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ALSO Pre test question and answers A 26 year-old gravida 2 para 1 female at 9 weeks' estimated gestational age (by last normal menstrual period) presents to the Emergency Department complaining of heavy vaginal bleeding which began two hours earlier. She denies having any sexual intercourse in the past seven days. Her vital signs are stable. A quantitative serum hCG returns at a value of 3200 mIU/mL and a transvaginal ultrasound reveals a mean gestational sac diameter of 30mm and no embryo. She reports passing no tissue and a speculum examination reveals the cervix is visually closed. In counseling the patient about her options, which of the following statements is true? - correct answers-Medical management with misoprostol is more effective than expectant management Correct Which of the following is a contraindication for medical management of an ectopic pregnancy with methotrexate? - correct answers-Presence of embryonic cardiac activity Correct

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ALSO Pre test question and answers
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Atr26tryear-
oldtrgravidatr2trparatr1trfemaletrattr9trweeks'trestimatedtrgestationaltragetr(bytrlasttrnormaltrmenstr
ualtrperiod)trpresentstrtotrthetrEmergencytrDepartmenttrcomplainingtroftrheavytrvaginaltrbleedin
gtrwhichtrbegantrtwotrhourstrearlier.trShetrdeniestrhavingtranytrsexualtrintercoursetrintrthetrpasttrs
eventrdays.trHertrvitaltrsignstraretrstable.trAtrquantitativetrserumtrhCGtrreturnstrattratrvaluetroftr320
0trmIU/mLtrandtratrtransvaginaltrultrasoundtrrevealstratrmeantrgestationaltrsactrdiametertroftr30m
mtrandtrnotrembryo.trShetrreportstrpassingtrnotrtissuetrandtratrspeculumtrexaminationtrrevealstrth
etrcervixtristrvisuallytrclosed.trIntrcounselingtrthetrpatienttrabouttrhertroptions,trwhichtroftrthetrfollow
ingtrstatementstristrtrue?tr-
trcorrecttranswers-Medicaltrmanagementtrwithtrmisoprostoltristrmoretreffectivetrthantrexpectantt

rmanagementtrCorrect

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ancytrwithtrmethotrexate?tr-trcorrecttranswers-
PresencetroftrembryonictrcardiactractivitytrCorrect
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trcmtrdilatedtrandtr80%treffacedtrattrstationtr-

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havingtrhadtrseveretrheadachestrfortrthreetrdaystrandtrhastrnoticedtrswellingtrintrhertrhandstrandtrf
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monarytrembolus.trShetristrhemodynamicallytrstabletrandtryoutraretrdiscussingtrtherapeutictrant
icoagulationtrwithtrher.trAccordingtrtotrthetr2012trAmericantrCollegetroftrChesttrPhysicianstrGuid
elines,trthetrtreatmenttroftrchoicetrfortrvenoustrthromboembolismtrintrpregnancytristrwhichtronetro
ftrthetrfollowing?tr-trcorrecttranswers-Low-moleculartrweighttrheparintrCorrect
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chtroftrthetrfollowingtrprimiparoustrlabortrscenarios?tr-trcorrecttranswers-
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rgeneratetradequatetrcontractionstrortrprogresstrattr7trcmtrCorrect

, Whichtroftrthetrfollowingtrdefinestrantrocciputtrposteriortrposition?tr-trcorrecttranswers-
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T:tr-trcorrecttranswers-TheretristratrdecreasedtrincidencetroftrcongenitaltranomaliestrCorrect
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oldtrgravidatr2trparatr1trfemaletrattr40tr6/7trweeks'trestimatedtrgestationaltragetrhastrbeentrfullytrdil
atedtrfortrfourtrhours,trandtrhastrnowtrbeentrpushingtrfortrtwotrhours.trShetristrphysicallytrandtremoti
onallytrexhausted,trsotryoutrhavetratrdiscussiontrwithtrhertrregardingtrassistedtrvaginaltrdelivery.tr
Whichtroftrthetrfollowingtraretrprerequisitestrtotrantrinstrumentedtrdelivery?tr-trcorrecttranswers-
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Whichtroftrthetrfollowingtristrantrantenataltrrisktrfactortrfortrshouldertrdystocia?tr-
trcorrecttranswers-MaternaltrobesitytrCorrect

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ntialtrrisktrmanagementtrtool.trWhichtroftrthetrfollowingtrshouldtrbetrdocumentedtrintrthetrmedicaltr
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babytrCorrect
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istrontrthetrrise.trWhichtronetroftrthetrfollowingtristrthetrmosttrcommontrcausetroftrpostpartumtrhemo
rrhage?tr-trcorrecttranswers-AtonictruterustrCorrect
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ceptiontroftrchronictrhypertensiontrtreatedtrwithtrLabetaloltr100trmgtrpotrBID.trAftertratrnormaltrspo
ntaneoustrvaginaltrdelivery,tryoutrnotetratrlargetrgushtroftrblood,trprompttrdeliverytroftrthetrplacent
a,trandtrbrisktrvaginaltrbleeding.trIntradditiontrtotruterinetrmassage,trwhichtroftrthetrfollowingtrutero
tonictragentstrshouldtrnottrbetrusedtrtotrtreattrpostpartumtrhemorrhagetrintrthistrpatient?tr-
trcorrecttranswers-Methylergonovine tr0.2trmgtrIMtrCorrect

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restrimmediatetrmaternaltrresuscitationtrmeasurestrusingtrantrinterdisciplinarytrteamtrapproach
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trcorrecttranswers-1500trmLtrCorrect

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trterm,trandtrwastradmittedtrtwotrhourstragotrfortrlabortrmanagement.trIntrthetrfacetroftrmaternaltrca

rdiopulmonarytrarresttraftertr4trminutestroftradequatetrcardiopulmonarytrresuscitation,tryoutrrec
alltrthetrAmericantrHearttrAssociation'strgoaltristrtotrachievetrdeliverytroftrthetrfetustrviatremergenc
ytrhysterotomytrbytrnotrmoretrthantrhowtrmanytrminutestraftertrthetrmother'strhearttrhastrstoppedtr
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minortrMVC,trortrblunttrabdominaltrtrauma)trshouldtrbetrmonitoredtrbytrcardiotocographtrfortratrmi
nimumtroftrhowtrmanytrhours?tr-trcorrecttranswers-4trhourstrCorrect
IntrdiscussingtrobstetrictremergenciestrwithtratrnewtrregisteredtrnursetrontrLabortrandtrDelivery,tr
youtrinitiatetratrconversationtrreviewingtrthetrcommontrrisktrfactorstrfortrpostpartumtrhemorrhag

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