Ob-Gyn NBME Form 1 Comprehensive
Questions (Frequently Tested) with
Verified Answers Graded A+
18 yo - 1 day of fever, N/V, diarrhea w/ diffuse rash
menses regular
LMP started 3 days ago - uses tampons and pads
sexually active w/ 1 male partner - contraceptive patch
102.2 F
RR - 22/min
BP - 90/60 mmHg
PE: diffuse, erythematous, maculopapular rash over perineum and thighs
pelvic exam: cervical motion, uterine, and BL adnexal tenderness w/ no masses
most likely organism? - Answer: S.aureus
homegirl has toxic shock syndrome
S.aureus produces epidermal toxin: TSST-1
symptoms: high fever, HoTN, diffuse erythematous macular rash, desquamation of palms and
soles 1-2 wks after acute illness, and multi system involvement of 3+ organ systems
extra: GI disturbances, myalgia, mucous membrane hyperemia, inc BUN and Cr, platelets
<100,000, and alteration in consciousness
tx: admit; IV fluids + pressors; clindamycin + vancomycin or linezolid (MRSA) or nafcillin/oxacillin
(MSSA)
24 yo - 30 wks gest
bright red vaginal bleeding - 12 hrs post sex
bleeding has inc
US at 20 wks - fundal placenta
,PE: uterine fundus nontender; fundal height 30 cm
fetal HR: 150/min w/ mod variability
ext fetal monitoring: 2 contractions during next hr
cause of bleeding? - Answer: cervical trauma
not abnormal to bleed post sex during pregnancy - due to the tiny blood vessels
other answer choices:
abruptio placentae - 3rd trimester vag bleeding w/ severe abd pain and/or frequent, strong
contractions
placenta previa - sudden and profuse painless vag bleeding; however her US at 20 wks shows a
fundal placenta
87 yo - urinary incontinence past 6 yrs
fear of having loss of urine in public
occurs w/ sneezing, coughing, or exertion
PSHx: hysterectomy 30 yrs ago
BMI: 31
PE: abd surgical scar
most likely cause? - Answer: decreased external urethral sphincter tone
homegirl has stress incontinence - involuntary loss of urine on effort or physical exertion,
sneezing, coughing, etc.
tx: lifestyle modifications (including Kegel exercises); incontinence pessaries; surgery (sling)
32 yo woman - G5P4 - 18 wks gest
Rh-neg
previous pregnancies: C-sections bet 33 and 35 wks gest for premature labor and breech
presentation
received RhoGAM during each pregnancy
, FHx: dad - HTN; mom - T2DM
PE: gucci
US: intrauterine preg of single fetus w/ normal anatomy in breech presentation; uterus is
bicornuate
inc risk for what OB complication? - Answer: preterm labor and delivery
labor before week 37
risk factors: preterm rupture of membranes; chorioamnionitis; mult gest; uterine anomalies
(like *bicornuate uterus*); *previous preterm delivery*; maternal pre pregnancy weight < 50 kg;
placental abruption; maternal dz like preeclampsia, infections, intra-abd dz/surgery; low
socioeconomic status
17 yo - no period, no breast development
not sex active; no meds
BMI: 31 - 4' 1", 48 kg (105 lb)
Tanner stage 1 breasts
thyroid not enlarged
grade 2/6 cont murmur - midsternal border and back
pelvic exam: gucci
PE: no palpable masses
mgnt of what serum conc is the most appropriate next step in dx? - Answer: FSH
pt has uterus but no breasts
DDx: hypergonadotropic hypogonadism - gonadal dysgenesis and defects in steroid pathways;
hypogonadotropic hypogonadism - CNS, hypothalamic, and pit dysfxn
serum FSH level will differentiate bet these two
22 yo - inc vaginal bleeding during past 2 days
LMP: 8 wks ago
several home pregnancy tests: positive
Questions (Frequently Tested) with
Verified Answers Graded A+
18 yo - 1 day of fever, N/V, diarrhea w/ diffuse rash
menses regular
LMP started 3 days ago - uses tampons and pads
sexually active w/ 1 male partner - contraceptive patch
102.2 F
RR - 22/min
BP - 90/60 mmHg
PE: diffuse, erythematous, maculopapular rash over perineum and thighs
pelvic exam: cervical motion, uterine, and BL adnexal tenderness w/ no masses
most likely organism? - Answer: S.aureus
homegirl has toxic shock syndrome
S.aureus produces epidermal toxin: TSST-1
symptoms: high fever, HoTN, diffuse erythematous macular rash, desquamation of palms and
soles 1-2 wks after acute illness, and multi system involvement of 3+ organ systems
extra: GI disturbances, myalgia, mucous membrane hyperemia, inc BUN and Cr, platelets
<100,000, and alteration in consciousness
tx: admit; IV fluids + pressors; clindamycin + vancomycin or linezolid (MRSA) or nafcillin/oxacillin
(MSSA)
24 yo - 30 wks gest
bright red vaginal bleeding - 12 hrs post sex
bleeding has inc
US at 20 wks - fundal placenta
,PE: uterine fundus nontender; fundal height 30 cm
fetal HR: 150/min w/ mod variability
ext fetal monitoring: 2 contractions during next hr
cause of bleeding? - Answer: cervical trauma
not abnormal to bleed post sex during pregnancy - due to the tiny blood vessels
other answer choices:
abruptio placentae - 3rd trimester vag bleeding w/ severe abd pain and/or frequent, strong
contractions
placenta previa - sudden and profuse painless vag bleeding; however her US at 20 wks shows a
fundal placenta
87 yo - urinary incontinence past 6 yrs
fear of having loss of urine in public
occurs w/ sneezing, coughing, or exertion
PSHx: hysterectomy 30 yrs ago
BMI: 31
PE: abd surgical scar
most likely cause? - Answer: decreased external urethral sphincter tone
homegirl has stress incontinence - involuntary loss of urine on effort or physical exertion,
sneezing, coughing, etc.
tx: lifestyle modifications (including Kegel exercises); incontinence pessaries; surgery (sling)
32 yo woman - G5P4 - 18 wks gest
Rh-neg
previous pregnancies: C-sections bet 33 and 35 wks gest for premature labor and breech
presentation
received RhoGAM during each pregnancy
, FHx: dad - HTN; mom - T2DM
PE: gucci
US: intrauterine preg of single fetus w/ normal anatomy in breech presentation; uterus is
bicornuate
inc risk for what OB complication? - Answer: preterm labor and delivery
labor before week 37
risk factors: preterm rupture of membranes; chorioamnionitis; mult gest; uterine anomalies
(like *bicornuate uterus*); *previous preterm delivery*; maternal pre pregnancy weight < 50 kg;
placental abruption; maternal dz like preeclampsia, infections, intra-abd dz/surgery; low
socioeconomic status
17 yo - no period, no breast development
not sex active; no meds
BMI: 31 - 4' 1", 48 kg (105 lb)
Tanner stage 1 breasts
thyroid not enlarged
grade 2/6 cont murmur - midsternal border and back
pelvic exam: gucci
PE: no palpable masses
mgnt of what serum conc is the most appropriate next step in dx? - Answer: FSH
pt has uterus but no breasts
DDx: hypergonadotropic hypogonadism - gonadal dysgenesis and defects in steroid pathways;
hypogonadotropic hypogonadism - CNS, hypothalamic, and pit dysfxn
serum FSH level will differentiate bet these two
22 yo - inc vaginal bleeding during past 2 days
LMP: 8 wks ago
several home pregnancy tests: positive
