01 Nms Obstetrics And Gynecology

Front 1

A 26 yo presents to the ER c/o severe RLQ pain. She is taken to the OR for presumed appendicitis. At the time of her surgery her appendix is normal. The surgeon sees a large mass on her R ovary and removes the ovary. Frozen section on the mass shows a corpus luteum. Immediately after, her pregnancy test is found to be positive. She is by dates 6 weeks pregnant. Your main concern is:

Back 1

C. Removing the corpus luteum will affect the pregnancy

Front 2

A 36 yo woman, G6P2, at 8 weeks gestation, presents with painless vaginal bleeding. Her vital signs: T=99.9, BP=162/94, P=100, and R=18. Her uterus is consistent with 14 weeks pregnancy. Her serum hCG is 320,000 IU/L. Which of the following endocrine glands is most likely to be affected by hCG?

Back 2

E. Thyroid

Front 3

A 29 yo woman who is pregnant calls you for advice. She has just found out that her hCG level is elevated. Which of the following is true?

Back 3

D. A high level of hCG is the most sensitive marker for Down syndrome.

Front 4

Estrogens are produced by the mother, fetus, and placenta. Which of the following is true?

Back 4

B. Estriol is produced primarily by the placenta.

Front 5

Match the hormone: Suppresses maternal lymphocyte activity

Back 5

D. Progesterone

Front 6

Match the hormone: Most sensitive marker for abnormal karyotype

Back 6

A. hCG

Front 7

Match the hormone: Elevates ketone levels

Back 7

B. hPL

Front 8

Match the hormone: Produced by the uterus

Back 8

C. Prolactin

Front 9

Match the hormone: Inhibits lactation during pregnancy

Back 9

E. Estriol

Front 10

Match the hormone: Lack of this hormone can cause spontaneous abortion in the first trimester

Back 10

D. Progesterone

Front 11

Match the hormone: Lack of this hormone is associated with an enzyme deficiency in the placenta

Back 11

E. Estriol

Front 12

Match the hormone: Elevated levels of this hormone are associated with twin pregnancy

Back 12

A. hCG

Front 13

Match the hormone: Anencephaly causes lack of production of this hormone

Back 13

E. Estriol

Front 14

A 37 yo woman, G1P1....long stem...Which event(s) is/are directly responsible for the most efficient oxygenation of the lungs?

Back 14

C. Closure of foramen ovale and ductus arteriosus

Front 15

You are listening to a discussion...The cardiac output and oxygen consumption is a fetus are approximately what multiple / fraction of that compared with an adult, respectively?

Back 15

B. 3; 3

Front 16

The most oxygenated blood is found in which part of the fetal circulation?

Back 16

A. Ductus venosus

Front 17

For each substance, select its route of transfer across the placenta: glucose

Back 17

B. Facilitated transport

Front 18

For each substance, select its route of transfer across the placenta: Iron

Back 18

A. Endocytosis

Front 19

For each substance, select its route of transfer across the placenta: Amino acids

Back 19

D. Active transport

Front 20

For each substance, select its route of transfer across the placenta: Carbon dioxide

Back 20

C. Passive diffusion

Front 21

Match the trimester during which the event occurs: Highest concentration of hemoglobin containing two a and two B chains

Back 21

D. Third trimester

Front 22

Match the trimester during which the event occurs: Amniotic fluid volume derived from transudation

Back 22

A. First trimester

Front 23

Match the trimester during which the event occurs: Significant amniotic fluid volume contribution from the lung

Back 23

B. Early 2nd trimester

Front 24

Match the trimester during which the event occurs: Production of red blood cells by the spleen

Back 24

A. First trimester

Front 25

Which vessels lead into and out of the ductus venosus, respectively?

Back 25

D. Umbilical vein; ingerior vena cava

Front 26

A 41-year-old woman presented to the office with 4-month history of irregular menstrual periods.Her last episode of vaginal bleeding was 3 weeks ago, but only spotted for a day when her normal period usually lasts about 5 days. She reports fatigue with some nausea but without vomiting. She denies any pelvic pain but admits to mild cramping in the lower abdomen at times. she denies any history of sexually transmitted infection nor abnormal Pap smear. You did an office urine pregnancy test which was positive. Your next best step of action after performing a pelvic examination on the patient should be:

Back 26

B. Order a pelvic ultrasound of the pelvis

Front 27

A 26-year-old primigravida woman presented to the office for her first prenatal care visit. the first day of her LMP was September 10, 2010, and the last day was Sept 15, 2010. She reports regular menstrual cycles every 35 days. she also recalls a positive home urine pregnancy test end of may, and has no vaginal bleeding since. She denies use of birth control pills, Depo-Provera, or other contraceptive in the last 7 months. What is the best estimate of her due date on the basis of her menstrual history?

Back 27

C. June 24, 2011

Front 28

During a routine prenatal visit in the office, you noticed that the fundal height of a 23-year-old primigravida woman who is 32 weeks' gestational age with normal blood pressure is measuring only 28 cm. She has been compliant with her prenatal care since 7 weeks' gestation, and reported a normal appetite. she denies any leakage of fluid per vagina. what is the next best course of action?

Back 28

D. Perform an ultrasound to determine the estimated fetal weight and AF index volume

Front 29

A 19-year-old gravida 2, para 1, presents at 39 weeks' gestational age to the labor and delivery unit with complaints of leakage of brown tinged fluid per vagina for 12 hours. she denies contraction, vaginal bleeding, fever, and chills. her examination revealed positive signs and symptoms of rupture of AF. she is afebrile and the fetus is confirmed to be in vertex presentation by US. which of the following course of action is indicated?

Back 29

A. Induction of labor

Front 30

A 25 yo G5P4 woman rapidly delivered an infant weighing 3,900g upon presenting to the labor and delivery unit without any anesthetic. After and hour, the placenta was manually extracted. A total of 20 U of oxytocin in 1,00 mL of lactated ringer's solution was initiated IV. After careful inspection of the genital tract, no laceration was noted on the vaginal wall and the cervix. You are called back to the room 30min later by the nurse to evaluate increase vaginal bleeding for the patient. You begin massaging the uterine fundus by her bleeding continues to be brisk. Her fundus appears to be firm, after you have given her a dose of 0.25 m IM Prostaglandin F2 alpha. Her blood pressure 164/92, P 102, T 98.9, R 18. The patient continues to experience intermittent vaginal bleeding. her toal blood loss is estimated at 1,500 cc. which of the following is the best step in management?

Back 30

E. Manual exploration followed by curettage of the uterine cavity