women's health Exam Questions With Complete Solutions
1st trimester screening/tests -- chorionic villus sampling
Correct Answer 10-13wks. for women w/ prior child w/
chromosomal abnormality, maternal age >35y, abnormal 1st or
2nd trimester maternal screening tests, abnormal US, prior
pregnancy loss
advantage: allows for option of early termination fo pregnancy if
abnormalities are found
disadvantage: performing increases risk of spontaneous abortion
1st trimester screening/tests -- maternal blood screening tests
Correct Answer down syndrome screening (3 markers)
-free b-hCG abnormally high or low may be indicative of
abnormalities
-PAPP-A: usually low w/ fetal down syndrome
-nuchal translucency (US at 10-13wks), increased thickness is
abnormal
uterine size and gestation: if abnormal, chorionic villus sampling
(CVS) or amniocentesis can be offered at around 10-13wks
1st trimester screening/tests -- US Correct Answer fetal heart
tones usually heard around 10-12wks by doppler
heart beat at 5-6wks via US of fetus
2nd trimester screening/tests Correct Answer week 13-37.
,triple screening: measured at 15-20wks: alpha-fetoprotein, B-
hCG, estradiol
-low a-FP, high B-hCG, low estradiol = down syndrome
(trisomy 21)
-high a-FP = open neural tube defects (spinal bifida) (or multiple
gestation)
-low a-FP, B-hCG, estradiol = trisomy 18 -- stillborn or die w/in
1st yr of life
inhibin-A: high levels indicative of chromosomal abnormalities
US: amniotic fluid level, fetal viability, and growth for
gestational age
amniocentesis: women w/ prior child w/ chromosomal
abnormality, maternal age >35y, abnormal 1st or 2nd trimester
maternal screening tests, abnormal US, prior pregnancy loss, 15-
18wks gestation
gestational diabetes screening: 24-28wks
abrupt placentae dx Correct Answer pelvic US, do not
perform pelvic exam
abrupt placentae pathophys Correct Answer premature
separation of placenta from uterine wall after 20wks gestation
maternal HTN MC cause
bloody vaginal discharge
-I: mild, slightly bleeding
,-II: moderate/partial
-III: complete (increase risk to fetus and mother)
abrupt placentae sx Correct Answer 3rd trimester bleeding --
continuous often dark red
severe abdominal pain, painful uterine contractions, rigid uterus
+/- back pain, abdominal pain, shock sx
fetal bradycardia (fetal distress because interferes w/ fetal
oxygenation
abrupt placentae tx Correct Answer hospitalization for
hemodynamic stabilization
immediate delivery, c-section preferred
complications: may lead to DIC
adenomyosis dx Correct Answer diagnosis of exclusion 2ry to
amenorrhea (rule out pregnancy first).
MRI.
post-total abdominal hysterectomy examination uterus --
definitive diagnosis
adenomyosis pathophysiology Correct Answer *islands of
endometrial tissue w/in the myometrium* (muscular layer of
uterine wall)
, ectopic endometrial tissue induces hypertrophy and hyperplasia
of the surrounding myometrium --> diffusely enlarged uterus.
