Ob-Gyn NBME Form 3 Exam with Questions and Answers

Ob-Gyn NBME Form 3 Exam with Questions and Answers 22 yo primigravid - 24 wks gest - fullness in lower pelvic area for 12 hrs no contractions fundal height: 20 cm fetal heart tones good PE: breech; no cervix palpated most likely dx? ANSWER incompetent cervix considering no cervix was palpated 32 yo - G3P2 LMP: 17 wks ago PE: uterine funds palpated midway bet pubic symphysis and umbilicus serum AFP: 2.6 multiples of median next step in mgnt? ANSWER US umbilicus - 20 cm if palpated midway - 10 cm aka 10 wks gest discrepancy in gest age (10 vs 17) US in first trimester - most accurate in dating (w/in 1 wk) inc AFP (>2.5 MoMs) - open NTDs, abd wall defects, mult gest, *incorrect gest dating*, fetal death, placental abnormalities dec AFP - trisomy 21 and 18, fetal demise, inaccurate gest dating 77 yo - G2P2 - 1 month of int episodes of vag bleeding episodes last 3-4 days; no association w/ trauma/sex