinuing ehormonal
econtraceptives?
2 e/
, 12. e Arborization e seen e in e amniotic e fluid e microscopy e whenowed e it e is e alleFlu
eto
edry.
If epregnant ept eis eleaking eclear evaginal efluid, ethe efinding eof eferningeindicate
in ea
13.Fasting e<95
1hr epostprandial e<140
2hr epostprandial e<120: eTarget eglucose erange efor egestational ediabetes:
14.1. eDiet emodification
2. Oral einsulin e(1st eline: edoesn't ecross eplacenta)
3. Metformin eor esulfonylureas
(others eare eCI): eGestational ediabetes etherapies, ein eorder:
15.: eTable: eManagement eof eshoulder edystocia
16.: eFlowchart: eapproach eto epostmenopausal evaginal ebleeding
~note ethat epostmeno eendometrial ethickness eshould enever eexceed
e4mm e(whereas emenstrual ecycles ecan ecause enormal evariation)
*note ethat eGeisinger egoes estraight eto ein-office eendometrial ebiopsy.
**TVUS ewould ebe euseful ein emeasuring eendo ethickness epainlessly,
ebut eit edoes enot edetect eatypia.
17.: eFlowchart: emanagement eof eendometriosis
18.Single edeepest efluid epocket e<2 ecm: eWhat eis ethe esign eof
eoligohydramnios eon eUS?
19.The eaging eplacenta eis eless eefficient eat edelivering eoxygen eand enutrients
e(uteroplacental einsufficiency), eso efluid eis eshunted efrom ethe ekidneys eto ebaby's
ebrain eto eprotect eit.: eWhy edoes eoligohydramnios eoccur ein epregnancies
e>40 eweeks?
3 e/
, 20.Low eestrogen ecauses evulvovaginal eatrophy, eas ewell eas edecreased ebulk eand
eelasticity eof ethe ebladder etrigone eand eurethra e(bacs ecan eascend emore eeasily)
and,
elevated evaginal epH e(decreases elactobacillus) e- ebacs esurvive emore eeasily.: e-
ePostmenopausal ewomen ewith erecurrent eUTI e(3+/yr eor e2+/6mos) ecan
ebe egiven etopical eestrogen e(following eabx, eofc).
Why eis ethis ehelpful?
21.>5 econtractions ein e10 emins
Will ep/w eLATE efetal edecelerations ein e>50% eof econtractions; eindication ebaby enot
egetting eenough eoxygen edue eto econtractions ebeing etoo efrequent:
= efrequent einterruption eto evillous eblood eflow
= einadequate erecovery etime e(resumption eof eblood eflow) ebtwn eco ntractions
Management: eSLOW econtractions.
- d/c euterotonic eagents e(eg, eoxytocin)
- Lateral ematernal epositioning
- Tocolytics: eWhat eis euterine etachysystole eand ewhy eis eit eproblematic?
22.Lowered eHgb, ebut enormal eMCV e= erelative edilutional eanemia eof epregnancy
e(peaks eat e34 eweeks)
MCV e>100 e= emacrocytic eanemia e= efolate edeficiency
MCV e>80 e= emicrocytic eanemia e= eiron edeficiency eor ethalassemias: eHow eto
einter- epret eblood evolumes ein epregnancy:
23.Admin eLasix e20mg eIV e(Furosemide)
Tocolytics eincrease esusceptibility eto epulmonary eedema. eAdd eon ethe efact ethat
eshe ewas egiven eLR, ethat's etotally ewhat's egoing eon.: ePt ewas eadmitted
24 ehours
ago efor epremature elabor eand etreated eappropriately ewithers,
elactated eringe etocolytics, eMgSO4, eand eNifedipine. eNow esheesteroids,
ecomplains eof ecough, eSO esputum. eBilateral ebasalar
ecrackles eare eheard eon eauscultation.
What's eyour enext emove, eand ewhy?
24."Dextrorotation eof ethe euterus"
4 e/
SOLUTION VERIFIED BY EXPERTS
1. 35-37 eweeks egestation: eWhen edo ewe etest efor egroup eB estrep e(strep
eagalactiae)?
2. : eFlowchart: emanagement eof epostpartum ehemorrhage e(PPH)terine edue eto eu
wome
3. Mittelschmerz: ePRESENTATION: eAcute epelvic e/ elower eabd epain ein
n:
4. ectopic epregnancy: ePRESENTATION: eAcute epelvic e/ elower eabd epein
ain
5. Ovarian eTorsion
Enlarged eovary ew/ edecreased eor eabsent eblood eflow eon eUS: ePRES ENTATION
eAcute epelvic e/ elower eabd epain ein ewomen: :
6. Ruptured eovarian ecyst
pw efree efluid eon eUS
When esevere, emay epw ehemiperitoneum e(rigid eabdomen, erebound, eguarding): e-
e
PRESENTATION: eAcute epelvic e/ elower eabd epain ein ewomen:
e
7. PID
+/- etuboovarian eabscess: ePRESENTATION: eAcute epelvic e/ elower eab e
d epain
ewomen:
8. SSRI e- elow edose
Black ecohash e(not eFDA eregulated)
Clonidine e(a-adrenergic eagonist, evasoactive): eWhat eare ethe enon-hormonal
1 e/
,ethera- epies efor ehot eflashes?