MC presents later in reproductive yrs
adenomyosis sx Correct Answer *menorrhagia*
(progressively worsens), *dysmenorrhea*, +/- infertility
tender, symmetrically enlarged *boggy uterus, globular
enlargement*
adenomyosis tx Correct Answer *total abdominal
hysterectomy only effective therapy*
conservative tx used to preserve fertility -- analgesics, low dose
OCPs
amenhorrhea Correct Answer absence of menstruation
apgar score Correct Answer
bacterial vaginosis complications Correct Answer pregnancy:
PROM (premature rupture of amniotic sac), preterm labor,
chorioamnionitis
bacterial vaginosis dx Correct Answer vaginal pH >5
whiff test: positive *fishy odor* w/ *10% KOH prep*
*clue cells*: epithelial cells covered by bacteria
*few WBCs*, few lactobacilli
bacterial vaginosis pathophys Correct Answer decreased
lactobacilli acidophilus (normally maintains vaginal pH) -->
1st trimester screening/tests -- chorionic villus sampling
Correct Answer 10-13wks. for women w/ prior child w/
chromosomal abnormality, maternal age >35y, abnormal 1st or
2nd trimester maternal screening tests, abnormal US, prior
pregnancy loss
advantage: allows for option of early termination fo pregnancy if
abnormalities are found
disadvantage: performing increases risk of spontaneous abortion
1st trimester screening/tests -- maternal blood screening tests
Correct Answer down syndrome screening (3 markers)
-free b-hCG abnormally high or low may be indicative of
abnormalities
-PAPP-A: usually low w/ fetal down syndrome
-nuchal translucency (US at 10-13wks), increased thickness is
abnormal
uterine size and gestation: if abnormal, chorionic villus sampling
(CVS) or amniocentesis can be offered at around 10-13wks
1st trimester screening/tests -- US Correct Answer fetal heart
tones usually heard around 10-12wks by doppler
heart beat at 5-6wks via US of fetus
2nd trimester screening/tests Correct Answer week 13-37.
,triple screening: measured at 15-20wks: alpha-fetoprotein, B-
hCG, estradiol
-low a-FP, high B-hCG, low estradiol = down syndrome
(trisomy 21)
-high a-FP = open neural tube defects (spinal bifida) (or multiple
gestation)
-low a-FP, B-hCG, estradiol = trisomy 18 -- stillborn or die w/in
1st yr of life
inhibin-A: high levels indicative of chromosomal abnormalities
US: amniotic fluid level, fetal viability, and growth for
gestational age
amniocentesis: women w/ prior child w/ chromosomal
abnormality, maternal age >35y, abnormal 1st or 2nd trimester
maternal screening tests, abnormal US, prior pregnancy loss, 15-
18wks gestation
gestational diabetes screening: 24-28wks
abrupt placentae dx Correct Answer pelvic US, do not
perform pelvic exam
abrupt placentae pathophys Correct Answer premature
separation of placenta from uterine wall after 20wks gestation
maternal HTN MC cause
bloody vaginal discharge
-I: mild, slightly bleeding
,-II: moderate/partial
-III: complete (increase risk to fetus and mother)
abrupt placentae sx Correct Answer 3rd trimester bleeding --
continuous often dark red
severe abdominal pain, painful uterine contractions, rigid uterus
+/- back pain, abdominal pain, shock sx
fetal bradycardia (fetal distress because interferes w/ fetal
oxygenation
abrupt placentae tx Correct Answer hospitalization for
hemodynamic stabilization
immediate delivery, c-section preferred
complications: may lead to DIC
adenomyosis dx Correct Answer diagnosis of exclusion 2ry to
amenorrhea (rule out pregnancy first).
MRI.
post-total abdominal hysterectomy examination uterus --
definitive diagnosis
adenomyosis pathophysiology Correct Answer *islands of
endometrial tissue w/in the myometrium* (muscular layer of
uterine wall)
, ectopic endometrial tissue induces hypertrophy and hyperplasia
of the surrounding myometrium --> diffusely enlarged uterus.
MC presents later in reproductive yrs
adenomyosis sx Correct Answer *menorrhagia*
(progressively worsens), *dysmenorrhea*, +/- infertility
tender, symmetrically enlarged *boggy uterus, globular
enlargement*
adenomyosis tx Correct Answer *total abdominal
hysterectomy only effective therapy*
conservative tx used to preserve fertility -- analgesics, low dose
OCPs
amenhorrhea Correct Answer absence of menstruation
apgar score Correct Answer
bacterial vaginosis complications Correct Answer pregnancy:
PROM (premature rupture of amniotic sac), preterm labor,
chorioamnionitis
bacterial vaginosis dx Correct Answer vaginal pH >5
whiff test: positive *fishy odor* w/ *10% KOH prep*
*clue cells*: epithelial cells covered by bacteria
*few WBCs*, few lactobacilli
bacterial vaginosis pathophys Correct Answer decreased
lactobacilli acidophilus (normally maintains vaginal pH) -->
