Answers
Postterm Breech Pregnancy: Types, Risk factors, and
Management Correct Answer: Types:
-Frank breech: 75% of cases; thighs flexed and knees
extended
-Complete breech: thighs and knees flexed
-Footling breech: one or both legs extended
Risk factors prematurity, multiple gestation,
polyhydramnios, uterine anomaly, placenta previa
*Treatment most cases will resolve before labor; external
cephalic version
may be applied to abdomen at 37 weeks' gestation to
attempt repositioning of
fetus (up to 75% effective); caesarean section
performed in most cases*
,Galactorrhea, Drug-Induced, Pathophysiologic
Mechanism Correct Answer: -Risperidone. Risperidone is
one of the atypical antipsychotics most likely to induce
hyperprolactinemia.
-Amisulpride
-Clozapine
-Olanzapine
(methyldopa, opioids, antipsychotics, serotonin
reuptake inhibitors, as well as licorice)
Pelvic Inflammatory Disease, Presentation Correct
Answer: lower abdominal pain starting within days of
menses, nausea, vomiting, dysuria; purulent cervical
discharge, abdominal tenderness, fever, cervical motion
tenderness, adnexal tenderness, possible abdominal
guarding
Labs:
-Increased white blood cell count (WBC)
-increased erythrocyte sedimentation
,rate (ESR)
-positive serology for Chlamydia or Nesisseria
gonorrhoeae
-Culdocentesis (i.e., aspiration of intraperitoneal fluid
from cul-de-sac posterior to uterus) yields pus.
Treatment empiric antibiotics until specific agent
identified (doxycycline,
ceftriaxone, cefoxitin); treat as inpatient if high fevers or
young age; treat sexual
partners
Amenorrhea, Chromosomal Abnormalities, Presentation
Correct Answer: Primary: absence of menses (never has
happened) with normal secondary sexual
characteristics by a 16-year-old or absence of both
menses and secondary sexual characteristics by a 13-
year-old
Cause: Chromosome abnormalities with gonadal
dysgenesis
, -Most cases of outflow obstruction result from congenital
abnormalities in the development and canalization of
the mullerian ducts
-Imperforate hymen as well the absence of the uterus or
vagina are the most common anomalies that result in
primary amenorrhea
Trichomonas Vaginitis, Presentation Correct Answer: Thin,
yellow-green malodorous frothy discharge, pH > 4.5,
Motile trichomonads, strawberry patches/petechiae
(present in the upper vagina or on the cervix)
Dx: microscopic examination of the vaginal secretions
suspended in normal saline
Tx: Metronidazole
Physiologic Nipple Discharge, Presentation Correct
Answer: defined as nonpathologic nipple discharge
unrelated to pregnancy or breastfeeding. Galactorrhea
is usually manifested as bilateral milky nipple discharge
involving multiple ducts. The nipple discharge, although
usually bilateral and white or clear, may also be