9. Hemorrhage
eHypovolemic eshock
DIC: eMajor ecomplications efor emother ein eabruptio eplacentae?
10.: eFlowchart: emanagement eof eHSV ein epregnancy
The egoal eis eto eavoid eneeding eto edo ea ec-section. eIf elesionsannot
edevelop, ewe ec ebaby eto epass ethrough evagina. eHence, eallow e36
eprophylaxis e(acyclovir) estarting eat enecessary eto eprevent
elesions efrom edeveloping.
11.Within e3 emonths e(may estill ebe esorta eabnormal efor ea ewhile ethereafter): eHow
elong eshould eit etake efor emenses eto ereturn eafter ediscontinuing ehormonal
econtraceptives?
2 e/
, 12. e Arborization e seen e in e amniotic e fluid e microscopy e whenowed e it e is e alleFlu
eto
edry.
If epregnant ept eis eleaking eclear evaginal efluid, ethe efinding eof eferningeindicate
in ea
13.Fasting e<95
1hr epostprandial e<140
2hr epostprandial e<120: eTarget eglucose erange efor egestational ediabetes:
14.1. eDiet emodification
2. Oral einsulin e(1st eline: edoesn't ecross eplacenta)
3. Metformin eor esulfonylureas
(others eare eCI): eGestational ediabetes etherapies, ein eorder:
15.: eTable: eManagement eof eshoulder edystocia
16.: eFlowchart: eapproach eto epostmenopausal evaginal ebleeding
~note ethat epostmeno eendometrial ethickness eshould enever eexceed
e4mm e(whereas emenstrual ecycles ecan ecause enormal evariation)
*note ethat eGeisinger egoes estraight eto ein-office eendometrial ebiopsy.
**TVUS ewould ebe euseful ein emeasuring eendo ethickness epainlessly,
ebut eit edoes enot edetect eatypia.
17.: eFlowchart: emanagement eof eendometriosis
18.Single edeepest efluid epocket e<2 ecm: eWhat eis ethe esign eof
eoligohydramnios eon eUS?
19.The eaging eplacenta eis eless eefficient eat edelivering eoxygen eand enutrients
e(uteroplacental einsufficiency), eso efluid eis eshunted efrom ethe ekidneys eto ebaby's
ebrain eto eprotect eit.: eWhy edoes eoligohydramnios eoccur ein epregnancies
e>40 eweeks?
3 e/
, 20.Low eestrogen ecauses evulvovaginal eatrophy, eas ewell eas edecreased ebulk eand
eelasticity eof ethe ebladder etrigone eand eurethra e(bacs ecan eascend emore eeasily)
and,
elevated evaginal epH e(decreases elactobacillus) e- ebacs esurvive emore eeasily.: e-
ePostmenopausal ewomen ewith erecurrent eUTI e(3+/yr eor e2+/6mos) ecan
ebe egiven etopical eestrogen e(following eabx, eofc).
Why eis ethis ehelpful?
21.>5 econtractions ein e10 emins
Will ep/w eLATE efetal edecelerations ein e>50% eof econtractions; eindication ebaby enot
egetting eenough eoxygen edue eto econtractions ebeing etoo efrequent:
= efrequent einterruption eto evillous eblood eflow
= einadequate erecovery etime e(resumption eof eblood eflow) ebtwn eco ntractions
Management: eSLOW econtractions.
- d/c euterotonic eagents e(eg, eoxytocin)
- Lateral ematernal epositioning
- Tocolytics: eWhat eis euterine etachysystole eand ewhy eis eit eproblematic?
22.Lowered eHgb, ebut enormal eMCV e= erelative edilutional eanemia eof epregnancy
e(peaks eat e34 eweeks)
MCV e>100 e= emacrocytic eanemia e= efolate edeficiency
MCV e>80 e= emicrocytic eanemia e= eiron edeficiency eor ethalassemias: eHow eto
einter- epret eblood evolumes ein epregnancy:
23.Admin eLasix e20mg eIV e(Furosemide)
Tocolytics eincrease esusceptibility eto epulmonary eedema. eAdd eon ethe efact ethat
eshe ewas egiven eLR, ethat's etotally ewhat's egoing eon.: ePt ewas eadmitted
24 ehours
ago efor epremature elabor eand etreated eappropriately ewithers,
elactated eringe etocolytics, eMgSO4, eand eNifedipine. eNow esheesteroids,
ecomplains eof ecough, eSO esputum. eBilateral ebasalar
ecrackles eare eheard eon eauscultation.
What's eyour enext emove, eand ewhy?
24."Dextrorotation eof ethe euterus"
4 e/
