Ob-Gyn NBME Form 2 Exam with Questions and Answers

Ob-Gyn NBME Form 2 Exam with Questions and Answers 15 yo - ED bc of N/V and lower abd pain for 4 days LMP: 9 days ago sex active; no contraception 103.5F P: 105/min BP: 110/75 mmHg PE: BL lower abd tenderness and peritoneal signs pelvic exam: copious yellow cervical discharge and exquisite uterine tenderness next step in mgnt? ANSWER admission to the hospital for IV antibiotic therapy homegirl def has some sort of infection 24 yo primigravid - labor not been screened for GBS cervix - 80% effaced vertex - +1 station contractions q10 min membranes ruptured 12 hrs ago PE: areas of vag erythema cx for GBS: pending next step to prevent GBS sepsis in newborn? ANSWER antibiotic therapy if delivery hasn't occurred 18 hrs after rupture of membranes inc risk of infection when ROM is prolonged (>18 hrs) in case of labor or ROM before 37 wks - pts should be screened and tx empirically until delivery or neg cx results