Verified Answers 2025-2026. Graded A
17 yo G1 at 24 wks has vaginal bleeding. Fundal placenta and viable fetus.
Vaginal exam shows uniformly friable cervix and small amt of blood at
vault. Digital exam shows firm, closed cervix. Dx? - ANSCervicitis
-caused by chlamydia, gonorrhea, trichomonas, infections
-cervix more vascular and inflamm can lead to bleeding
17 yo, CPP and severe dysmenorrhea. next best step? - ANSdx
laparoscopy
-can be dx and therapeutic in pt in whom you suspect et
19 yo G1P0 presents w/3mth hx of palpitations and intermittent chest pain.
grade II/VI systolic ejection murmur w/clinic. Rx? - ANSB blockers
-MVP
-B blockers dec sympathetic tone, relieve chest pain and palpatations, and
reduce risk of life threatening arrhythmias
23 yo G1 w/6 wks amenorrhea presents w/lower ab pain and vaginal
bleeding. temp is 102. Cervix 1 cm dilated. Uterus is 8 wk size, tender, preg
test positive. Next step? - ANSuterine evacuation + antibiotics
-septic abortion
-medical termination is not the best option since prompt evac is indicated if
septic
,23 yo G1P0 at 10wks gestation w/intrauterine embryonic demise. BP
120/80, hR 67, afebrile. Cervix closed and no evidence of bleeding. Wants
minimally invasive rx - ANSmisoprostol
-missed abortion
-misoprostol can be admin orally and vaginally and will induce uterine
cramping w/expulsion of products of conception
-RF: hemorrhage, failure
24 yo G1 at 8 wks. Fam hx of DM2, BMI 40. Rec to screen for GDM? -
ANSscreen now w/50G oral glucose challenge
high risk, screening should be done asap
27 yo G2P1 w/lower ab pain, nausea, scant bleeding, fever. 2 days postop
from suction D&C for incomplete abortion. rebound tenderness and ab
guarding, uterus soft and slightly tender - ANSperforated uterus
29 yo G3P0 presents at 8 wks. 2 prior pregnancies ended in losses. In both
cases cervix dilated completely w/amnionic sac bulging thru vagina. Next
step? - ANSplacement of cervical cerclage at 14 wks gestation
-incompetent cervix
30 yo G2P1 has contractions vvery 2-3 min. membranes intact. 4 hrs after
7 cm and 0 station, unchanged. Next step? - ANSperform amniotomy
-secondary arrest of dilation
, 30 yo w/L sided ab pain. adenexal mass. L ovarian mass w/cystic and solid
components - ANSdermoid tumor
32 yo G2P1 at 20 wks. her prior pregnancy was complicated by
endometritis and early onset neonatal sepsis due to GBS. Management? -
ANSdo not perform recto-vaginal cultures and rx w/antibiotics during labor
-should receive intrapartum antibiotic prophylaxis anyway
33 yo G2P1 at 29 wks has PPROM. What is next step in management? -
ANSamp and erythromycin
-antibiotic therapy prolong latency period by 5-7 days
-reduce incidence of maternal amnionitis and neonatal sepsis
34 yo G3P1 at 26 wks has difficulty catching her breath - ANSphysiologic
dyspnea of pregnancy
36 yo G2P0 at 11 wks gestation requests surgical termination. chronic HTN
and DM. BP 120/80 and blood glucose 100. What is CI for manual vacuum
aspiration? - ANSgestational age
-vacuum aspiration 99% effective in early pregnancy (<8wks)
37 yo G3P3 has BMI 52, BP 140/80, HR 86. 3 previous CS. what is best
method of permanent sterilization? - ANShysteroscopic tubal occlusion
(Essure)
-places coils into fallopian tubes that cause scarring that blocks tubes
-req to use backup method of contraception for 3 mths