OBGYN APGO UWISE (ACTUAL 2025/2026) | QUESTIONS
WITH 100% VERIFIED CORRECT ANSWERS | | LATEST
UPDATE
An 18-year-old G1P0 woman is seen in the clinic for a routine
prenatal visit at 28 weeks gestation. Her prenatal course has been
unremarkable. She has not been taking prenatal vitamins. Her pre-
pregnancy weight was 120 pounds. Initial hemoglobin at the first visit
at eight weeks gestation was 12.3 g/dL. Current weight is 138 pounds.
After performing a screening complete blood count (CBC), the results
are notable for a white blood count 9,700/mL, hemoglobin 10.6 g/dL,
mean corpuscular volume 88.2 fL (80.8 - 96.4) and platelets
215,000/mcL. The patient denies vaginal or rectal bleeding. Which of
the following is the best explanation for this patient's anemia?
A. Folate deficiency
B. Relative hemodilution of pregnancy
C. Iron deficiency
D. Beta thalassemia trait
E. Alpha thalassemia trait
B. Relative hemodilution of pregnancy
There is normally a 36% increase in maternal blood volume; the
maximum is reached around 34 weeks. The plasma volume increases
47% and the RBC mass increases only 17%. This relative dilutional
effect lowers the hemoglobin, but causes no change in the MCV.
Folate deficiency results in a macrocytic anemia. Iron deficiency and
thalassemias are associated with microcytic anemia.
,A 37-year-old G3P1 woman presents with elevated blood pressure
and 2+ proteinuria. She is 37 weeks gestation and the estimated fetal
weight is 2500 grams. The patient is diagnosed with preeclampsia and
is treated with MgS04. Magnesium level is 7.2 mEq/L. Maternal labs
show: blood type B+; RPR non-reactive; HBsAg negative; HIV
negative; and GBS negative. She is currently pushing during the
second stage of labor and the delivery of the infant is imminent. What
is the most likely complication to be encountered in this infant?
A. Meconium aspiration syndrome
B. Respiratory distress
C. Hypertension
D. Hypoglycemia
E. Sepsis
B. Respiratory distress
The first objective after delivery is to assess respiratory effort due to
use of magnesium and make sure that the neonate is being oxygenated
adequately, which might require a bag mask. Hypoglycemia would
not be the first concern in this case and is usually associated with
poorly controlled maternal diabetes and infection. Magnesium and
maternal hypertension are not risk factors for neonatal hypertension.
A 30-year-old G2P0 woman at 38 weeks gestation has just delivered a
male infant. She has a history of type 1 diabetes since age 11.
Maternal labs show: blood type B+; RPR non-reactive; HBsAg
negative; HIV negative; and GBS negative. She had moderate control
of blood sugar during her pregnancy. Which of the following would
be the most likely finding in the newborn?
,A. Large and hypoglycemic
B. Small and hypoglycemic
C. Large and hyperglycemic
D. Small and hyperglycemic
E. Normal size and euglycemic
B. Small and hypoglycemic
Small babies are more common with type 1 diabetes than with
gestational diabetes, and the blood sugar level of all newborns of
diabetic mothers should be monitored closely after delivery, as they
are at increased risk for developing hypoglycemia. Macrosomic
(large) infants are typically associated with gestational diabetes.
A 24-year-old G1P0 woman presents in active labor at 39 weeks
gestation. She reports leaking fluid for the last two days. She develops
a temperature of 102.0°F (38.9°C) and fetal heart rate is 180
beats/min with minimal variability. Maternal labs show: blood type
O+; RPR non-reactive; HBsAg, negative; HIV negative; and GBS
unknown. What will be the expected appearance of the baby at
delivery?
A. Vigorous, pink with normal temperature
B. Vigorous, pale with low temperature
C. Lethargic, pink with high temperature
D. Lethargic, pale with low temperature
E. Lethargic, pale with high temperature
E. Lethargic, pale with high temperature
, This patient clearly has chorioamnionitis. The fetal tachycardia may
be in response to the maternal fever. Fetal tachycardia coupled with
minimal variability is a warning sign that the infant can be septic. A
septic infant will typically appear pale, lethargic and have a high
temperature.
A 24-year-old G1P0 woman has just delivered 37 week male twins.
On your initial assessment, you notice twin A is large and plethoric,
and twin B is small and pale. A complete blood count (CBC) is
obtained on both twins. What is the most likely finding in this case?
A. Twin A is at high risk for polycythemia
B. Twin A is at high risk for thrombocytopenia
C. Twin B is at high risk for thrombocytopenia
D. Twin B is at high risk for tachycardia
E. Twin B is at high risk for hyperbilirubinemia
A. Twin A is at high risk for polycythemia
This case is suggestive of twin-twin transfusion syndrome (TTTS).
Polycythemia is a common complication for the plethoric twin. TTTS
is a complication of monochorionic pregnancies. It is characterized by
an imbalance in the blood flow through communicating vessels across
a shared placenta leading to under perfusion of the donor twin, which
becomes anemic and over perfusion of the recipient, which becomes
polycythemic. The donor twin often develops IUGR and
oligohydramnios, and the recipient experiences volume overload and
polyhydramnios that may lead to heart failure and hydrops.
