OBGYN APGO UWise EXAM, questions answered
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,7/9/25, 8:08 AM OBGYN APGO UWise EXAM, questions answered MULTIPLE CHOICES WITH RATIONALES| 2025 verified graded A+ already pas…
An 18-year-old G1P0 B. Relative hemodilution of pregnancy
woman is seen in the clinic
for a routine prenatal visit There is normally a 36% increase in maternal blood
at 28 weeks gestation. Her volume; the maximum is reached around 34 weeks.
prenatal course has been The plasma volume increases 47% and the RBC mass
unremarkable. She has not increases only 17%. This relative dilutional effect
been taking prenatal lowers the hemoglobin, but causes no change in the
vitamins. Her pre- MCV. Folate deficiency results in a macrocytic anemia.
pregnancy weight was 120 Iron deficiency and thalassemias are associated with
pounds. Initial hemoglobin microcytic anemia.
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
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A 34-year-old G3P1 C. Physiologic dyspnea of pregnancy
woman at 26 weeks
gestation reports Physical examination findings are not consistent with
"difficulty catching her pulmonary embolus (e.g tachycardia, tachypnea,
breath," especially after hypoxia, chest pain, signs of a DVT) or mitral stenosis
exertion for the last two (diastolic murmur, signs of heart failure). Physiologic
months. She is a non- dyspnea of pregnancy is present in up to 75% of
smoker. She does not have women by the third trimester. Peripartum
any history of pulmonary cardiomyopathy is an idiopathic cardiomyopathy that
or cardiac disease. She presents with heart failure secondary to left
denies fever, sputum, ventricular systolic function towards the end of
cough or any recent pregnancy or in the several months following delivery.
illnesses. On physical Symptoms include fatigue, shortness of breath,
examination, her vital signs palpitations, and edema. The history and physical do
are: blood pressure not suggest a pathologic process, nor does her
108/64, pulse 88, hemoglobin level.
respiratory rate 15, and she
is afebrile. Pulse oximeter
is 98% on room air. Lungs
are clear to auscultation.
Heart is regular rate and
rhythm with II/VI systolic
murmur heard at the
upper left sternal border.
She has no lower
extremity edema. A
complete blood count
reveals a hemoglobin of
10.0 g/dL. What is the most
likely explanation for this
woman's symptoms?
A. Pulmonary embolism
B. Mitral valve stenosis
C. Physiologic dyspnea of
pregnancy
D. Peripartum
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cardiomyopathy
E. Anemia
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