WITH 100% VERIFIED CORRECT ANSWERS | | LATEST
UPDATE
An 18-year-old G1P0 woman is seen in the clinic for a routine
prenatal visit at 28 weeks gestation. Her prenatal course has been
unremarkable. She has not been taking prenatal vitamins. Her pre-
pregnancy weight was 120 pounds. Initial hemoglobin at the first visit
at eight weeks gestation was 12.3 g/dL. Current weight is 138 pounds.
After performing a screening complete blood count (CBC), the results
are notable for a white blood count 9,700/mL, hemoglobin 10.6 g/dL,
mean corpuscular volume 88.2 fL (80.8 - 96.4) and platelets
215,000/mcL. The patient denies vaginal or rectal bleeding. Which of
the following is the best explanation for this patient's anemia?
A. Folate deficiency
B. Relative hemodilution of pregnancy
C. Iron deficiency
D. Beta thalassemia trait
E. Alpha thalassemia trait
B. Relative hemodilution of pregnancy
There is normally a 36% increase in maternal blood volume; the
maximum is reached around 34 weeks. The plasma volume increases
47% and the RBC mass increases only 17%. This relative dilutional
effect lowers the hemoglobin, but causes no change in the MCV.
Folate deficiency results in a macrocytic anemia. Iron deficiency and
thalassemias are associated with microcytic anemia.
,A 37-year-old G3P1 woman presents with elevated blood pressure
and 2+ proteinuria. She is 37 weeks gestation and the estimated fetal
weight is 2500 grams. The patient is diagnosed with preeclampsia and
is treated with MgS04. Magnesium level is 7.2 mEq/L. Maternal labs
show: blood type B+; RPR non-reactive; HBsAg negative; HIV
negative; and GBS negative. She is currently pushing during the
second stage of labor and the delivery of the infant is imminent. What
is the most likely complication to be encountered in this infant?
A. Meconium aspiration syndrome
B. Respiratory distress
C. Hypertension
D. Hypoglycemia
E. Sepsis
B. Respiratory distress
The first objective after delivery is to assess respiratory effort due to
use of magnesium and make sure that the neonate is being oxygenated
adequately, which might require a bag mask. Hypoglycemia would
not be the first concern in this case and is usually associated with
poorly controlled maternal diabetes and infection. Magnesium and
maternal hypertension are not risk factors for neonatal hypertension.
A 30-year-old G2P0 woman at 38 weeks gestation has just delivered a
male infant. She has a history of type 1 diabetes since age 11.
Maternal labs show: blood type B+; RPR non-reactive; HBsAg
negative; HIV negative; and GBS negative. She had moderate control
of blood sugar during her pregnancy. Which of the following would
be the most likely finding in the newborn?
,A. Large and hypoglycemic
B. Small and hypoglycemic
C. Large and hyperglycemic
D. Small and hyperglycemic
E. Normal size and euglycemic
B. Small and hypoglycemic
Small babies are more common with type 1 diabetes than with
gestational diabetes, and the blood sugar level of all newborns of
diabetic mothers should be monitored closely after delivery, as they
are at increased risk for developing hypoglycemia. Macrosomic
(large) infants are typically associated with gestational diabetes.
A 24-year-old G1P0 woman presents in active labor at 39 weeks
gestation. She reports leaking fluid for the last two days. She develops
a temperature of 102.0°F (38.9°C) and fetal heart rate is 180
beats/min with minimal variability. Maternal labs show: blood type
O+; RPR non-reactive; HBsAg, negative; HIV negative; and GBS
unknown. What will be the expected appearance of the baby at
delivery?
A. Vigorous, pink with normal temperature
B. Vigorous, pale with low temperature
C. Lethargic, pink with high temperature
D. Lethargic, pale with low temperature
E. Lethargic, pale with high temperature
E. Lethargic, pale with high temperature
, This patient clearly has chorioamnionitis. The fetal tachycardia may
be in response to the maternal fever. Fetal tachycardia coupled with
minimal variability is a warning sign that the infant can be septic. A
septic infant will typically appear pale, lethargic and have a high
temperature.
A 24-year-old G1P0 woman has just delivered 37 week male twins.
On your initial assessment, you notice twin A is large and plethoric,
and twin B is small and pale. A complete blood count (CBC) is
obtained on both twins. What is the most likely finding in this case?
A. Twin A is at high risk for polycythemia
B. Twin A is at high risk for thrombocytopenia
C. Twin B is at high risk for thrombocytopenia
D. Twin B is at high risk for tachycardia
E. Twin B is at high risk for hyperbilirubinemia
A. Twin A is at high risk for polycythemia
This case is suggestive of twin-twin transfusion syndrome (TTTS).
Polycythemia is a common complication for the plethoric twin. TTTS
is a complication of monochorionic pregnancies. It is characterized by
an imbalance in the blood flow through communicating vessels across
a shared placenta leading to under perfusion of the donor twin, which
becomes anemic and over perfusion of the recipient, which becomes
polycythemic. The donor twin often develops IUGR and
oligohydramnios, and the recipient experiences volume overload and
polyhydramnios that may lead to heart failure and hydrops.
